Cranial Nerve Palsies: a Rare, Long-Term Complication of Radiotherapy for Nasopharyngeal Carcinoma
Alcon, A.; Geiger, E.J.; Pandit, A.; McGregor, A.; Narayan, D.
Connecticut Medicine 79(9): 543-546
2015
ISSN/ISBN: 0010-6178 PMID: 26630706 Document Number: 679411
Cranial nerves (CN) are believed to be relatively resistant to radiotherapy (RT); however, there have been case reports of cranial nerve palsy (CNP) following RT. We present a case of a gentleman with cranial nerve palsy of CN V and VII after RT for nasopharyngeal carcinoma (NPC). A 54-year-old male presented to our clinic with masticatory difficulty, facial hypoesthesia, and dysphagia. In 1998, he was treated with external beam RT for NPC. He underwent sural nerve grafting, anastomosing his functioning hypoglossal nerve to the buccal branch of the facial nerve in an end-to-side fashion, and direct implantation of a nerve graft from the spinal accessory to the masseter muscle. He unfortunately was unable to regain masticatory function postoperatively. Cranial nerve palsies are severely debilitating to patients and difficult to treat. Radiation-induced CNP is important to consider in the differential diagnosis in patients previously treated for NPC.