Resolution of hypoglossal nerve palsy associated with retropharyngeal abscess after prompt medical and surgical treatment

Isolated hypoglossal nerve palsy due to retropharyngeal abscess is extremely rare. We report two patients with this finding, both of whom presented with concomitant retropharyngeal abscess/cellulitis. In one patient, the hypoglossal nerve palsy presented early in the course of the infection, whereas in the other patient, the hypoglossal nerve palsy occurred as the patient was clinically improving. Both patients were treated with intravenous antibiotics and surgical drainage. These cases suggest that hypoglossal nerve palsy should be an indication for aggressive therapy of a retropharyngeal abscess, and that hypoglossal nerve palsy may be reversible if managed expeditiously.