Throat sensitivity disorders: causes, symptoms, diagnosis, treatment

Sensory disorders of the pharynx are divided into anesthesia, hypesthesia, hyperesthesia and paresthesia.

Anesthesia and hypoesthesia are characterized by the disappearance or sharp decrease in the severity of the pharyngeal reflex. Sensitivity disorders are most often observed after diphtheria, in subatrophic and atrophic processes (pharyngeal cavity), in leprosy processes, in epileptics treated with bromide preparations, less often in spinal cord, syringomyelia, affecting the bulbar centers of the sensory nerves of the pharynx; very often observed in persons suffering from hysteria. Unilateral anesthesia can be observed with syringobulbia, sometimes with hysteria, after affecting the sensitive nerves of the pharynx with herpes zoster. Lesions of the glossopharyngeal nerve lead to anesthesia of the pharynx, and parts of the sensitive fibers of the vagus nerve - the soft palate and palatine arch.

Hyperesthesia in some cases occurs with dorsal dryness, in some hysterics with neuralgia of the glossopharyngeal nerve. This disease is described by the French neurologist R. Sikar and was called the Sikar syndrome, which is characterized by the sudden occurrence of intolerable (dagger) pain in the corresponding half of the soft palate, resembling an electric shock, irradiating in the corresponding half of the pharynx, the root of the tongue, the ear-temporal region and the eye. The pain is paroxysmal and lasts from a few seconds to 3 minutes and can be repeated several times a day.

The attack is usually provoked by swallowing, chewing, twitching at the tongue, loud voice during conversation, pressure on the angle of the lower jaw, washing the face with cold or hot water, cold or hot food. Sikar syndrome is characterized by the fact that in the area of the mucosa of the root of the tongue or the posterior pharyngeal wall there are limited areas (so-called trigger zones), the touch of which provokes the onset of an attack, which resembles a triggering mechanism of pain in Slader's syndrome (frequent sneezing, constant, less paroxysmal , searing, boring, pulling pain in the inner corner of the eye, in the eyeball, nose, upper jaw, palate, pain often radiates to the nape and shoulder, kinesis of the mucous membrane of the vertebral column alveolar processes, palate and pharynx on the side of the lesion, unilateral lacrimation, may be triggered by the same factors as the attack of pain in the Sikar syndrome).

The attack can also be triggered by pressure on the palatine tonsils, for example, if it is necessary to remove the caseous masses from XT from the lacunae.

Because of severe pain in patients, there is a fear of eating, which leads to gradual emaciation; such patients try to speak in a low voice, their speech is unclear, they avoid active sneezing and yawning.

Before the attack, often a feeling of numbness of the sky and a brief hypersalivation. In addition, there is a one-sided hyperhepia with increased sensitivity to bitterness in the region of the posterior third of the tongue (the zone of innervation of the glossopharyngeal nerve). During an attack, dry cough often occurs.

Neuralgia of the glossopharyngeal nerve is not accompanied by disturbances in the motor function of the pharynx, taste sensitivity, any objective signs of a violation of general sensitivity.

The cause of neuralgia of the glossopharyngeal nerve is in most cases not clear. In each case, the patient must carry out a retgenological study to exclude the giant styloid process and diseases of the root system of the teeth. Signs of neuralgia of the glossopharyngeal nerve can occur in malignant tumors of the palatine tonsils or pharynx, as well as in the region of MMU with a lesion of the root of the IX cranial nerve, arachnoiditis of this region, an aneurysm of the internal carotid artery, syphilis,

Differential diagnosis is carried out between essential nerve of the glossopharyngeal nerve and symptomatic (secondary) neuralgia, caused by inflammatory, toxigenic, vascular, tumor or other cause. Pain in the secondary neuralgia of the glossopharyngeal nerve is of a permanent nature, unlike paroxysmal periodic pain in essential neuralgia (Sikar syndrome). This syndrome is also differentiated from the neuralgia of the third branch of the trigeminal nerve, which also has a paroxysmal character, from the neuralgia of the superior laryngeal nerve, in which pain arises from pressure on the innervation region by this nerve produced between the large horn of the thyroid cartilage and the horn of the hyoid bone, from the posterior sympathetic syndrome Barre-Liuu (occurs with cervical osteochondrosis and deforming spondylosis, manifests itself as a headache, usually in the nape, dizziness, imbalance, noise and pain in shah, vision disorder and accommodation, neuralgic pain in the eyes and face, etc., the disease is associated with irritation of the sympathetic plexus of the vertebral arteries and secondary hemodynamic disturbances in the basilar artery basin), in which signs resemble symptoms in neuralgia of the ninth nerve: glossodynia, disorders of swallowing, atrophy of pharyngeal musculature and guttural dysfunction.

Treatment of neuralgia of the glossopharyngeal nerve is divided into symptomatic and radical (surgical). The first is blockade by injecting a solution of novocaine into the zamindalic space and into the region of the superior plus of the palatine tonsil. This procedure stops for some time the occurrence of seizures. Surgical treatment consists in the intersection of the IX nerve with either extracranial or intracranial access.