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Type I Chiari malformation presenting with isolated unilateral hypoglossal nerve and vocal cord paralysis

Year 2008, Volume: 18 Issue: 2, 118 - 120, 18.04.2008

E. Eylem Ertuğrul Hakan Cıncık Engin Çekin Salim Doğru Atila Güngör

Abstract

Chiari malformation refers to caudal displacement of posterior fossa structures through the foramen magnum in the cervical canal and is classified according to the severity of displacement and accompanying cranial nerve and cervical pathologies. We presented a 24-year-old male patient who had isolated unilateral paralysis of the hypoglossal nerve and vagus nerve, with thyroid cartilage asymmetry. Chiari type I malformation was diagnosed by craniospinal magnetic resonance imaging. Suboccipital craniectomy and cervical 1-level large partial laminectomy were performed by the neurosurgery department. No improvement was observed in hypoglossal and vagal paralysis during an 18-month follow-up.

Keywords

Arnold-Chiari malformation hypoglossal nerve paralysis/etiology thyroid cartilage vagus nerve

References

  • Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY. Chiari type I malformations in adults: a morpho- metric analysis of the posterior cranial fossa. Surg Neurol 2005;64:237-41.
  • Şen O, Aydın MV, Erdoğan B. Chiari I malformasyonu ve güncel tedavi yöntemleri. MEÜ Tıp Fak Derg 2001; 2:342-6.
  • Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 1999;44:1005-17.
  • Greer M. Structural malformations. In: Rowland LP, editor. Merritt’s neurology. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 587-601.
  • Alkan A, Kutlu R, Baysal T, Sığırcı A, Altınok T, Orkan İ ve ark. Korpus kallozum disgenezisine eşlik eden beyin anomalileri ve klinik bulgular. Tanısal ve Girişimsel Radyoloji 2003;9:411-7.
  • Cavender RK, Schmidt JH 3rd. Tonsillar ectopia and Chiari malformations: monozygotic triplets. Case report. J Neurosurg 1995;82:497-500.
  • Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology 1992;183:347-53.
  • Levy WJ, Mason L, Hahn JF. Chiari malformation pre- senting in adults: a surgical experience in 127 cases. Neurosurgery 1983;12:377-90.
  • Steinmetz MP, Benzel EC. Surgical management of Chiari malformation. Neurosurgery Quarterly 2003; 13:105-12.
  • Combarros O, Alvarez de Arcaya A, Berciano J. Isolated unilateral hypoglossal nerve palsy: nine cases. J Neurol 1998;245:98-100.
  • Tsara V, Serasli E, Kimiskidis V, Papagianopoulos S, Katsaridis V, Fylaktakis M, et al. Acute respiratory fail- ure and sleep-disordered breathing in Arnold-Chiari malformation. Clin Neurol Neurosurg 2005;107:521-4.
  • Blitzer A. Neurolaryngology. In: Cummings CW. Otolaryngology- head and neck surgery. Vol. 3, 2nd ed. St. Louis: Mosby-Year Book; 1993. p. 2054-5.
  • Dyste GN, Menezes AH, VanGilder JC. Symptomatic Chiari malformations. An analysis of presentation, management, and long-term outcome. J Neurosurg 1989; 71:159-68.
  • Schady W, Metcalfe RA, Butler P. The incidence of craniocervical bony anomalies in the adult Chiari mal- formation. J Neurol Sci 1987;82:193-203.
  • Vega A, Quintana F, Berciano J. Basichondrocranium anomalies in adult Chiari type I malformation: a mor- phometric study. J Neurol Sci 1990;99:137-45.
  • Coria F, Quintana F, Rebollo M, Combarros O, Berciano J. Occipital dysplasia and Chiari type I deformity in a family. Clinical and radiological study of three genera- tions. J Neurol Sci 1983;62:147-58.
  • Williams B. Progress in syringomyelia. Neurol Res 1986;8:130-45.
  • Morgan D, Williams B. Syringobulbia: a surgical apprais- al. J Neurol Neurosurg Psychiatry 1992;55:1132-41.

İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu

Year 2008, Volume: 18 Issue: 2, 118 - 120, 18.04.2008

E. Eylem Ertuğrul Hakan Cıncık Engin Çekin Salim Doğru Atila Güngör

Abstract

Posterior fossa yapılarının foramen magnumdan çıkarak servikal kanalda kaudale doğru yer değiş- tirmesi olarak tanımlanan Chiari malformasyonu, yer değiştirmenin derecesine ve beraberindeki kraniyal ve servikal patolojilere göre sınıflandırılır. Yazımızda, izole sol hipoglossus ve vagus sinir paralizisi ile tiroid kartilajında asimetri olan 24 yaşında bir erkek hasta sunuldu. Beyin ve beyin sapı manyetik rezonans görüntülemesinde Chiari tip I malformasyonu saptandı. Beyin cerrahisi tara- fından suboksipital kraniyektomi ve servikal-1 geniş parsiyel laminektomi uygulandı. On sekiz aylık takipte hipoglossus ve vagus sinir paralizilerinde düzelme gözlenmedi

Keywords

Arnold-Chiari malformasyonu hipoglossal sinir paralizi/etyoloji tiroid kartilaj vagus siniri

