Skip to main content

Advertisement

SpringerLink
Log in

From the expert’s office: localized neural lesions following tonsillectomy

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Due to various reasons, localized neural lesions following tonsillectomy are presumably an under-reported complication in the literature. This study was undertaken to compile our experiences including a literature review to disseminate useful insights in the etiology and prognosis of this rare entity. A retrospective chart review of expert reports written by at least one of the authors for malpractice claims in relation to tonsillectomy was undertaken. Additionally, a retrospective analysis of 648 patient documents that had undergone tonsillectomy in 2001 at our institution and a comprehensive literature review were performed. The research was restricted to the item “localized neural lesion”. Seven cases from the expert’s offices, one of our patients who had undergone tonsillectomy at our institution and 122 cases from the literature matched our search criteria. Including our own cases, the glossopharyngeal nerve was affected in 82 patients. Other lesions encompassed injury of the hypoglossal nerve as solitary (15) or combined (5) lesion, recurrent nerve paralysis with (2) or without additional nerve lesions (7), facial nerve paralysis (10) in combination with other nerve lesions (1), and a lingual nerve deficiency as solitary (4) or combined lesion (9). A single report existed for lesion of the phrenic nerve. There were five reported cases with blindness and nine cases with Horner’s syndrome. Albeit rare, localized neural lesions may occur as a troublesome complication following tonsillectomy and/or means to achieve hemostasis. Some of these cases may not result from the dissection itself but injection procedures. Surgical dissection should include careful mouth gag insertion and meticulous dissection to minimize the risk of localized neural complications. A long-term follow-up is recommended for patients with dysgeusia related to glossopharyngeal nerve injury and patients with recurrent nerve dysfunction. Other lesions are much less likely to resolve in the long-term. Localized neural lesions should adequately be included in the informed consent for tonsillectomy as well as for surgical treatment of post-tonsillectomy hemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wienke A (1992) Hypoglossusparese nach beidseitiger Tonsillektomie. Laryngorhinootologie 71:332–333

    Article  PubMed  CAS  Google Scholar 

  2. Eigler G (1958) Regressanspruch wegen Geschmacksverlustes nach Tonsillektomie. Z Laryngol Rhinol Otol 37:581–589

    PubMed  CAS  Google Scholar 

  3. Chilla R, Limberg C (1980) Lingualisparese nach Tonsillektomie. Objektivierung mit Hilfe trigemino-facialer Reflexe. Aus der Gutachterpraxis HNO 28:413–415

    CAS  Google Scholar 

  4. Beck C (1979) N. glossopharyngeus und Tonsillektomie. Laryngol Rhinol Otol 58:463–465

    CAS  Google Scholar 

  5. Wienke A (1992) Schädigung des Geschmacksempfindens und Aufklärungsumfang bei Tonsillektomien. Laryngorhinootologie 71:487–488

    Article  PubMed  CAS  Google Scholar 

  6. Berendes J, Theissing G (1953) Geschmacksstörungen nach Tonsillektomie. HNO 4:15–18

    PubMed  CAS  Google Scholar 

  7. McKenzie D (1925) Injury to lingual nerves in guillotine removal of the tonsil. Zbl Hals Nasen Ohren Hlk 6:141

    Google Scholar 

  8. Bolliger E (1950) Geschmacksstörungen nach Tonsillektomie. Zentralbl Hals Nasen Ohren Hlkd 40:187–188

    Google Scholar 

  9. Rieder C (1981) Eine seltene Komplikation: Geschmacksstörung nach Tonsillektomie. Laryngol Rhinol Otol 60:342

    Article  CAS  Google Scholar 

  10. Haapanen ML, Ignatius J, Rihkanen H, Ertama L (1994) Velopharyngeal insufficiency following palatine tonsillectomy. Eur Arch Otorhinolaryngol 251:186–189

    Article  PubMed  CAS  Google Scholar 

  11. Collet S, Eloy P, Rombaux P, Bertrand B (2005) Taste disorders after tonsillectomy: case report and literature review. Ann Otol Rhinol Laryngol 114:233–236

