Oropharyngeal dysphagia may be a consequence of necrotizing otitis externa: case report

Abstract

Individuals with episodes of necrotizing otitis externa not treated properly can come to present changes not only in the external auditory canal, but also in other structures such as the cranial nerves. Taking into account these characteristics and the fact that the individual can manifest changes in swallowing biomechanics this study aims to report a case of a female patient of 55 years, accompanied by the ORL team and forwarded to the speech therapy team during her hospitalization complaining of difficulty in swallowing, in use of a nasogastric feeding tube, vocal and facial paralysis. She performed Videolaringoscopy and Videofluoroscopy of Deglutition with results compatible with the complaints. The patient had good adhesion to speech therapy and clinical treatment of necrotizing external otitis, received systematic speech therapy care with orofacial exercises for mobility and tone to facial expressions, vocal exercises for vocal fold vibration and glottal closure, as well as head postural maneuvers during the time of swallowing. This treatment was carried out 3 times a week totaling twelve attendances in her first hospitalization and eleven in the second, in a period of 4 months. After this period she was discharged with a prescribed diet for overall consistency orally without restriction. In this case, in particular, it was notable the impact on swallowing and the importance of early speech therapy and multidisciplinary approach to help a favorable prognosis of the patient.