Chen Yun-Chiang, Lu Shiang-Ru, Wang Yi-Chi, Yang Shu-Yu, Hsiao Pei-Chi
Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, TWN.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, TWN.
Cureus. 2025 May 24;17(5):e84762. doi: 10.7759/cureus.84762. eCollection 2025 May.
Nasopharyngeal carcinoma (NPC) is prevalent in East and Southeast Asia, with radiotherapy being the primary treatment modality. Carotid artery stenosis is a serious but often overlooked complication of radiotherapy. We present the case of a middle-aged NPC survivor who developed progressive symptoms, including left facial numbness, dysphagia, tongue atrophy, postural dizziness, and pulsatile tinnitus, 18 years after concurrent chemoradiation. Carotid ultrasound revealed high-grade stenosis of the left cervical internal carotid artery. Following carotid stenting, his dizziness and tinnitus resolved. This case illustrates the insidious progression of carotid stenosis after radiotherapy and underscores the importance of early vascular assessment in post-radiation patients with atypical symptoms such as pulsatile tinnitus. Clinicians should maintain a high index of suspicion in at-risk individuals, and physical therapists should adopt precautionary rehabilitation strategies to minimize the risk of vascular complications.
鼻咽癌（NPC）在东亚和东南亚地区较为常见，放射治疗是主要的治疗方式。颈动脉狭窄是放射治疗的一种严重但常被忽视的并发症。我们报告了一例中年鼻咽癌幸存者的病例，该患者在同步放化疗18年后出现进行性症状，包括左侧面部麻木、吞咽困难、舌萎缩、姿势性头晕和搏动性耳鸣。颈动脉超声显示左侧颈内动脉高度狭窄。在进行颈动脉支架置入术后，他的头晕和耳鸣症状得到缓解。该病例说明了放疗后颈动脉狭窄的隐匿进展，并强调了对有搏动性耳鸣等非典型症状的放疗后患者进行早期血管评估的重要性。临床医生应对高危个体保持高度警惕，物理治疗师应采取预防性康复策略，以尽量降低血管并发症的风险。
