Patient: I noticed tonight that my uvula deviates to the left. I don’t spend much time looking at it, so I’d never noticed it before. There are no oropharyngeal masses or tonsilar inflammation. I know uvular deviation can indicate a vagus motor lesion, but I am not experiencing any associated symptoms. I am wondering if this is something I should be concerned about or if there are cases of nonpathological uvular deviation?
Doctor: The is innervated by the vagus nerve (Cranial Nerve X). Deviation of the uvula to one side implies a lower motor lesion of the vagus nerve opposite to the side the uvula is deviating to. An upper motor neuron vagus nerve lesion will be present with the uvula deviating toward the side of the lesion. I would advise attending your family physician for history of any associated symptoms (difficulty swallowing, speech problems, nasal regurgitation, hoarseness) and physical examination including cranial nerve examination and testing the gag reflex, which is innervated by the vagus nerve, to identify any cranial nerve pathology and investigation as appropriate.
Comments / Follow Ups
Doctor: The main reason for having a uvular deviation is when you have a weakness of the 9th and the 10th cranial nerve. The cranial nerves originate from the brain and any lesion or injury at any point in their course can cause damage. A few causes I can think of deviation of uvula:
- Infection of nerve
- Compression of the nerve
- Tumours causing compression of nerve
- Direct physical injury to the uvula may also cause its deviation. Such causes can be:
- Swallowing a big object or something that cut the uvula
- Injury to the throat
- Injury to the jaw like that in a road traffic accident or a sport
If you have deviation of the uvula, please see an Ear, Nose and Throat Doctor and they will help you reach the diagnosis and also advise you the best treatment option.