Evidence map›Paper›PMID 42289571›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Multilevel surgical management for severe dysphagia due to lower cranial nerve palsy with multimodal functional assessment: a case report.

Rumi Ueha, Maria Angela Dealino, Kaoru Yamakawa, Miguel Limbert Ramos, Masaki Tatebayashi, Atsushi Kuramochi, Takao Goto, Kenji Kondo

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rumi UehaSwallowing Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. UEHAR-OTO@h.u-tokyo.ac.jp.ORCID http://orcid.org/0000-0002-0608-7237
Maria Angela DealinoDepartment of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Kaoru YamakawaDepartment of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Miguel Limbert RamosDepartment of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Masaki TatebayashiAdvanced Imaging Center Yaesu Clinic, Tokyo, Japan.
Atsushi KuramochiDepartment of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Takao GotoSwallowing Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Kenji KondoDepartment of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLower cranial nerve (LCN) palsy may develop following tumor resection in the cerebellopontine angle or jugular foramen, often resulting in dysphagia and dysphonia. Although many patients recover with rehabilitation, some exhibit persistent functional deficits. In such cases, detailed pathophysiologic evaluation may assist in guiding surgical intervention to improve outcomes. CASE PRESENTATION: A 77-year-old woman presented with severe dysphagia and hoarseness after resection of a right cerebellopontine angle meningioma, which caused glossopharyngeal, vagus, and accessory nerve palsies. Despite initial recovery, she developed repeated aspiration pneumonia and malnutrition. Comprehensive reassessment using high-resolution manometry (HRM) and dynamic swallowing computed tomography (CT) revealed right-sided velopharyngeal insufficiency, pharyngeal constrictor dysfunction, vocal fold paralysis with paramedian fixation, and impaired upper esophageal sphincter relaxation. A tailored multi-procedural surgical approach was performed, including right pharyngeal flap, arytenoid adduction, right hypopharyngeal pharyngoplasty with expanded polytetrafluoroethylene mesh reinforcement, right cricopharyngeal myotomy, and tracheostomy. Postoperatively, swallowing and phonation significantly improved. The patient resumed oral intake, and tracheostoma closure was performed on postoperative day (POD) 25. Maximum phonation time improved sevenfold by POD 32. She was discharged on POD 33, and resumed a regular diet with some limitations by 3 months postoperatively.

conclusionsIntractable dysphagia due to complex LCN dysfunction requires individualized surgical strategies. Multimodal functional assessment, including dynamic swallowing CT and HRM, aids precise evaluation and helps refine surgical planning in selected complex cases, potentially leading to significant improvements in quality of life.

Indexed as

Cranial Nerve DiseasesDeglutition DisordersPostoperative ComplicationsAgedFemaleHumansManometryMeningeal NeoplasmsTomography, X-Ray ComputedVocal Cord ParalysisDysphagiaHigh-resolution pharyngeal manometryLower cranial nerve palsiesSwallowing CTSwallowing improvement surgeryVirtual reality

Identifiers

PMID42289571
PMCPMC13407462

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.