Abstract
Cranial nerve paralysis is an uncommon complication of radiotherapy for head and neck carcinomas because cranial nerves are relatively resistant to radiation. The incidence of this complication has been declared to be 1-5% in different studies. Unlike the other cranial nerves, isolated hypoglossal nerve paralysis in patients who have been treated with radiotherapy for nasopharyngeal carcinomas is a worrisome sign of recurrence. We report a 45-year-old male patient admitted to our clinics with complaints of difficulty in moving his tongue and dysphasia five years after combined radiotherapy and chemotherapy for nasopharyngeal carcinoma. Recurrence of the tumor was thought to be the cause of the isolated hypoglossal nerve paralysis at first, however late toxicity of radiotherapy was found to be the etiological factor after detailed examinatons.
References
- Hwang JM, Fu KK, Phillips TL. Results and prog- nostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1998;41:1099-111.
- Wei WI, Ho CM, Wong MP, Ng WF, Lau SK, Lam KH. Pathological basis of surgery in the management of postradiotherapy cervical metastasis in nasopharyn- geal carcinoma. Arch Otolaryngol Head Neck Surg 1992;118:923-9.
- Sanguineti G, Geara FB, Garden AS, Tucker SL, Ang KK, Morrison WH, et al. Carcinoma of the nasophar- ynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 1997;37:985-96.
- Chan AT, Teo PM, Leung TW, Johnson PJ. The role of chemotherapy in the management of nasopharyngeal carcinoma. Cancer 1998;82:1003-12.
- Tsao SY, Shiu WC. Radiotherapy and chemotherapy for nasopharyngeal carcinoma. Ear Nose Throat J 1990; 69:272-8.
- Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiothera- py in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-7.
- Ensley JF, Youssef E, Kim H, Yoo G. Locally advanced nasopharyngeal cancer. Curr Treat Options Oncol 2001;2:15-23.
- Kang MY, Holland JM, Stevens KR Jr. Cranial neuropa- thy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx. J Laryngol Otol 2000;114:308-10.
- Stern Y, Marshak G, Shpitzer T, Segal K, Feinmesser R. Vocal cord palsy: possible late complication of radio- therapy for head and neck cancer. Ann Otol Rhinol Laryngol 1995;104:294-6.
- Janfaza P, Richard LF. Oral cavity. In: Janfaza P, editor. Surgical anatomy of the head and neck. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 332-3.
- Tsai MH, Shiau YC, Kao CH, Shen YY, Lin CC, Lee CC. Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro- 2-deoxyglucose in patients with indeterminate mag- netic resonance imaging findings after radiotherapy. J Cancer Res Clin Oncol 2002;128:279-82.
Abstract
Kraniyal sinir paralizisi, kraniyal sinirlerin göreceli olarak radyasyona dirençli olmaları nedeni ile baş ve boyun kanserlerinde radyoterapinin nadir komplikas- yonu olarak, nadiren ortaya çıkar. Farklı çalışmalar- da bu komplikasyon oranı %1-5 olarak bildirilmiştir. Radyoterapi tedavisi almış nazofarenks karsinomlu hastalarda izole hipoglossus sinir felci, diğer alt kra- niyal sinir felçlerinin aksine nüksü düşündüren kaygı verici bir bulgudur. Bu yazıdanazofarenks karsinomu nedeniyle aldığı kombine radyoterapi ve kemote- rapiden beş yıl sonra dilini hareket ettirememe ve konuşma zorluğu yakınmaları ile kliniğimize başvu- ran 45 yaşında bir erkek hasta sunuldu. İlk olarak, izole hipoglossus felcinin tümör nüksüne bağlı olarak geliştiği düşünüldü, fakat yapılan detaylı incelemeler sonucunda etyolojik faktörün radyoterapinin geç tok- sisitesi olduğu görüldü
References
- Hwang JM, Fu KK, Phillips TL. Results and prog- nostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1998;41:1099-111.
- Wei WI, Ho CM, Wong MP, Ng WF, Lau SK, Lam KH. Pathological basis of surgery in the management of postradiotherapy cervical metastasis in nasopharyn- geal carcinoma. Arch Otolaryngol Head Neck Surg 1992;118:923-9.
- Sanguineti G, Geara FB, Garden AS, Tucker SL, Ang KK, Morrison WH, et al. Carcinoma of the nasophar- ynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys 1997;37:985-96.
- Chan AT, Teo PM, Leung TW, Johnson PJ. The role of chemotherapy in the management of nasopharyngeal carcinoma. Cancer 1998;82:1003-12.
- Tsao SY, Shiu WC. Radiotherapy and chemotherapy for nasopharyngeal carcinoma. Ear Nose Throat J 1990; 69:272-8.
- Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiothera- py in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16:1310-7.
- Ensley JF, Youssef E, Kim H, Yoo G. Locally advanced nasopharyngeal cancer. Curr Treat Options Oncol 2001;2:15-23.
- Kang MY, Holland JM, Stevens KR Jr. Cranial neuropa- thy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx. J Laryngol Otol 2000;114:308-10.
- Stern Y, Marshak G, Shpitzer T, Segal K, Feinmesser R. Vocal cord palsy: possible late complication of radio- therapy for head and neck cancer. Ann Otol Rhinol Laryngol 1995;104:294-6.
- Janfaza P, Richard LF. Oral cavity. In: Janfaza P, editor. Surgical anatomy of the head and neck. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 332-3.
- Tsai MH, Shiau YC, Kao CH, Shen YY, Lin CC, Lee CC. Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro- 2-deoxyglucose in patients with indeterminate mag- netic resonance imaging findings after radiotherapy. J Cancer Res Clin Oncol 2002;128:279-82.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | August 20, 2010 |
| Published in Issue | Year 2010 Volume: 20 Issue: 4 |