Glossopharyngeal, vagus & accessory nerve complexes

Dr / Hytham Nafady

Introduction

Nuclei • The glossopharyngeal & vagus nerves arise from 3

nucleus columns.

Special visceral motor column of the medulla

Nucleus ambiguus

Preganglionic parasympathetic column

Dorsal motor nucleus of vagus

Visceral sensory column Solitary nucleus

3-nucleus ambiguus

1-solitary nucleus

2-dorsal motor nucleus

Vagus nerve

3-nucleus ambiguus

2-dorsal motor nucleus

1-solitary nucleus

Vagus nerve

Jugular foramen

Sphenoid spine

Vaginal process

Hypoglossal canal

Stylomastoid foramen

Carotico-jugular spine

Facial nerve canal

Sigmoid sinus

Facial nerve canal

Petro-occipital fissure

Jugular spine

Cochlear aqueduct Hypotympanum

Petro-occipital fissure

Petro-occipital fissure

Foramen lacerum

Cn10&11

Interjugular process

septum

Cn9

Sigmoid sinus

ICA

IPS Cn9

IPS

Cn9

IPS IPS

Sigmoid sinus

Vagus nerve

Vagus nerve

Pharyngeal plexus

Pharyngeal plexus

SuperiorLaryngeal

nerve

SuperiorLaryngeal

nerve

RecurrentLaryngeal

Nerve

RecurrentLaryngeal

Nerve

External Laryngeal

nerve

External Laryngeal

nerve

Internal Laryngeal

nerve

Internal Laryngeal

nerve

A. Pharyngeal plexus

B. superior laryngeal N.

C. internal laryngeal N.

D. external laryngeal N.

E. recurrent laryngeal N.

Ultrasound imaging of Vagus N.

Vagus N.

Recurrent laryngeal

N.

Vagus N.CCA

IJV

Plexiform neurofibroma of the vagus nerve in patient with NF1

Perineural tumor spread along 9, 10 & 11 cranial nerves from left parotid

acinic cell carcinoma

Glomus vagale

Ultrasound imaging of spinal accessory N.

Inferior tympanic canaliculus

Inferior tympanic canaliculus

Aberrant internal carotid artery with enlarged inferior tympanic canaliculus

Vascular loop compression

VA

Vagus N

VA

Vascular loop compression of the glossopharyngeal N.

• Glossopharyngeal neuralgia in a 56-year-old woman due to neurovascular contact between the left CN IX and the vertebral artery

GP hiatus

GP N.

GP N.

GP N.PICA A

VA

Atrophy of posterior crico-arytenoid muscle

Rt posterior cricoarytenoid

Lt posterior cricoarytenoid

Atrophy of thyro-arytenoid muscle

Thyro-arytenoid Ligament

Trapezius muscle atrophy

Atrophy of trapezius muscle & hypertrophy of levator scapulae muscle

after radical neck dissection