Treatment for vagus nerve damage

As we all know, the life activities of the human body are inseparable from the command of the nervous system. The movements of the entire human body require the nervous system to issue instructions to complete, so the integrity of the nervous system is necessary. When the vagus nerve is damaged, it will cause the patient to have language barriers, difficulty eating, and seriously endanger the patient's health.

The vagus nerve is the longest and most widely distributed cranial nerve. After exiting the skull through the jugular foramen together with the glossopharyngeal nerve and accessory nerve, it descends in the carotid sheath between the carotid artery and the internal jugular vein in the neck. The vagus nerve is a mixed nerve. The nucleus ambiguus, nucleus solitarius and spinal nucleus of the trigeminal nerve coexist with the glossopharyngeal nerve. Therefore, simple vagus nerve damage is rare, and it often occurs simultaneously with the glossopharyngeal nerve.

When the glossopharyngeal nerve, vagus nerve or its nerve nucleus on one side is damaged, paralysis of the soft palate on the same side, disappearance of the pharyngeal reflex, choking, coughing and hoarseness may occur. When bilateral damage occurs, the patient has severe problems with eating, swallowing, and pronunciation. In severe cases, the patient may even be unable to pronounce, swallow, or saliva. This is called true bulbar palsy.

The nucleus ambiguus is innervated by bilateral pyramidal tracts, so damage to the pyramidal tract or cortex on one side does not cause symptoms. Bilateral lesions can cause bilateral soft palate paralysis, inability to swallow and pronounce, thinning of the voice, and the presence of pharyngeal reflex but it is relatively slow, which is called pseudobulbar palsy.

1) Firearm injuries

Firearm-induced nerve damage is mostly caused by high-speed projectiles (shrapnel or bullets). The nerve damage is extensive and the wounds are severely contaminated, which can easily lead to wound infection. The principles of initial treatment are: the wound should be thoroughly debrided instead of suturing the nerve; the damaged part of the nerve should not be removed, nor should the stump be freed to prevent the spread of contamination; the stump of the nerve should not be marked with silk thread, nor should it be sutured to the tissue; the free nerve should be covered with normal tissue; and the wound should be healed as soon as possible to create conditions for secondary repair.

(2) In the case of skull base fracture, the fracture itself does not require special treatment. The focus of treatment is to prevent infection and use antibiotics appropriately. People with cerebrospinal fluid rhinorrhea or otorrhea should avoid packing or blowing their noses, reduce sneezing and coughing, and keep the external auditory canal clean. Lumbar puncture should be avoided as much as possible to prevent retrograde infection.

(3) It is very important to apply microneurosurgical techniques during skull base surgery and carefully protect the vagus nerve and glossopharyngeal nerve from irreversible damage. Stereotactic radiosurgery for small tumors in the jugular foramen area should be designed reasonably and scientifically to avoid aggravating the damage to the vagus nerve and glossopharyngeal nerve.

Through the above information, everyone must have a certain understanding of the treatment methods of vagus nerve injury, and also know the importance of the nervous system. Therefore, if there are such patients around you, it is recommended to seek medical attention as soon as possible. There are many treatment methods for vagus nerve, but the specific method to be used depends on the individual's situation.