    PubMed  Google Scholar 

  12. Süss W, Hopf HC, Krämer G, Rohrbach P (1984) Hypoglossusparesen nach Tonsillektomie. Akt Neurol 11:21–22

    Article  Google Scholar 

  13. Schliack H, Malin JP (1983) Läsionen des Nervus hypoglossus. Akt Neurol 10:24–28

    Article  Google Scholar 

  14. Jebeles JA, Reilly JS, Gutierrez JF, Bradley EL Jr, Kissin I (1993) Tonsillectomy and adenoidectomy pain reduction by local bupivacaine infiltration in children. Int J Pediatr Otorhinolaryngol 25:149–154

    Article  PubMed  CAS  Google Scholar 

  15. Jebeles JA, Reilly JS, Gutierrez JF, Bradley EL Jr, Kissin I (1991) The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. Pain 47:305–308

    Article  PubMed  CAS  Google Scholar 

  16. Goldsher M, Podoshin L, Fradis M et al (1996) Effects of peritonsillar infiltration on post-tonsillectomy pain. A double-blind study. Ann Otol Rhinol Laryngol 105:868–870

    PubMed  CAS  Google Scholar 

  17. Schoem SR, Watkins GL, Kuhn JJ, Alburger JF, Kim KZ, Thompson DH (1993) Control of early postoperative pain with bupivacaine in adult local tonsillectomy. Arch Otolaryngol Head Neck Surg 119:292–293

    PubMed  CAS  Google Scholar 

  18. Orntoft S, Longreen A, Moiniche S, Dhal JB (1994) A comparison of pre- and postoperative tonsillar infiltration with bupivacaine on pain after tonsillectomy. A pre-emptive effect? Anaesthesia 49:151–154

    Article  PubMed  CAS  Google Scholar 

  19. Hollis LJ, Burton MJ, Millar JM (2000) Perioperative local anaesthesia for reducing pain following tonsillectomy. Cochrane Database Syst Rev CD001874

  20. Fradis M, Goldsher M, David JB, Podoshin L (1998) Life-threatening deep cervical abscess after infiltration of the tonsillar bed for tonsillectomy. Ear Nose Throat J 77:418–421

    PubMed  CAS  Google Scholar 

  21. Veit S, Muser HG, Bottcher E, Bruckner JB (1993) Signs of a severe myocardial ischemia following peritonsillar infiltration with ornipressin (POR 8). Anaesthesist 42:320–323

    PubMed  CAS  Google Scholar 

  22. Murakawa T, Koh H, Tsubo T, Ishihara H, Matsuki A (1998) Two cases of circulatory failure after local infiltration of epinephrine during tonsillectomy. Masui 47:955–962

    PubMed  CAS  Google Scholar 

  23. Tajima K, Sato S, Miyabe M (1997) A case of acute pulmonary edema and bulbar paralysis after local epinephrine infiltration. J Clin Anesth 9:236–238

    Article  PubMed  CAS  Google Scholar 

  24. Bean-Lijewski JD (1997) Glossopharyngeal nerve block for pain relief after pediatric tonsillectomy: retrospective analysis and two cases of life-threatening upper airway obstruction from an interrupted trial. Anesth Analg 84:1232–1238

    Article  PubMed  CAS  Google Scholar 

  25. Roseburg B (1964) Gaumensegelparesen durch Depotanaesthesie bei Tonsillektomien. Hno 12:201–205

    PubMed  CAS  Google Scholar 

  26. Richardson GS (1953) Bilateral abductor paralysis of vocal cords during local tonsillectomy; report of a case and its management. Laryngoscope 63:1197–1198

    Article  PubMed  CAS  Google Scholar 

  27. Neta L (1949) Facial paralysis during local regional (procaine) anesthesia for total tonsillectomy. Rev Bras Oto Rhino 17:105

    Google Scholar 

  28. Alsarraf R, Sie KC (2000) Brain stem stroke associated with bupivacaine injection for adenotonsillectomy. Otolaryngol Head Neck Surg 122:572–573

    Article  PubMed  CAS  Google Scholar 

  29. Harlowe HD (1972) Congestive heart failure and pulmonary edema following local tonsillectomy. Report of two cases. Laryngoscope 82:139–140

