PDF(Pubmed)
Abstract：
Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell\'s palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell\'s palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell\'s palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell\'s palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell\'s palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell\'s palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell\'s palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.
摘要：
伴随放化疗（CCRT）治疗的患者会出现各种并发症。我们介绍了一个罕见的CCRT后贝尔麻痹病例，并描述了其各种可能的原因，以提高临床医生对贝尔麻痹是CCRT相关不良反应的认识。该患者是一名48岁的男性，诊断为鳞状细胞癌，并表现为CCRT后贝尔氏麻痹。放疗6周后（总体67.5Gy）和四轮顺铂化疗，他抱怨整个左脸瘫痪。最后一次CCRT治疗后33天进行了一项测试，以区分贝尔麻痹与其他致病因素。根据磁共振成像结果，确定由于肿瘤大小增加而侵犯面神经不会引起贝尔氏麻痹。观察到左咽鼓管的炎症。因此，服用类固醇和泛昔洛韦，面瘫发展后56天内面瘫症状明显改善。总之,由于各种CCRT机制的复杂作用，患者可以发展为贝尔麻痹。虽然贝尔麻痹的确切原因尚未确定，在这种情况下，药物治疗的有效性值得怀疑，应通过各种测试排除不太可能的致病因素，并必须采取适当和及时的措施。
