Case Report: Glossopharyngeal Allodynia-Related Odynophagia and Dysphagia Post Anterior Cervical Discectomy and Fusion Managed with Glossopharyngeal Nerve Block

Author:

Pokuri Krishna1,Fonseca Alexandra2,Raj Vijay3,Tolba Reda4,Kollenburg Linda5,van der Meer Peter6,Alrowaily Fahed7,Kaye Alan D.8,Schatman Michael E.910,Robinson Christopher L.2

Affiliation:

1. Department of Anesthesiology, Tufts Medicine, Boston, Massachusetts

2. Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts

3. Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts

4. Pain Management Department in the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

5. Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands

6. Department of Radiology, Southern New Hampshire Radiology Consultants, Bedford, New Hampshire

7. Department of Physical Medicine and Rehabilitation, Medical Affairs, and Internal Medicine, Prince Mohammed Medical City, Aljouf, Sakaka City, Saudi Arabia

8. Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana

9. Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, New York

10. Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, New York.

Abstract

Dysphagia after anterior cervical spine surgery has a 5% to 15% incidence beyond 1-year postsurgery, often attributed to mechanical factors such as pharyngeal thickening and epiglottis inversion. Despite normal neurological examination and electromyography, nerve distortion related to stretching also remains a possibility in these patients and may cause allodynia resulting in odynophagia and dysphagia. Current treatment options for dysphagia after anterior cervical discectomy and fusion are limited to local intraoperative steroid injections and tracheal traction exercises. In our patient, a glossopharyngeal nerve block was effectively used to manage the glossopharyngeal allodynia, thereby reducing the odynophagia and dysphagia, ultimately enhancing oral tolerance.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference10 articles.

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