A case of unilateral hypoglossus nerve palsy associated with chordoma in the region of clivus

We had a rare case of 50-year-old woman with a unilateral hypoglossus nerve palsy as a sign of clival chordoma. A computed tomography (CT) scan of the skull base showed bone destruction at the anterior part of the foramen magnum and CT scan of the neck reveals asymmetrical area at the base of the to...

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Bibliographic Details
Published in:European archives of oto-rhino-laryngology 2009-12, Vol.266 (12), p.2001-2003
Main Authors: Alharbi, Fahd Ali, Lenarz, Thomas, Stoever, Timo
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biopsy
Case Report
Chondroma - complications
Chondroma - diagnosis
Chondroma - surgery
Cranial Fossa, Posterior
Diagnosis, Differential
Diseases of the osteoarticular system
Female
Follow-Up Studies
Head and Neck Surgery
Humans
Hypoglossal Nerve Diseases - diagnosis
Hypoglossal Nerve Diseases - etiology
Hypoglossal Nerve Diseases - surgery
Magnetic Resonance Imaging
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Neurosurgery
Neurosurgical Procedures - methods
Otorhinolaryngology
Otorhinolaryngology. Stomatology
Skull Base Neoplasms - complications
Skull Base Neoplasms - diagnosis
Skull Base Neoplasms - surgery
Tomography, X-Ray Computed
Tumors of striated muscle and skeleton
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Summary:We had a rare case of 50-year-old woman with a unilateral hypoglossus nerve palsy as a sign of clival chordoma. A computed tomography (CT) scan of the skull base showed bone destruction at the anterior part of the foramen magnum and CT scan of the neck reveals asymmetrical area at the base of the tongue. Magnetic resonance imaging showed a mass at the skull base in the region of the clivus with bone destruction in the middle and right side of the clivus. The tumor was biopsied through transnasal biopsy from the region of the clivus using a navigation system and microscopical surgical technique. Postoperatively, the patient received radiotherapy. Surgery is the most effective treatment of chordomas. An endoscopic approach provides easy, rapid and direct access to the clivus. A postoperative radiation therapy is recommended. A carbon ion radiotherapy is an effective treatment for chordomas of the skull base with minimal side effects. Close interdisciplinary collaboration between ORL, neuroradiology, pathology and oncology is desirable for effective therapy.
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-009-1037-1