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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*
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: [email protected]

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2015 

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