Department of Otolaryngology, Peking Union Medical College Hospital
The pharyngeal muscles are mainly dominated by motor nerve fibers from the pharyngeal plexusparalysisCommon, the causes can be divided into central and peripheral paralysis.Central lesions are found in the medulla oblongata caused by various reasons, such as bulbar paralysisencephalitis、Acoustic neuromaThe medulla oblongata is invaded.Peripheral paralysisPolyneuritisCommon, others such as infectionmyasthenia gravis、DermatomyositisAnd skull base lesions caused by compression of the fourth, fifth and sixth cranial nerves.
Foreign name
pharyngoparalysis
Visiting department
Otolaryngology
Common location
Pharynx
Common causes
Central paralysis can be seen in medullary diseases caused by various reasons, such as medullary paralysis, encephalitis, etc.Peripheral paralysis is more common with polyneuritis
common symptom
There is an open nasal sound when speaking, and it is easy to flow back into the nasal cavity when entering a liquid diet
Pharyngeal muscle paralysis can be divided into complete or incomplete, unilateral or bilateral.Because of the soft palate paralysis, the nasopharynx cannot be closed, and the patient has an open nasal sound when speaking, it is easy to flow back into the nasal cavity when entering the liquid diet.When the pharyngeal constrictor muscle is paralyzed, the swallowing function is affected, and it is difficult to eat liquid food in the early stage, which may lead to the danger of aspiration into the throat.
Physical examination showed that the healthy side moved while the affected side could not lift up when the mouth opened and the voice "ah" was pronounced.If both sides are paralyzed, the soft palate is loose and cannot be lifted.If the pharyngeal constrictor muscle is paralyzed, saliva or food retention can be seen in the pyriform fossa.
inspect
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Imaging examination can clarify the etiology and guide treatment.
differential diagnosis
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Mainly central and peripheralparalysisIdentification between the two.The skull base lesions were excluded.
treatment
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Treat according to the cause of disease.The central disease should be diagnosed and treated by the department of internal medicine and neurology.Patients with peripheral paralysis can be treated with anticholinesterase drugs, nerve stimulants, vitamins, and acupuncture.Constrictor muscle of pharynxparalysisThose who cannot eat or who inhale by mistake should be given nasal feeding.
