Downloaded from Medico Research Chronicles “Ganglion cells in portion of lingual nerve suspending submandibular ganglion – A case report”
ISSN No. 2394-3971
Case Study
GANGLION CELLS IN PORTION OF LINGUAL NERVE SUSPENDING SUBMANDIBULAR GANGLION – A CASE REPORT
Srividya Sreenivasan*, Vishnu Gopal Sawant, Joy Ajoykumar Ghoshal
Department of Anatomy , D Y Patil Medical College, Nerul, Navi Mumbai, India
Submitted on: July 2017 Accepted on: July 2017 For Correspondence Email ID:
Abstract: Haematoxylin and Eosin sections of a submandibular ganglion and its two roots suspended by the lingual nerve, with a portion of the submandibular gland were prepared from tissue obtained from an adult male cadaver during routine dissection. Ganglion cells were present in the submandibular ganglion, in the hilum of the submandibular gland, and in the epineurium, perineurium and within the fascicles of lingual nerve in longitudinal sections. Most parasympathetic ganglia of the head and neck are cell bodies of neurons clumped together, to form tiny ganglia scattered in supporting tissue. The ganglion cells in the nerve were thought to be derived from myelencephalic neural crest cells arrested in their descent along the lingual nerve. A review of recent literature reveals that they are derived from Schwann cell precursors that migrate along nerves.
Keywords: submandibular gland, gangliogenesis, parasympathetic ganglion Introduction: partial capsule around it. This case report A ganglion is a collection of neurons, their shares an incidental finding of ganglion cells processes and supporting cells outside the found in the trunk of the lingual nerve in the central nervous system. [1] In the case of segment that suspends the submandibular cranial parasympathetic ganglia, ganglion ganglion of an adult male cadaver (fig 1). A
cells are very often scattered in the reference to standard textbooks of anatomy ronicles, 2017 surrounding tissue and may not be present as and relevant literature on the subject does a recognizable ganglion. [2] Under light not reveal ganglion cells in this location. Ch microscopy autonomic ganglia appear as Case Report: large relay stations with large multipolar H&E sections of the submandibular neurons surrounded by afferent and efferent ganglion of an adult male cadaver were search fibers and non-neural cells. The ganglion prepared with the part of lingual nerve Re
cell has a characteristic owl’s eye suspending it and a part of the ico appearance with satellite cells forming a submandibular gland. Ganglion cells were Med
Sreenivasan S. et al. , Med. Res. Chron., 2017, 4 (4), 461-468 461
Downloaded from Medico Research Chronicles “Ganglion cells in portion of lingual nerve suspending submandibular ganglion – A case report” found in the trunk of the lingual nerve (fig Fibers passing through anterior root 2), its epineurium (fig 3), in the hilum of the of submandibular ganglion carry secreto- gland (fig 4) and the submandibular motor fibers to the sublingual and anterior ganglion proper (fig 5). lingual glands. The post- ganglionic fibers Discussion: of ganglion cells observed by us in trunk of Ganglion cells have been reported in the lingual nerve may be serving the same course of oculomotor and internal laryngeal function; thereby supplementing the nerve. [3,4] A ganglion cell cluster has been function of the submandibular ganglion. reported along the glossopharyngeal nerve This could have clinical significance in near the human palatine tonsil by Oda K et surgeries of the submandibular region where al in 2013. [5] Presence of nerve cell bodies the submandibular ganglion, gland and in the lingual nerve in the third molar area surrounding tissue may be sacrificed with has been reported by Smith EE in 1989. [ 6] preservation of lingual nerve. Nerve cell bodies were found within the The cell bodies of neurons in structure of 40 of the 44 individual nerves parasympathetic ganglia may form well (90.91%). There were two patterns of organized ganglia of moderate size (otic organization of the nerve cell bodies: ganglion). More commonly, a few cell isolated nerve cell bodies and ganglion-like bodies are clumped together to form ganglia clusters of nerve cell bodies. Due to their scattered in supporting tissue. [2] By that proximity to the submandibular ganglion, it corollary, the ganglion cells found in the was inferred that these cell bodies were perineurium & endoneurium of lingual parasympathetic in function. In our case we nerve, and hilum of the gland, are the observed ganglion like clusters of nerve cell scattered component of the submandibular bodies in the trunk of the lingual nerve in ganglion. various sections throughout the segment The submandibular ganglion is under consideration. Whereas isolated nerve derived from myelencephalic neural crest cell bodies were found in the epineurium of and may receive contribution from nucleus the same segment. The typical appearance of of facial nerve (superior salivatory nucleus) ganglion cell, large cell body with eccentric according to Gray’s Anatomy 40th edition. [3] nucleus and prominent nucleolus (owl’s eye The ganglion cells found in the trunk of the appearance); with satellite cells forming a lingual nerve may be cells migrating from partial capsule around it is characteristic of Superior Salivatory Nucleus, or neural crest an autonomic ganglion cell. cells migrating along the lingual nerve. The ganglion-like clusters reported Dyachuk et al 2014; Espinosa- by us, being even closer to the Medina et al, 2014 stated that submandibular ganglion than the cells parasympathetic ganglia are derived from observed by Smith, it may be inferred that peripheral Schwann cell precursors that they are parasympathetic in function. The migrate along nerves to their target tissue to
