The hypoglossal nerve is the motor nerve to the tongue, with unilateral palsy producing tongue deviation toward the weak side on protrusion (the intact genioglossus pushes the tongue toward the paralysed side). It carries C1 fibres for the infrahyoid strap muscles (geniohyoid and thyrohyoid). The hypoglossal-to-facial nerve anastomosis restores facial tone and movement in facial palsy.
| Origin | Hypoglossal nucleus in the medulla (dorsal motor column) |
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Hypoglossal nerve palsy from skull base tumour, carotid endarterectomy, or trauma produces ipsilateral tongue weakness and atrophy. XII-VII anastomosis (hypoglossal-facial nerve transfer) restores facial tone and voluntary movement — the patient activates the face by tongue movements. The 'jump' graft (partial XII sacrifice + ansa cervicalis nerve graft to CN XII cut end) preserves some tongue function while providing reinnervation to the facial nerve.
Unilateral tongue weakness from XII lesion producing tongue deviation to the weak side managed with speech therapy or XII-VII anastomosis for permanent palsy.
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