Radiation Oncology/Anatomy/Clinical syndromes with cn palsy

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Cerebellopontine Angle Syndrome

  • Acoustic Tumours
  • CN IX and CN VIII and CN V can be affected
  • Symptoms:
    • IX:
      • Tinnitus
      • Gag reflex decreased
    • VIII:
      • Vertigo
      • Deafness
    • V
      • Facial Sensory defecit

Jugular Foramen Syndrome (Vernet Syndrome)

  • Glomus Jugular Tumours
  • Base of skull fx
  • Meningioma
  • CN IX, X, XI
  • Symptoms:
    • Dull unilat aching pain behind ear
    • XI
      • Ipsilateral Trapezius and SCM palsy
    • IX
      • Depressed gag reflex
      • Loss of taste at post 1/3 tongue
      • Loss pf sensation of uvula
    • X
      • Dysphonia
      • Dysphagia
      • Palatal drop
      • Loss of sensation of pharynx and larynx

Retropharyngeal & Retroparotid Space Syndrome

Collet-Sicard Syndrome

  • CN IX, X, XI, XII
  • Symptoms:
    • Paralysis of the vocal cords, palate, trapezius muscle and sternocleidomastoid muscle.
    • Anaesthesia of the larynx, pharynx and soft palate.

Villaret's Syndrome (Retroparotid)

  • CN IX, X, XI, XII, Sympathetic chain and sometime CN VII
  • Symptoms:
    • IX
      • Loss of posterior taste of tongue
      • Depressed gag reflex
    • X
      • Loss of sensation of soft palate, pharynx and larynx
    • XII
      • Ipsilateral deviation of tongue
    • Sympathetic involvement
      • Horner's syndrome