[Dysphagia] Acoustic neuroma

[eripley at yahoo.com (Irene Campbell-Taylor)]

If this unfortunate gentleman has had unsuccessful nerve and muscle grafts including the 7th, 9th and 10th cranial nerves there would be no possibility of recovery of a swallow as all are essential.  With such wide denervation I can't see how any intervention would make any difference. The vocal cord paralysis is related to UES dysfunction - the real reason that vocal cord paralysis can cause aspiration. The UES is innervated by the recurrent laryngeal from 10 anteriorly and the pharyngeal plexus posteriorly.

The pharyngeal plexus is composed of branches of the vagus nerve supply with efferent motor fibres from the cranial part of the accessory and afferent general somatic fibres originating in the sensory nucleus of the trigeminal nerve as well as pharyngeal branches of  the glossopharyngeal nerve and cervical sympathetic fibres, complete loss of these nerves makes swallowing impossible.

I would want to know if there is any hope at all of future function of any of the above. Without that, attempts at intervention are futile.


Dr I Campbell-Taylor
Clinical Neuroscientist
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