Stern Y, Marshak G, Shpitzer T, Segal K, Feinmesser R
Department of Otolaryngology-Head and Neck Surgery, Beilinson Medical Center, Petah-Tiqva, Israel.
Ann Otol Rhinol Laryngol. 1995 Apr;104(4 Pt 1):294-6. doi: 10.1177/000348949510400407.
Cranial nerve palsies are uncommon complications of radiotherapy for head and neck cancer. A review of the literature reveals that cranial nerve damage after radiotherapy has been reported for the optic, oculomotor, trigeminal, abducens, cochlear, vagus, spinal accessory, and hypoglossal nerves. The hypoglossal nerve appears to be the most commonly affected, and the recurrent laryngeal nerve is seldom involved. The case histories of three patients who developed vocal cord palsy from 21 to 34 years after a course of curative or postoperative radiotherapy for carcinoma of the head and neck are presented. Two patients had bilateral palsy, and in the third patient, bilateral damage cannot be excluded. Physical examination and radiographic investigations on admission and on follow-up did not demonstrate any evidence of tumor recurrence, cervical or distant metastases, or second primary tumors. The distinction between irradiation-induced palsy and that due to malignancies is emphasized.
颅神经麻痹是头颈部癌放疗罕见的并发症。文献回顾显示，放疗后已报道视神经、动眼神经、三叉神经、展神经、耳蜗神经、迷走神经、副神经和舌下神经出现损伤。舌下神经似乎是最常受影响的，而喉返神经很少受累。本文介绍了3例患者的病例史，这些患者在接受头颈部癌根治性放疗或术后放疗21至34年后出现声带麻痹。2例患者为双侧麻痹，第3例患者不能排除双侧损伤。入院时及随访时的体格检查和影像学检查未发现肿瘤复发、颈部或远处转移或第二原发性肿瘤的任何证据。强调了放疗引起的麻痹与恶性肿瘤引起的麻痹之间的区别。
