Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T05:45:23.495Z Has data issue: false hasContentIssue false
  • English
  • Français

Bilateral glossopharyngeal nerve palsy following tonsillectomy: a very rare and difficult complication of a common procedure

Published online by Cambridge University Press:  20 February 2015

A Trinidade  and
C M Philpott
A Trinidade*
Affiliation:
ENT Department, James Paget University Hospital, Great Yarmouth, UK
C M Philpott
Affiliation:
ENT Department, James Paget University Hospital, Great Yarmouth, UK
*
Address for correspondence: Mr A Trinidade, ENT Department, James Paget University Hospital, Lowestoft Road, Great Yarmouth NR31 6LA, UK E-mail: aarontrinidade@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Tonsillectomy is one of the most commonly performed otolaryngological procedures. Bilateral palsy of the glossopharyngeal nerve is an exceedingly rare complication that can result in significant morbidity. This case report aimed to raise awareness of this complication and outline management strategies.

Case report:

A 31-year-old woman who underwent routine tonsillectomy presented with progressive numbness of the palate, dysgeusia, xerostomia, paraesthesia of the tongue and the feeling of something in her throat within 2 weeks of surgery. She reported the post-operative onset of snoring. Examination revealed a symmetrically low, ‘dropped’ soft palate. Over time, her symptoms have lessened, but dysgeusia and snoring remain.

Conclusion:

The position of the glossopharyngeal nerve in the tonsillar bed makes it prone to injury during tonsillectomy, especially if ‘hot’ methods are used. Bilateral injury can result in significant morbidity that can be difficult to treat. Patients should be warned about this risk and care should be taken to minimise it.

Keywords

Glossopharyngeal NerveTonsillectomyDysgeusia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 392 - 394
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Uzun, C, Adali, MK, Karasalihoglu, AR. Unusual complication of tonsillectomy: taste disturbance and the lingual branch of the glossopharyngeal nerve. J Laryngol Otol 2003;117:314–7CrossRefGoogle ScholarPubMed
2Scinska, A, Jodkowska, A, Korkosz, A, Kukwa, W, Sienkiewicz-Jarosz, H. Post-tonsillectomy dysgeusia with weight loss: possible involvement of soft palate. J Laryngol Otol 2008;122:e5CrossRefGoogle ScholarPubMed
3Ohtsuka, K, Tomita, H, Murakami, G. Anatomy of the tonsillar bed: topographical relationship between the palatine tonsil and the lingual branch of the glossopharyngeal nerve. Acta Otolaryngol Suppl 2002:99–109Google Scholar
4Ford, LC, Cruz, RM. Bilateral glossopharyngeal nerve paralysis after tonsillectomy: case report and anatomic study. Laryngoscope 2004;114:2196–9Google Scholar
5Haapanen, ML, Ignatius, J, Rihkanen, H, Ertama, L. Velopharyngeal insufficiency following palatine tonsillectomy. Eur Arch Otorhinolaryngol 1994;25:186–9Google Scholar
6Back, GW, Nadig, S, Uppal, S, Coatesworth, AP. Why do we have a uvula?: literature review and a new theory. Clin Otolaryngol Allied Sci 2004;29:689–93CrossRefGoogle Scholar