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Two-year-old with post-surgical hypoglossal nerve injury and obstructive sleep apnea

Lourdes M Delrosso1, Romy Hoque1, Eduardo Gonzalez-Toledo2

  • 1Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 16, 2014
PubMed

Insights

Severe sleep disordered breathing and tongue fasciculation in a child were linked to hypoglossal nerve damage at the medulla after ependymoma surgery. This highlights the critical role of the hypoglossal nerve in maintaining airway patency.

Area of Science:

  • Neurology
  • Pediatric Neurosurgery
  • Sleep Medicine

Background:

  • Airway patency relies on hypoglossal nerve function controlling tongue and pharyngeal muscles.
  • The hypoglossal nerve originates at the medullary level, crucial for breathing control.

Observation:

  • A 2-year-old developed severe sleep disordered breathing and tongue fasciculation post-surgery.
  • The patient had undergone resection of a fourth ventricle anaplastic ependymoma.

Findings:

  • Polysomnography revealed severe obstructive sleep apnea with profound oxygen desaturation (33%).
  • Brain MRI demonstrated post-surgical effacement of the dorsal lateral medulla.

Implications:

  • Medullary hypoglossal nerve damage is postulated as the cause of severe obstructive sleep apnea in this case.
  • Tracheostomy was required for management, underscoring the severity of the breathing impairment.
Abstract

Keywords:
Hypoglossal nerve injurypediatric OSAsleep disordered breathingtracheostomy

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