Long Term Hypopharyngeal Dysfunction in a Pediatric Patient after Toxic Epidermal Necrolysis: A Case Report and Literature Review

Abstract

We report the case of an 8-year-old male who experienced failure to thrive and dysphagia following idiopathic Toxic Epidermal Necrolysis (TEN). Despite a normal barium esophagram preoperatively, a significant degree of hypopharyngeal scarring was noted during direct laryngoscopy and bronchoscopy one year after initial presentation. Hypopharyngeal dysfunction following TEN has been reported in adults. However, there are no cases in the published literature examining this phenomenon in a pediatric patient. The purpose of this report is to highlight the potentially significant aerodigestive tract abnormalities following TEN in a pediatric patient, and to advocate for early direct laryngoscopy in children with mild symptoms. Additionally, this case demonstrates the need for a multidisciplinary approach to TEN in order to minimize morbidity.