Description
A man aged 15 years was referred to the otolaryngology department with a 5-year history of persistent nasal blockage and nocturnal mouth breathing. He did not report any additional sinonasal, aerodigestive tract or neurological abnormalities. Flexible nasendoscopic examination revealed adenoidal hypertrophy occluding the choanae bilaterally.
Adenoidectomy by monopolar suction diathermy under direct visualisation was performed. Following adenoidectomy, intraoperative visualisation of the surgical site revealed a well-circumscribed left of midline soft tissue swelling of the posterior pharyngeal wall.
Postoperative MRI illustrated a destructive lesion arising from the left C2/3 nerve root with extracanalicular and intracanalicular components, the latter of which was causing severe cervical cord compression (figure 1A, B). The radiological diagnosis was consistent with neurofibroma. The patient was urgently referred to neurosurgery for definitive management. Although asymptomatic, neurosurgical evaluation demonstrated an upper motor neuron syndrome affecting the upper limbs and the left lower limb. Hoffman's...
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