Unilateral Palatal Adhesion for Paralysis After High Vagal Injury

Tumor involvement or sacrifice of the vagus nerve at the level of the jugular foramen is a cause of significant morbidity in skull base surgery. Management of the resulting dysphagia and dysphonia has been significantly improved by the development of vocal cord medialization. However, rehabilitation of palatal paralysis with the resulting velopharyngeal incompetence has not been widely addressed. In an effort to alleviate the symptoms of hypernasality and nasal reflux, unilateral adhesion of the palate to the posterior wall of the nasopharynx is proposed. This report summarizes the operative approach and results in eight patients. Results have been favourable with no significant postoperative complications observed to date.