A case of unilateral soft palate paralysis following minor head injury

Abstract

The development of isolated unilateral soft palate paralysis is rare, and no case of isolated soft palate paralysis following head trauma has been reported. Here, we report a case of unilateral soft palate paralysis subsequent to a head injury in an 11-year-old boy. He suffered a minor head injury while playing football. He experienced hypernasality and dysphagia on the 3rd day after the injury and then visited our hospital on the 8th day after the injury. The patient’s soft palate deviated to the left when he pronounced. With no other abnormal findings on imaging and blood examinations, we started tapered steroid therapy under a diagnosis of isolated unilateral soft palate paralysis. The symptoms completely recovered within 29 days from the start of therapy. We present the clinical course of the case in association with consecutive evaluations of velopharyngeal function, as assessed by nasoendoscopy, as well as auditory-perceptual examinations conducted by a speech and language therapist. The recovery process showed that hypernasality and consonant distortion improved early, whereas nasal emission in the blowing test improved later. Our data suggested that the blowing test possessed higher sensitivity than auditory-perceptual examinations for revealing velopharyngeal insufficiency caused by soft palate paralysis.