    Article  PubMed  CAS  Google Scholar 

  30. Albrecht W (1934) Über eine tödlich verlaufene Tonsillektomie. Zbl Hals Nasen Ohren Hlk 35:620

    Google Scholar 

  31. Chahine AN, Chiniara J (1951) Cécité bilatérale totale consécutive a une amygdalectomie traitement par la novocaine intraveineuse guérison. Ann Otolaryngol Chir Cervicofac 68:722–726

    PubMed  CAS  Google Scholar 

  32. Perekrest AI, Rakotoarinivo Zh M (1983) Neuritis of the facial nerve as a complication of local anesthesia and tonsillectomy. Vestn Otorinolaringol 3:77–78

    PubMed  Google Scholar 

  33. Zhemchyev VI, Chashchina DA, Korzun EP (1973) Kratkovremennaia odnostoronnaia slepota posle tonzillektomii. Zh Ushn Nos Gorl Bolezn 33:103

    PubMed  CAS  Google Scholar 

  34. Korneev ST (1980) Temporary blindness after a tonsillectomy. Vestn Otorinolaringol 2:70–71

    PubMed  Google Scholar 

  35. Ellis PP (1968) Visual loss following tonsillectomy; possible association with injections in tonsillar fossae. Arch Otolaryngol 87:436–438

    PubMed  CAS  Google Scholar 

  36. Formby ML (1971) Hazards in ear, nose and throat surgery. J Laryngol Otol 85:683–702

    Article  PubMed  CAS  Google Scholar 

  37. Forschner L, Loos S (1927) Zur Erklärung der bei der Anästhesierung der Tonsillen vorkommenden Fazialisparesen. Mschr Ohrenheilk 61:231

    Google Scholar 

  38. Shlizerman L, Ashkenazi D (2005) Peripheral facial nerve paralysis after peritonsillar infiltration of bupivacaine: a case report. Am J Otolaryngol 26:406–407

    Article  PubMed  Google Scholar 

  39. Tezel EB (1953) Seltene Komplikationen bei und nach Tonsillektomie. Zbl Hals Nasen Ohren Hlk 48:327

    Google Scholar 

  40. Stutz E (1953) Flüchtige Facialisparese nach Tonsillektomie. HNO 4:90

    PubMed  CAS  Google Scholar 

  41. Neto I (1951) Facialislähmung bei Loco-Regionalanästhesie für totale Tonsillektomie. Zbl Hals Nasen Ohren Hlk 42:222

    Google Scholar 

  42. Urbantschitsch E (1931) Über Tonsillektomie-Komplikationen. Hypoglossus-Facialis-Parese nach Mandelausschälung. Wien Med Wochenschr 48:1600–1602

    Google Scholar 

  43. Del castillo L (1940) Un casi di paralisi degli ultimi quatro nervi cranici consecutiva ad anestesia locale per tonsillectomia. Zbl Hals Nasen Ohren Hlk 33:263

    Google Scholar 

  44. Fischer G (1956) Rekurrensparese nach Tonsillektomie. Monatsschr Ohrenheilkd Laryngorhinol 90:348–353

    PubMed  CAS  Google Scholar 

  45. Baglione L (1961) Considerations on 2 cases of paralysis of a vocal cord after tonsillectomy. Ann Laringol Otol Rinol Faringol 60:652–663

    PubMed  CAS  Google Scholar 

  46. Zöllner B, Herrmann IF (1971) Horner-, Hypoglossus- und Rekurrensparese als entzündliche Spätkomplikation anch Tonsillektomie. Monatsschr Ohrenheilkd Laryngorhinol 105:228–232

    PubMed  Google Scholar 

  47. Weksler N, Nash M, Rozentsveig V, Schwartz JA, Schily M, Gurman GM (2001) Vocal cord paralysis as a consequence of peritonsillar infiltration with bupivacaine. Acta Anaesthesiol Scand 45:1042–1044