References

  • Aydin S, Hanimoglu H, Tanriverdi T, Yentur E, Kaynar MY. Chiari type I malformations in adults: a morpho- metric analysis of the posterior cranial fossa. Surg Neurol 2005;64:237-41.
  • Şen O, Aydın MV, Erdoğan B. Chiari I malformasyonu ve güncel tedavi yöntemleri. MEÜ Tıp Fak Derg 2001; 2:342-6.
  • Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, et al. Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 1999;44:1005-17.
  • Greer M. Structural malformations. In: Rowland LP, editor. Merritt’s neurology. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 587-601.
  • Alkan A, Kutlu R, Baysal T, Sığırcı A, Altınok T, Orkan İ ve ark. Korpus kallozum disgenezisine eşlik eden beyin anomalileri ve klinik bulgular. Tanısal ve Girişimsel Radyoloji 2003;9:411-7.
  • Cavender RK, Schmidt JH 3rd. Tonsillar ectopia and Chiari malformations: monozygotic triplets. Case report. J Neurosurg 1995;82:497-500.
  • Elster AD, Chen MY. Chiari I malformations: clinical and radiologic reappraisal. Radiology 1992;183:347-53.
  • Levy WJ, Mason L, Hahn JF. Chiari malformation pre- senting in adults: a surgical experience in 127 cases. Neurosurgery 1983;12:377-90.
  • Steinmetz MP, Benzel EC. Surgical management of Chiari malformation. Neurosurgery Quarterly 2003; 13:105-12.
  • Combarros O, Alvarez de Arcaya A, Berciano J. Isolated unilateral hypoglossal nerve palsy: nine cases. J Neurol 1998;245:98-100.
  • Tsara V, Serasli E, Kimiskidis V, Papagianopoulos S, Katsaridis V, Fylaktakis M, et al. Acute respiratory fail- ure and sleep-disordered breathing in Arnold-Chiari malformation. Clin Neurol Neurosurg 2005;107:521-4.
  • Blitzer A. Neurolaryngology. In: Cummings CW. Otolaryngology- head and neck surgery. Vol. 3, 2nd ed. St. Louis: Mosby-Year Book; 1993. p. 2054-5.
  • Dyste GN, Menezes AH, VanGilder JC. Symptomatic Chiari malformations. An analysis of presentation, management, and long-term outcome. J Neurosurg 1989; 71:159-68.
  • Schady W, Metcalfe RA, Butler P. The incidence of craniocervical bony anomalies in the adult Chiari mal- formation. J Neurol Sci 1987;82:193-203.
  • Vega A, Quintana F, Berciano J. Basichondrocranium anomalies in adult Chiari type I malformation: a mor- phometric study. J Neurol Sci 1990;99:137-45.
  • Coria F, Quintana F, Rebollo M, Combarros O, Berciano J. Occipital dysplasia and Chiari type I deformity in a family. Clinical and radiological study of three genera- tions. J Neurol Sci 1983;62:147-58.
  • Williams B. Progress in syringomyelia. Neurol Res 1986;8:130-45.
  • Morgan D, Williams B. Syringobulbia: a surgical apprais- al. J Neurol Neurosurg Psychiatry 1992;55:1132-41.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

E. Eylem Ertuğrul This is me

Hakan Cıncık This is me

Engin Çekin This is me

Salim Doğru This is me

Atila Güngör This is me

Publication Date April 18, 2008
Published in Issue Year 2008 Volume: 18 Issue: 2

Cite

APA Ertuğrul, E. E., Cıncık, H., Çekin, E., Doğru, S., et al. (2008). İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu. The Turkish Journal of Ear Nose and Throat, 18(2), 118-120.
AMA Ertuğrul EE, Cıncık H, Çekin E, Doğru S, Güngör A. İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu. Tr-ENT. April 2008;18(2):118-120.
Chicago Ertuğrul, E. Eylem, Hakan Cıncık, Engin Çekin, Salim Doğru, and Atila Güngör. “İzole Tek Taraflı Hipoglossal Sinir Ve Vokal Kord Paralizisi Ile Ortaya çıkan Chiari Tip I Malformasyonu”. The Turkish Journal of Ear Nose and Throat 18, no. 2 (April 2008): 118-20.
EndNote Ertuğrul EE, Cıncık H, Çekin E, Doğru S, Güngör A (April 1, 2008) İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu. The Turkish Journal of Ear Nose and Throat 18 2 118–120.
IEEE E. E. Ertuğrul, H. Cıncık, E. Çekin, S. Doğru, and A. Güngör, “İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu”, Tr-ENT, vol. 18, no. 2, pp. 118–120, 2008.
ISNAD Ertuğrul, E. Eylem et al. “İzole Tek Taraflı Hipoglossal Sinir Ve Vokal Kord Paralizisi Ile Ortaya çıkan Chiari Tip I Malformasyonu”. The Turkish Journal of Ear Nose and Throat 18/2 (April 2008), 118-120.
JAMA Ertuğrul EE, Cıncık H, Çekin E, Doğru S, Güngör A. İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu. Tr-ENT. 2008;18:118–120.
MLA Ertuğrul, E. Eylem et al. “İzole Tek Taraflı Hipoglossal Sinir Ve Vokal Kord Paralizisi Ile Ortaya çıkan Chiari Tip I Malformasyonu”. The Turkish Journal of Ear Nose and Throat, vol. 18, no. 2, 2008, pp. 118-20.
Vancouver Ertuğrul EE, Cıncık H, Çekin E, Doğru S, Güngör A. İzole tek taraflı hipoglossal sinir ve vokal kord paralizisi ile ortaya çıkan Chiari tip I malformasyonu. Tr-ENT. 2008;18(2):118-20.