submandibular ganglion receives form both the glia and neurons of the ronicles, 2017 sympathetic post-ganglionic fibers from the ganglia. [7,8] Thus, the parasympathetic Ch superior cervical ganglion that traverse it ganglion (PSG) in the submandibular gland without synapsing. It also receives (SMG) arises from Schwann cell precursors parasympathetic pre-ganglionic fibers from that migrate along the chorda tympani and search the superior salivatory nucleus. Some of differentiate into βIII-tubulin-expressing these fibers could be traversing and /or neurons (TUBB3+). Re
synapsing with the ganglion cells in this ico portion of the lingual nerve. The next critical step in
parasympathetic gangliogenesis occurs Med Sreenivasan S. et al. , Med. Res. Chron., 2017, 4 (4), 461-468 462
Downloaded from Medico Research Chronicles “Ganglion cells in portion of lingual nerve suspending submandibular ganglion – A case report” when the PSG neurons coalesce around the tympanii component of lingual nerve. These primary duct to form the ganglion and neurons found in the nerve probably failed establish communication with the to coalesce to form a macroscopically developing epithelium. [9] Therefore, visible ganglion due to failure of activation parasympathetic innervations are critical for of Wnt signaling pathway by K5+ epithelial SMG development and regeneration. progenitors in the developing submandibular The process of parasympathetic gland. Since the neuro-epithelial interaction gangliogenesis, is achieved by activation of is of essence for both development of the wingless-related integration site (Wnt) parasympathetic ganglion and secretion by signaling pathway which is done by keratin the gland, the functional significance of the 5 –positive (K5+) epithelial progenitors in ganglion cells in the trunk of the nerve is the SMG. [9] Suppression of the fibroblast questionable. Performing an immuno- growth factor (FGF) signaling pathway is histochemical analysis of the sections of required for SMG parasympathetic lingual nerve for tyrosine hydroxylase and gangliogenesis. 9 nitric oxide synthase may throw light on the Key intracellular modulators of FGF functional significance of occurrence of signaling are Sprouty (Spry) proteins, which these cells in the trunk of lingual nerve. [13] act as negative-feedback antagonists. [10,11,12] Abbreviations Used: Therefore, epithelial Spry 1/2 are required PSG- parasympathetic ganglion; SMG for SMG parasympathetic gangliogenesis. submandibular gland; βIII tubulin- Thus, our finding ganglion cells in expressing neurons- TUBB3+; wingless- trunk of lingual nerve is explained by the related integration site –Wnt; keratin 5 – recent theory of parasympathetic positive K5+; fibroblast growth factor FGF; gangliogenesis from Schwann cell Sprouty –Spry precursors migrating along the chorda
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Fig 1: Diagram showing portion of the lingual nerve sectioned search
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Sreenivasan S. et al. , Med. Res. Chron., 2017, 4 (4), 461-468 463
Downloaded from Medico Research Chronicles “Ganglion cells in portion of lingual nerve suspending submandibular ganglion – A case report”
Fig 2a : Ganglion cells in trunk of lingual nerve (40xmagnification encircled in black)
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search Fig 2b: Ganglion cells in trunk of lingual nerve (400xmagnification black arrows) Re ico ico Med
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Fig 3a: Ganglion cells in the epineurium (40xmagnification encircled in black)
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Re Fig 3b: Ganglion cells in the epineurium (400xmagnification black arrow) ico Med
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Fig 4a: Ganglion cells in hilum of gland (40× magnification encircled in black)
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Re Fig 4b : Ganglion cells in hilum of gland (400× magnification black arrows) ico Med
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Downloaded from Medico Research Chronicles “Ganglion cells in portion of lingual nerve suspending submandibular ganglion – A case report”
Fig 5: Ganglion cells in submandibular gland proper (400× magnification)
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