    Article  PubMed  CAS  Google Scholar 

  48. Kreuzbauer FH (1960) Zur Kasuistik der Tonsillektomiekomplikationen. Monatsschr Ohrenheilkd Laryngorhinol 94:164–168

    PubMed  CAS  Google Scholar 

  49. Hobson JC, Malla JV, Kay NJ (2006) Horner’s syndrome following tonsillectomy. J Laryngol Otol 120:800–801

    Article  PubMed  CAS  Google Scholar 

  50. Link R (1941) Eigenartiger Zwischenfall nach Infiltrationsanästhesie bei Tonsillektomie. Hals Nasen Ohrenarzt 31:368–372

    Google Scholar 

  51. Boku E, Eiton F (1937) Hornersches Syndrom nach Lokalanästhesie bei der Tonsillektomie. Zbl Hals Nasen Ohren Hlk 27:620

    Google Scholar 

  52. Hammer C (1933) Einseitiger Hornerscher Symptomenkomplex nach beiderseitiger Gaumenmandelaussschälung. Klin Monatsbl Augenheilk 90:79

    Google Scholar 

  53. Tisch M, Bruder M, Maier H (2002) Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia. HNO 50:230–232

    Article  PubMed  CAS  Google Scholar 

  54. Gerlings PG (1932) Acta Otolaryngol 17:420–423

    Article  Google Scholar 

  55. Fuller JE, Thomas DV (1956) Facial nerve paralysis after general anesthesia. JAMA 162:9

    Google Scholar 

  56. Mummenthaler M (1970) Mechanische Läsionen peripherer Nerven durch ärztliche Eingriffe. Ther Umsch 27:365–368

    Google Scholar 

  57. Shissias CG, Golnik KC (1994) Horner’s syndrome after tonsillectomy. Am J Ophthalmol 117:812–813

    PubMed  CAS  Google Scholar 

  58. Novoselitskii EM (1979) Sindrom Kloda Bernara-Gornera, voznikshii posle tonzillektomii. Zh Ushn Nos Gorl Bolezn 4:82–83

    PubMed  Google Scholar 

  59. Malik V, Belloso A, Khwaja S, De Carpentier J (2006) Posttonsillectomy Horner′s syndrome. Laryngoscope 116:494–495

    Article  Google Scholar 

  60. Hald E, Godtfredsen E (1942) Transitory occurence of Horner’s syndrome after paratonsillar anaesthetization for tonsillectomy. Acta Otolaryngol 30:156–161

    Article  Google Scholar 

  61. Fowler R (1933) Stylohyoid ossification, bilateral, and injury of ninth nerve after tonsillectomy. Laryngoscope 43:287–290

    Article  Google Scholar 

  62. Dehnen T (1950) Geschmacksstörungen nach Tonsillektomie. Z Laryngol Rhinol Otol 29:546–551

    PubMed  CAS  Google Scholar 

  63. Haas E (1953) Kasuistischer Beitrag zum Thema: Geschmacksstörungen nach Tonsillektomie. Z Laryngol Rhinol Otol 32:413–414

    PubMed  CAS  Google Scholar 

  64. Tarab S (1955) Troubles de la gustation apres tonsillectomie. Pract Otorhinolaryngol 17:260–262

    CAS  Google Scholar 

  65. Holzlöhner (1956) Geschmacksstörungen nach Operationen im Mund- und Rachenbereich. HNO 6:91–92

    Google Scholar 

  66. Gessini L, Valente V (1966) Neuralgia del linguale ed ageusia permanente dopo tonsillectomia. Caso clinico. Ann Laringol Otol Rinol Faringol 65:650–653

    PubMed  CAS  Google Scholar 

  67. Fleischer K (1981) Geschmacksverlust nach Tonsillektomie. Dtsch Med Wochenschr 106:1274–1275

    Google Scholar 

  68. Arnhold-Schneider M, Bernemann D (1987) Über die Häufigkeit von Geschmacksstörungen nach Tonsillektomie. HNO 35:195–198

    PubMed  CAS  Google Scholar 

  69. Bicknell JM, Wiggins RV (1988) Taste disorder from zinc deficiency after tonsillectomy. West J Med 149:457–460

    PubMed  CAS  Google Scholar 

  70. Dressler D, Conrad B (1989) Geschmacksstörungen nach Tonsillektomie. Seltene Komplikation einer häufigen Operation. Nervenarzt 60:572–575

