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J Korean Dysphagia Soc

Published online November 2, 2022

© The Korean Dysphagia Society.

Dysphagia Due to Bilateral Facial Palsy in B-Cell Acute Lymphoblastic Leukemia: A Case Report

Hyeong-Eun Jeon, M.D., Han-Young Jung, M.D., Kyung-Lim Joa, M.D.

Department of Physical & Rehabilitation Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea

Correspondence to:Kyung-Lim Joa, Department of Physical & Rehabilitation Medicine, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
Tel: +82-32-890-2480, Fax: +82-32-890-2486, E-mail: drjoakl@gmail.com

Received: September 6, 2022; Revised: September 14, 2022; Accepted: October 24, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dysphagia can cause aspiration pneumonia, a critical condition that increases the risk of morbidity and mortality in immunosuppressed patients. The facial nerve plays an important role in oropharyngeal swallowing. Here, we present a rare case of a leukemia patient with bilateral facial palsy and dysphagia, detected by a videofluoroscopic swallowing study (VFSS), which revealed oropharyngeal phase dysfunction. Severe drooling was observed due to poor lip sealing in the oral phase. The tongue movement was normal, but the patient had difficulty controlling dense food between his teeth and tongue, and under the tongue. In the pharyngeal phase, decreased elevation and closure of the larynx were observed. Penetration and aspiration were observed during liquid tests, however there was no cough. This case highlights the fact that the facial nerve plays an important role in the oropharyngeal phase of swallowing. VFSS should be preferentially considered to rule out aspiration pneumonia in bilateral facial palsy with suspected dysphagia.

Keywords: Dysphagia, Facial palsy, Acute lymphoblastic leukemia, Bilateral, Videofluoroscopic swallowing study

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J Korean Dysphagia Soc

Published online November 2, 2022

Copyright © The Korean Dysphagia Society.

Dysphagia Due to Bilateral Facial Palsy in B-Cell Acute Lymphoblastic Leukemia: A Case Report

Hyeong-Eun Jeon, M.D., Han-Young Jung, M.D., Kyung-Lim Joa, M.D.

Department of Physical & Rehabilitation Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea

Correspondence to:Kyung-Lim Joa, Department of Physical & Rehabilitation Medicine, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
Tel: +82-32-890-2480, Fax: +82-32-890-2486, E-mail: drjoakl@gmail.com

Received: September 6, 2022; Revised: September 14, 2022; Accepted: October 24, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dysphagia can cause aspiration pneumonia, a critical condition that increases the risk of morbidity and mortality in immunosuppressed patients. The facial nerve plays an important role in oropharyngeal swallowing. Here, we present a rare case of a leukemia patient with bilateral facial palsy and dysphagia, detected by a videofluoroscopic swallowing study (VFSS), which revealed oropharyngeal phase dysfunction. Severe drooling was observed due to poor lip sealing in the oral phase. The tongue movement was normal, but the patient had difficulty controlling dense food between his teeth and tongue, and under the tongue. In the pharyngeal phase, decreased elevation and closure of the larynx were observed. Penetration and aspiration were observed during liquid tests, however there was no cough. This case highlights the fact that the facial nerve plays an important role in the oropharyngeal phase of swallowing. VFSS should be preferentially considered to rule out aspiration pneumonia in bilateral facial palsy with suspected dysphagia.

Keywords: Dysphagia, Facial palsy, Acute lymphoblastic leukemia, Bilateral, Videofluoroscopic swallowing study

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