Burns B V, Shotton J C
Department of Otolaryngology, Kent County Ophthalmic and Aural Hospital, Maidstone, UK.
J Laryngol Otol. 1998 May;112(5):485-7. doi: 10.1017/s002221510014085x.
We report two patients with Hodgkin's disease on chemotherapy, one with vincristine, the other with vinblastine, who were referred to the ENT department with a vocal fold palsy. These drugs are commonly used in the treatment of haematological malignancies, and head and neck sarcomas. Examination showed a unilateral immobile fold. No causative local pathology was identified, and they were otherwise thought to be achieving remission, but the development of a fold palsy suggested a poor response to treatment. One patient's palsy resolved following completion of chemotherapy, but the other patient's persists, despite an otherwise good response to the treatment. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial mononeuropathies are a rare side-effect. A total of 27 previous cases of vocal fold palsy have been reported with the use of the vinca alkaloids, and such a lesion should not be assumed to be due to advancing lymphoma.
我们报告了两名正在接受化疗的霍奇金病患者，一名使用长春新碱，另一名使用长春花碱，他们因声带麻痹被转诊至耳鼻喉科。这些药物常用于治疗血液系统恶性肿瘤以及头颈部肉瘤。检查显示单侧声带固定不动。未发现引起该症状的局部病变，并且认为他们在其他方面正处于缓解期，但声带麻痹的出现提示对治疗反应不佳。一名患者的麻痹在化疗完成后得到缓解，但另一名患者的麻痹仍然存在，尽管在其他方面对治疗反应良好。长春花生物碱具有神经毒性，通常会导致周围神经病变，但颅单神经病是一种罕见的副作用。此前共报告了27例使用长春花生物碱后出现声带麻痹的病例，不应将这种病变假定为是由进展性淋巴瘤所致。