    PubMed  CAS  Google Scholar 

  71. Donati F, Pfammatter JP, Mauderli M, Vassella F (1991) Neurologische Komplikationen nach Tonsillektomie. Schweiz Med Wochenschr 121:1612–1617

    PubMed  CAS  Google Scholar 

  72. Garnett JD, Ramadan HH (1996) Swallowing dysfunction after tonsillectomy. Otolaryngol Head Neck Surg 114:813–817

    Article  PubMed  CAS  Google Scholar 

  73. Vories AA (1999) Dysgeusia associated with tonsillectomy. Otolaryngol Head Neck Surg 121:303–304

    PubMed  CAS  Google Scholar 

  74. Wachtel JM, Kuehn DP, Weiss KS (2000) Hypernasality after tonsillectomy without adenoidectomy in an adult. Otolaryngol Head Neck Surg 122:112–113

    Article  PubMed  CAS  Google Scholar 

  75. Tomita H, Ohtuka K (2002) Taste disturbance after tonsillectomy. Acta Otolaryngol Suppl 546:164–172

    Article  PubMed  Google Scholar 

  76. Oluwasanmi AF (2004) Unusual complication of tonsillectomy: taste disturbance and the lingual branch of the glossopharyngeal nerve. J Laryngol Otol 118:248–249 author reply 249

    Article  PubMed  CAS  Google Scholar 

  77. Uzun C, Adali MK, Karasalihoglu AR (2003) Unusual complication of tonsillectomy: taste disturbance and the lingual branch of the glossopharyngeal nerve. J Laryngol Otol 117:314–317

    PubMed  Google Scholar 

  78. Ford LC, Cruz RM (2004) Bilateral glossopharyngeal nerve paralysis after tonsillectomy: case report and anatomic study. Laryngoscope 114:2196–2199

    Article  PubMed  Google Scholar 

  79. Goins MR, Pitovski DZ (2004) Posttonsillectomy taste distortion: a significant complication. Laryngoscope 114:1206–1213

    Article  PubMed  Google Scholar 

  80. Tomofuji S, Sakagami M, Kushida K, Terada T, Mori H, Kakibuchi M (2005) Taste disturbance after tonsillectomy and laryngomicrosurgery. Auris Nasus Larynx 32:381–386

    Article  PubMed  Google Scholar 

  81. Ohtsuka K, Tomita H, Murakami G (2002) Anatomy of the tonsillar bed: topographical relationship between the palatine tonsil and the lingual branch of the glossopharyngeal nerve. Acta Otolaryngol Suppl 546:99–109

    Article  PubMed  Google Scholar 

  82. Sieluzycki C (1967) Complications following tonsillectomy. (Komplikationen nach Tonsillektomie.). Zbl Hals Nasen Ohren Hlk 95:291–292

    Google Scholar 

  83. Lowe DA, Hajioff D, Jayaraj SM, Frosh AC (2002) Taste disturbance following adult tonsillectomy. CME Bull Otorhinolaryngol Head Neck Surg 6:102–103

    Google Scholar 

  84. Gibb AG, Stewart IA (1975) Hypernasality following tonsil dissection—hysterical aetiology. J Laryngol Otol 89:779–781

    Article  PubMed  CAS  Google Scholar 

  85. Hartenau W (1955) Seltene Komplikation nach Tonsillektomie. Monatsschr Ohrenheilkd Laryngorhinol 89:117–118

    PubMed  CAS  Google Scholar 

  86. Sakuma A, Kobayashi Y, Takahashi F (1990) Taste disorders after tonsillectomy. Jpn J Tonsil 29:99–103

    Google Scholar 

  87. Vartanian AJ, Alvi A (1997) Lingual nerve palsy following tonsillectomy. J Otolaryngol 26:389–391

    PubMed  CAS  Google Scholar 

  88. Richstein A (1981) Stimm- und Sprachstörungen nach Adenotomie und Tonsillektomie. Laryngol Rhinol Otol 60:351–354

    Article  CAS  Google Scholar 

  89. Boenninghaus HG, Denecke U (1982) Hypoglossusparese nach Tonsillektomie? Laryngol Rhinol Otol 61:189–192

    Article  CAS  Google Scholar 

  90. Guthrie D (1926) Hypoglossal paralysis following tonsillectomy. J Laryngol Otol 41:662–663

    Google Scholar 

  91. Michel O, Brusis T (1990) Hypoglossusparese nach Tonsillektomie. Laryngorhinootologie 69:267–270

    Article  PubMed  CAS  Google Scholar 

  92. Sharp CM, Borg HK, Kishore A, MacKenzie K (2002) Hypoglossal nerve paralysis following tonsillectomy. J Laryngol Otol 116:389–391

