Lower motor neuron facial nerve palsy (FNP) has many causes. Bell's palsy is by far the commonest cause. Among other causes include infective and neoplastic causes. While FNP caused by facial nerve schwannoma (FNS); a benign neoplastic condition of the facial nerve is slowly progressing, infective causes mainly viral origins present with acute FNP. We present a young female who complained of an acute onset of FNP on day five of her COVID-19 infection. She initially presented with symptoms suggestive of ear infection, and subsequent magnetic resonance imaging (MRI) showed evidence of FNS, which she was subjected to surgery later at our center. This rare acute incidence of FNP in schwannoma might be triggered by the COVID-19 infection and demonstrates the role of imaging in finding the cause of FNP.
Total laryngectomy (TL) is the treatment of choice for advanced glottic cancer. Post-operative complications can be debilitating for patients, family members and healthcare workers. Complications following TL have been reported in many studies, with pharyngocutaneous fistula and wound infection being the most common. Identifying the risk factors that may give rise to these complications is vital to minimise postoperative morbidity. We present the case of a 62-year-old male who underwent salvage TL following radiation therapy for recurrent glottic carcinoma. The patient developed diffuse submental swelling upon the commencement of oral feeding. A flexible nasopharyngolaryngoscopy revealed a sloughy area at the neopharynx, with the finding of a sealed anastomotic leak on a repeat barium swallow study. We report persistent Pseudomonas aeruginosa infection following salvage TL, after a sealed anastomotic leak.
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