A 68-year-old man presented with a Jefferson fracture leading to lower cranial nerve palsies affecting the ninth, tenth, and twelfth cranial nerves with a traumatic basilar impression. On the X day, the patient underwent occipitocervical posterior fixation surgery; the surgery was uneventful. However, just after the surgery, epipharyngeal palsy and airway obstruction occurred. Consequently, tracheostomy was needed. On the X+8 day, speech-language pathology (SLP) therapy was initiated for decannulation. On the X+21 day, the patient could clear all the checkpoints and was decannulated. On the X+36 day, the patient was discharged home and SLP therapy was continued. On the X+171 day, his SLP therapy was halted. However, the patient continued to complain that he could not speak as fast as before, and his quality of life remained compromised. Some studies reported that lower cranial nerve palsies affecting the ninth to the twelfth cranial nerve occur in conjunction with Jefferson fractures. Thus, SLP therapy is crucial for Jefferson fracture cases.