    PubMed  CAS  Google Scholar 

  93. Venkatesh B, Walker D (1997) Hypoglossal neurapraxia following endotracheal intubation. Anaesth Intensive Care 25:699–700

    PubMed  CAS  Google Scholar 

  94. Agnoli A, Strauss P (1970) Isolierte Hypoglossus- und kombinerte Hypoglossus-Lingualis-Paresen nach Intubation und direkter Laryngoskopie. HNO 18:237–239

    PubMed  CAS  Google Scholar 

  95. Gambetti P, Orioli G (1963) Singolare sindrome neurologica conseguente ad intubazione endotracheale: paralisi unilaterale dissociata degli ultimi nervi cranici e delle prime radici cervicali. G Psichiatr Neuropatol 91:391–397

    PubMed  CAS  Google Scholar 

  96. Ryba V, Konrad J (1968) Tonsillectomy and adenotomy in children under general anesthesia. Cesk Otolaryngol 17:26–30

    PubMed  CAS  Google Scholar 

  97. Kaess H (1955) Hypoglossusparese nach Bronchoskopie. HNO 5:115–116

    PubMed  CAS  Google Scholar 

  98. Bumm P (1974) Periphere Hypoglossusparesen. Laryngol Rhinol Otol 53:274–283

    CAS  Google Scholar 

  99. Mullins RC, Drez D, Cooper JC (1992) Hypoglossal nerve palsy after arthroscopy of the shoulder and open operation with the patient in the beach-chair position. J Bone Joint Surg 74:137–139

    PubMed  CAS  Google Scholar 

  100. Nagai K, Sakuramoto C, Goto F (1994) Unilateral hypoglossal nerve paralysis following the use of the laryngeal mask airway. Anasthesia 49:603–604

    Article  CAS  Google Scholar 

  101. Hinze F, Linke HO (1976) Kombinierte Hypoglossus-Lingualis-Schädigung nach direkter Laryngoskopie. Akt Neurol 3:233–235

    Google Scholar 

  102. Loughman E (1983) Lingual nerve injury following tracheal intubation. Anaesth Intensive Care 11:171–172

    PubMed  CAS  Google Scholar 

  103. Neugebauer P, Bonnekoh B, A Wevers et al (1996) Human keratinocyte culture from the peritonsillar mucosa. Eur Arch Otorhinolaryngol 253:245–251

    Article  PubMed  CAS  Google Scholar 

  104. Rubio-Nazabal E, Marey-Lopez J, Lopez-Facal S, Alvarez-Perez P, Martinez-Figueroa A, Rey del Corral P (2002) Isolated bilateral paralysis of the hypoglossal nerve after transoral intubation for general anesthesia. Anesthesiology 96:245–247

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, St Anna Hospital, Albertus Magnus Str. 33, 47259, Duisburg, Germany

    Jochen P. Windfuhr

  2. Department of Otorhinolaryngology, University Hospital of Aachen, Aachen, Germany

    Georg Schlöndorff

  3. Department of Otorhinolaryngology, University Hospital of the Philipps University, Marburg, Germany

    Andreas M. Sesterhenn

  4. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Maastricht, Maastricht, The Netherlands

    Bernd Kremer

Authors
  1. Jochen P. Windfuhr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georg Schlöndorff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas M. Sesterhenn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernd Kremer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jochen P. Windfuhr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Windfuhr, J.P., Schlöndorff, G., Sesterhenn, A.M. et al. From the expert’s office: localized neural lesions following tonsillectomy. Eur Arch Otorhinolaryngol 266, 1621–1640 (2009). https://doi.org/10.1007/s00405-009-0910-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-009-0910-2

Keywords

Search

Navigation