title: Hypernasality--a rare initial symptom of a cerebellar astrocytoma.
abstract: Nasality is a disorder due to nasal resonance, which may be induced by a variety of etiologies. Transitional hypernasality is frequently seen in children after adenoidectomy. The alleged post-surgical hypernasality in the case 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 characterized by increased hypernasality which failed speech therapy. A developing one-sided vocal fold palsy in combination with an ipsilateral soft-palate palsy indicated further investigation. Computerized tomography (CT) and magnetic resonance imaging (MRI) revealed a brain stem-tumor with a maximum size of 6 cm involving parts of the cerebellum. These findings demonstrated the need for a strict follow-up, even after adenoidectomy, in the presence of hypernasality for identifying concurrent etiologies as well as cases suitable for speech therapy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Auenbrugger Platz 20 8036, Graz, Austria. w_habermann@yahoo.com
authors.forename: W
authors.initials: W
authors.lastname: Habermann
authors.forename: K
authors.initials: K
authors.lastname: Kiesler
authors.forename: H J
authors.initials: HJ
authors.lastname: Dornbusch
authors.forename: G
authors.initials: G
authors.lastname: Friedrich
mesh_terms: D000233:Adenoidectomy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011878:Radiotherapy / Q000379:methods; D013061:Speech Acoustics; D014057:Tomography, X-Ray Computed; D014832:Voice Disorders / Q000209:etiology*; D014833:Voice Quality