Hypernasality - a rare initial symptom of a cerebellar astrocytoma

Nasality is a disorder due to nasal resonance, which may be induced by a va riety of etiologies. Transitional hypernasality is frequently seen in child ren after adenoidectomy. The alleged post-surgical hypernasality in the cas e presented was shown to be related to the late detection of an astrocytoma of the cerebellum and the brain stem in a 6-year-old boy. This case was ch aracterized by increased hypernasality which failed speech therapy. A devel oping one-sided vocal fold palsy in combination with an ipsilateral soft-pa late palsy indicated further investigation. Computerized tomography (CT) an d magnetic resonance imaging (MRI) revealed a brain stem-tumor with a maxim um size of 6 cm involving parts of the cerebellum. These findings demonstra ted the need for a strict follow-up, even after adenoidectomy, in the prese nce of hypernasality for identifying concurrent etiologies as well as cases suitable for speech therapy. (C) 2000 Elsevier Science Ireland Ltd. All ri ghts reserved.