title: Pharyngolaryngeal paralysis in a patient with pharyngeal tuberculosis.
abstract: Pharyngeal tuberculosis is a rare disease, and its commonly reported symptoms include sore throat, dysphagia, and throat discomfort. The dysphagia in pharyngeal tuberculosis cases is not due to pharyngolaryngeal paralysis but due to odynophagia. Herein, we describe the first case of dysphagia caused by pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. An irregular mass at the right nasopharynx was detected in a 57-year-old female patient, along with dysphagia and hoarseness. She had poor right soft palate elevation, inadequate right velopharyngeal closure, poor constrictor pharyngus muscle contraction, and an immobilized right vocal cord, which collectively indicate right pharyngolaryngeal paralysis. Pathological examination and culture testing revealed pharyngeal tuberculosis. She was diagnosed with pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. The pharyngolaryngeal paralysis resolved after beginning anti-tuberculous treatment. Right pharyngolaryngeal paralysis was attributed to glossopharyngeal and vagus nerve impairment in the parapharyngeal space. Prior reports indicate that peripheral nerve paralysis, including recurrent laryngeal nerve paralysis caused by tuberculous lymphadenitis, often recovers after anti-tuberculous treatment. Pharyngeal tuberculosis rarely causes dysphagia and hoarseness attributable to pharyngolaryngeal paralysis. The neuropathy may recover after anti-tuberculous treatment. Pharyngeal tuberculosis is a new potential differential diagnosis in pharyngolaryngeal paralysis.
authors.affiliation: Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama 350-8550, Japan. Electronic address: m-ohki@umin.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ohki
authors.affiliation: Department of Otolaryngology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 3-8-3, Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa 213-8507, Japan.
authors.forename: Sakurako
authors.initials: S
authors.lastname: Komiyama
authors.affiliation: Department of Otolaryngology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
authors.forename: Niro
authors.initials: N
authors.lastname: Tayama
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology*; D010608:Pharyngeal Diseases / Q000209:etiology*; D014376:Tuberculosis / Q000150:complications*; D014826:Vocal Cord Paralysis / Q000209:etiology*
keywords: Dysphagia; Nasal; Pharyngeal paralysis; Pharyngeal tuberculosis; Recurrent laryngeal nerve paralysis; Tuberculosis