Middle Peripheral Lesions

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Lesions at the jugular foramen, retropharyngeal space, or other peripheral locations produce syndromes involving the ninth and tenth nerves, and sometimes also the eleventh and twelfth cranial nerves. The lesions may be due to various potential etiologies, including neoplasm, infection, and trauma. The syndromes are associated with the names of authors describing them and are listedin Table 13-1 . The jugular foramen syndrome, also known as Vernet's syndrome, involves the ninth, tenth, and eleventh cranial nerves. The syndrome is comprised of weakness of the ipsilateral vocal cord, palate, and pharynx and the trapezius and sternocleidomastoid muscles. A lesion in the retropharyngeal space is responsible for Villaret's syndrome, which involves cranial nerves IX, X, XI, and XII and produces anesthesia of the palate, larynx, and pharynx; weakness of the trapezius and sternocleidomastoid muscles; atrophy and weakness of the tongue; and a Horner's syndrome. This last feature is due to involvement of cervical sympathetic fibers.

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