Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ortner's Syndrome (Cardiovocal Syndrome)
- Radiologic Findings
- Plain chest radiograph shows bulging contour-soft tissue lesion at left suprahilar area. Neck CT shows left vocal cord palsy. Chest CT shows two saccular aneurysms at isthmic portion of aortic arch.
- Brief Review
- Definition: Clinical entities manifested by hoarseness due to left recurrent laryngeal nerve palsy secondary to cardiac disease.
The left vagus nerve at the level of the aortic arch gives rise to the left recurrent laryngeal nerve. This nerve curves beneath the aorta on the outer side of ligamentum arteriosum and ascends to the groove between the esophagus and the trachea. It continues along this groove to supply all the muscles acting on the left vocal cord, except the cricothyroid muscle, which is innervated by the superior laryngeal nerve. In this syndrome, the left recurrent laryngeal nerve is thought to be injured due to compression caused by changes in the anatomy of the heart or great vessels. Cardiovascular disease is an unusual cause of vocal cord palsy, and this clinical entity is called cardiovocal syndrome. These causes include left ventricular failure, an atrial septal defect, Eisenmenger syndrome, mitral valve prolapse, primary pulmonary hypertension, an aortic aneurysm, and an aortic dissection.
- References
- 1. Lee SI, Pyun SB, Jang DH. Disphagia and hoarseness associated with painless aortic dissection: A rare case of cardiovocal syndrome. Dysogagua. 2006;21(2):129-132.
2. Annema JT et al. A rare cause of Ortner’s syndrome (cardiovocal hoarseness). Thorax. 2004;59(7):6361. Yoon YC, Lee KS, Kim TS et al. Intrapulmonary bronchogenic cyst: CT and pathologic findings in five adult patients AJR 2002;179:167-170
- Keywords
- Airway, Vascular, Vascular, left recurrent laryngeal nerve palsy secondary to cardiac disease,