Is the styloglossus muscle innervated by the hypoglossal (CN XII) nerve?

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Innervation of the Styloglossus Muscle

Yes, the styloglossus muscle is innervated by the hypoglossal nerve (CN XII). 1, 2

Hypoglossal Nerve Anatomy and Function

  • The hypoglossal nerve (CN XII) is a purely motor nerve that originates from the dorsal medulla and provides somatic motor innervation to the intrinsic and extrinsic muscles of the tongue 3
  • The nerve exits the brainstem in the preolivary sulcus, passes through the premedullary cistern, and exits the skull through the hypoglossal canal 1
  • After exiting the skull, the extracranial hypoglossal nerve travels caudally within the carotid space and courses anteriorly inferior to the hyoid 4

Specific Tongue Muscles Innervated by CN XII

  • The hypoglossal nerve innervates all intrinsic tongue muscles (superior longitudinal, inferior longitudinal, transverse, and vertical muscles) 1
  • It also innervates three extrinsic tongue muscles: styloglossus, hyoglossus, and genioglossus 1
  • The only tongue muscle not innervated by the hypoglossal nerve is the palatoglossus muscle 4

Embryological Development and Confirmation

  • Embryological studies have confirmed that the styloglossus muscle is innervated by the hypoglossal nerve from early development 5
  • The styloglossus muscle differentiates beyond the first lingual swellings in contact with a branch of the hypoglossal nerve 5
  • In all examined cases, the styloglossus muscle was consistently innervated by the hypoglossal nerve 2

Clinical Significance

  • Hypoglossal nerve palsy affects all muscles it innervates, including the styloglossus, resulting in dysarthria and deviation of the tongue to the side of the lesion upon protrusion 4, 3
  • Common causes of hypoglossal nerve palsy include neoplasms (most common), brainstem infarct, demyelinating disease, vascular lesions, trauma, and infectious processes 3, 6
  • MRI is the preferred imaging modality for evaluating hypoglossal nerve pathology, with CT providing complementary information on bony structures 4

Functional Anatomy

  • The styloglossus muscle originates from Reichert's cartilage (which gives rise to the temporal styloid process) and inserts into the lateral aspect of the tongue 2
  • It functions primarily to retract and elevate the tongue 7
  • The hypoglossal nerve branches to the styloglossus muscle emanate from its lateral division 7

Common Pitfalls in Assessment

  • Anatomical variations of the styloglossus muscle exist, including accessory muscle fascicles originating from the mandibular angle 2
  • When evaluating hypoglossal nerve function, it's important to assess all innervated muscles, not just the more commonly examined genioglossus 1
  • Isolated styloglossus dysfunction is rare; hypoglossal nerve pathology typically affects multiple tongue muscles simultaneously 6

References

Research

The Hypoglossal Nerve.

Seminars in ultrasound, CT, and MR, 2023

Guideline

Hypoglossal Nerve and Tongue Blood Supply

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Imaging Features of isolated hypoglossal nerve palsy.

Journal of neuroradiology = Journal de neuroradiologie, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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