VOCAL CORD PALSY - POSSIBLE LATE COMPLICATION OF RADIOTHERAPY FOR HEAD AND NECK-CANCER

Cranial nerve palsies are uncommon complications of radiotherapy for h ead and neck cancer. A review of the literature reveals that cranial n erve damage after radiotherapy has been reported for the optic, oculom otor, trigeminal, abducens, cochlear, vagus, spinal accessory, and hyp oglossal nerves. The hypoglossal nerve appears to be the most commonly affected, and the recurrent laryngeal nerve is seldom involved. The c ase 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 bil ateral palsy, and in the third patient, bilateral damage cannot be exc luded. Physical examination and radiographic investigations on admissi on and on follow-up did not demonstrate any evidence of tumor recurren ce, cervical or distant metastases, or second primary tumors. The dist inction between irradiation-induced palsy and that due to malignancies is emphasized.