Severe Transient Pharyngeal Paralysis Following C2 Fracture Repair

Abstract

Objectives:

We report a case of isolated pharyngeal plexus injury following posterior plating of a C2 fracture in an 84-year-old white male.

Methods:

Methods include a case report with literature review.

Results:

The patient presented with dense pharyngeal paralysis and inability to initiate swallowing but maintained true vocal cord movement. The patient required gastrostomy tube feeding for 3 months but eventually recovered his swallowing function. Prior literature on acute pharyngeal paralysis following upper cervical spine fracture repairs is reviewed with recommendations for care of this unique patient population.

Conclusions:

Traumatic C2 fracture repair can lead to isolated dense pharyngeal paralysis due to pharyngeal plexus injury with subsequent severe dysphagia. Observation may be appropriate in this population, with consideration of tracheotomy for recurrent aspiration.