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Vernet's Syndrome (Jugular foramen Syndrome) Laryngeal paralysis

last modified on: Fri, 03/23/2018 - 07:28

 

Vocal Fold Paralysis (Vocal Cord Paralysis) Etiologies

Vocal Cord Paralysis Evaluation and Etiology

see also: Collett-Sicard Syndrome

Jugular Foramen Syndrome

Affected Cranial Nerves

Collet-Sicard syndrome IX,X,XI,XII
Villaret syndrome IX,X,XI,XII sympathetic chain (Horner's syndrome)
Vernet syndrome IX,X,XI
Jackson syndrome X,XI,XII
Schmidt syndrome X,XI
Tapia syndrome X,XII

GENERAL

Vernet's Syndrome is characterized by a constellation of unilateral cranial nerve palsies due the compression or narrowing of the jugular foramen involving the 9th, 10th, and 11th cranial nerves (nerves that travel within the jugular foramen). A diversity of lesions have been shown to be involve in the jugular foramen, such as tumors, vascular lesions, infections, and trauma

 

SYMPTOMS

Symptoms of this syndrome are consequences of paresis of the above mentioned cranial nerves (9, 10, 11).

- dysphonia/hoarseness

- soft palate dropping

- deviation of the uvula towards the normal side

- dysphagia

- loss of sensory function from the posterior 1/3 of the tongue

- decrease in the parotid gland secretion

- loss of gag reflex

- sternocleidomastoid and trapezius muscles paresis.

CAUSES

There have been case reports of a variety of causes of Vernet's syndrome. Some of the causes of Vernet's syndrome include:

   1. Primary tumors

       - Glomus jugulare tumors (most frequently) 

      - Meningioma 

      - Vestibular schwannoma

      - Cerebellopontine angle metastases

   2. Inflammation

       - meningitis

       - malignant otitis externa

       - sarcoidosis

       - Guillain-Barre syndrome

  3. Trauma

  4. Cholesteatoma (very rare)

  5.  Narrowing of jugular foramen due to bone disease

  6. Varizella-zoster virus

 7. Giant cell arteritis

  8. Internal jugular vein thrombosis

  9. Post carotid endarterctomy

  10. Systemic erythematous Lupus

  11. Large mycotic aneurysm of the extracranial internal carotid artery after acute otitis media

  12. Metastatic cancer

DIAGNOSIS

Diagnosis is usually made on clinical exam and imaging with evidence of jugular foramen compression/narrowing

 

MANAGEMENT

Treat the cause.

 

Sources


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