PMC7365201_01
Findings of videoendoscopic examination of swallowing of the present patient. We noted
persistent upper esophageal sphincter opening (arrow), a reduction in pharyngeal
contractility, pooling of saliva in the pharynx, and paralysis of the left pharynx and
vocal cord.
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When the patient was transferred to our hospital, we performed videoendoscopic examination of swallowing (VE), which revealed persistent upper UES opening, pooling of saliva in the pharynx, left dominant bilateral IX and X nerve paralysis, and left XII nerve paralysis (Fig. 1).
Findings of head MRI (acute and chronic stages). (A) Acute stage: T1-weighted axial
MRI image. On T1-weighted MRI performed during the acute phase, the clivus marrow shows
a low signal (arrow), which reflects edema and bleeding caused by the fracture: normal
clivus marrow would exhibit a high signal. (B) Chronic stage: T1-weighted axial MRI
image. On T1-weighted MRI performed during the chronic stage, the signal of the clivus
marrow has improved to a normal high signal (arrow).
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Based on these findings, we diagnosed the patient with bilateral ALP with head trauma due to high-impact injury to the base of the skull (Fig. 2A,B).
Clinical course of the present patient. FILS, Food Intake LEVEL Scale.
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The entire clinical course is depicted in Fig. 3.