Hypoglossal Nerve Repair(Restoring Speech & Swallowing)
Advanced microsurgical reconstruction of the nerve that controls the tongue, preventing profound difficulties with articulation and eating.
What is Hypoglossal Nerve Repair?
The hypoglossal nerve (the 12th cranial nerve) provides motor control to the intrinsic and extrinsic muscles of the tongue. When this nerve is injured—often during tumor removals in the neck, skull base surgery, or severe trauma—the affected side of the tongue becomes paralyzed and gradually wastes away (atrophy).
A paralyzed tongue heavily deviates to the injured side when stuck out and struggles to maneuver food or articulate sounds. This leads to slurred speech (dysarthria), difficulty swallowing (dysphagia), and an increased risk of choking.
Hypoglossal Nerve Repair involves microsurgically reconnecting the severed nerve. If the gap between the cut ends is too large, Dr. Jowett utilizes a nerve graft (a sensory nerve taken from the leg or neck) to bridge the defect, allowing nerve fibers to grow back into the tongue musculature.
Common Causes of Injury
Early intervention is crucial to prevent irreversible atrophy of the tongue muscles.
The Transformative Impact
- Improved Articulation: Restores the tongue's ability to shape the oral cavity for clear, crisp consonant pronunciation.
- Safe Swallowing: Recovers the strength needed to properly propel food to the back of the throat without choking or aspiration.
- Preserved Muscle Bulk: Providing a nerve signal stops the tongue from shrinking, maintaining its volume and symmetrical appearance.
- Oral Hygiene: Restores the tongue's ability to clear food particles from the cheeks and teeth after eating.
Surgical Precision & Technique
Timing is a critical factor in nerve reconstruction. Ideally, repair should happen immediately at the time of injury (such as during the tumor resection) or within a few months.
Under a high-powered operating microscope, Dr. Jowett carefully aligns the internal bundles (fascicles) of the nerve. If a gap exists, a cable graft (often the great auricular nerve from the neck or the sural nerve from the leg) is sewn into place using sutures finer than a human hair to provide a scaffold for nerve regeneration. The nerve typically regrows at a rate of roughly 1 millimeter per day.
Why Choose Revitalis?
As an expert in head and neck micro-neurovascular surgery, Dr. Nate Jowett has extensive experience repairing the complex cranial nerves injured during massive skull base and oncologic resections.
Reconstructing nerves deep in the neck requires navigating around critical blood vessels (like the carotid artery) and executing perfect microsurgical connections. Dr. Jowett's deep foundational understanding of nerve regeneration ensures the highest probability of restoring meaningful function to the tongue, protecting your quality of life.
Selected References
- Reconstruction of Complex Skull Base Defects: Form and Function. Goyal N, Jowett N, Dwojak S, Cunane MB, Zander D, Hadlock TA, Emerick KS. Head Neck. 2016 Oct; 38(10):E2499-503.
- Current trends in head and neck microvascular reconstruction. Jowett N, Pineda R. Curr Opin Otolaryngol Head Neck Surg. 2021 Aug 01; 29(4):252-258.