A case of facial paralysis with swallowing disorder in the pharyngeal phase
Facial nerve paralysis leads to swallowing disorder in the oral and oropharyngeal phases. However, swallowing disorders in the pharyngeal phase have also been reported. We report a case of a male adult patient who was diagnosed with herpetic pharyngolaryngitis and right auricular shingles and prescribed an anti-herpes drug. Fourteen days later, right facial nerve paralysis was observed. He was diagnosed with Hunt syndrome, and steroid pulse therapy was started on the same day. A fluoroscopy swallow study revealed that the hyoid bone was leaning to the right when moving forward (lateral view) and that the shadow of the liquid in the pharyngeal cavity was lower on the right (anteroposterior view). The patient was instructed to perform facial massage and swallowing exercises. Approximately 3 months after the onset of facial nerve paralysis, the inclination of the hyoid bone and the shadow of the liquid in the pharyngeal cavity disappeared, and the facial nerve paralysis was cured. We believe that the elevation of the hyoid bone was impaired on the paralyzed side because of posterior abdominal digastric and stylohyoid muscle paralysis. When evaluating the swallowing function in patients with facial nerve paralysis, both the oral and pharyngeal phases should be evaluated.
