24 June 2025
: Case report 
Postoperative Dysphagia Management in Hemifacial Spasm: A Case Report of Combined Catheter Balloon and Neuromuscular Stimulation
Unusual setting of medical care, Patient complains / malpractice, Rare disease
Qian Zhang BCEF 1,2, Shuang Wu AD 1,2*, Yangmei Shi BC 1, Qian Chen CD 1, Jiajie Gao BC 1DOI: 10.12659/AJCR.948795
Am J Case Rep 2025; 26:e948795
Table 1 Comparison of functional assessment before and after treatment.
| Assessment Items | Before treatment (July 24, 2024) | After treatment (Aug 4, 2024) | Change |
|---|---|---|---|
| Oral, facial, and laryngeal function assessment | Mouth: Reduced sensation, right deviation, drooling, slightly impaired elevation | Mouth: Improvement in drooping and drooling, sensory improvement | Improved |
| Lips: Slight impairment in elevation and contraction | Lips, tongue, soft palate: Improved motion | Improved | |
| Tongue: Slight impairment in elevation | Larynx: Elevation to 2 finger widths | Improved | |
| Larynx: Elevation to 1 finger width | Pharyngeal reflex: Left side delayed | Improved | |
| Soft palate: Slight impairment in elevation | Cough reflex: Normal | Cough reflex restored | |
| FOIS | FOIS 1: Unable to eat orally | FOIS 6: Fully able to eat orally without special preparation, but with food restrictions | Improved |
| VFSS | Insufficient tongue propulsion and control, soft palate elevation present, no reflux observed, delayed initiation of swallowing, inadequate tongue-pharyngeal complex movement, poor epiglottic inversion, delayed laryngeal closure, insufficient pharyngeal peristalsis and constriction, and impaired cricopharyngeus muscle relaxation (see )Figure 1 | Tongue propulsion and control are largely normal, soft palate elevation is intact, no reflux observed, swallowing initiation is good, tongue-pharyngeal complex movement is nearly normal, epiglottic inversion is adequate, laryngeal closure is timely, pharyngeal peristalsis and constriction are enhanced, and cricopharyngeus muscle opening is normal. A small amount of contrast medium is seen at the vocal cord level but can be completely cleared by coughing. No significant oral-phase swallowing difficulties, and the pharyngeal-phase swallowing dysfunction has improved compared to before (see )Figure 2 | Improved |
| Ipsilateral MEP (μV) | 120.87 | 132.34 | Increased |
| Contralateral MEP (μV) | 142.49 | 157.69 | Increased |
| FOIS – functional oral intake scale; VFSS – videofluorographic swallowing study; MEP – motor evoked potentials; μV – microvolt. | |||