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Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm.

Massimo Mesolella1, Filippo Ricciardiello2, Domenico Tafuri3

  • 1Department of Neuros-cience Reproductive and Dentistry Sciences, Otholaryngology Unit; University of Naples "Federico II", Naples - Italy. Via G. Filangieri 36, 80121 Napoli, Italy.

Open Medicine (Warsaw, Poland)
|March 30, 2017
PubMed
Summary

Aortic pseudoaneurysm after chest trauma caused hoarseness due to recurrent laryngeal nerve palsy. Endovascular repair resolved the palsy, demonstrating a correctable link between cardiovascular conditions and vocal cord dysfunction.

Keywords:
Ortner’s syndromeRecurrent nerve paralysisaortic pseudoaneurysmcardiovocal syndrome

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Area of Science:

  • Cardiology
  • Neurology
  • Trauma Surgery

Background:

  • Blunt chest and neck trauma are common in emergency settings, often from accidents.
  • These injuries can present with diverse symptoms, including hoarseness and dysphagia.
  • The Ortner's syndrome, or cardiovocal syndrome, describes hoarseness caused by cardiovascular diseases compressing the recurrent laryngeal nerve.

Purpose of the Study:

  • To report an uncommon case of hoarseness and dysphagia caused by post-traumatic aortic pseudoaneurysm.
  • To highlight the potential for cardiovascular comorbidities to manifest as vocal cord impairment.
  • To demonstrate the successful treatment and resolution of recurrent laryngeal nerve palsy.

Main Methods:

  • A patient presented with hoarseness and dysphagia following chest and neck trauma.
  • Laryngoscopy revealed left recurrent laryngeal nerve palsy.
  • CT and MR imaging identified a post-traumatic aortic pseudoaneurysm.
  • Endovascular stent graft implantation was performed to repair the pseudoaneurysm.

Main Results:

  • The patient's hoarseness and dysphagia were attributed to left recurrent laryngeal nerve palsy.
  • A post-traumatic aortic pseudoaneurysm was diagnosed as the underlying cause.
  • Endovascular repair of the pseudoaneurysm was successful.
  • Vocal cord palsy resolved completely within 30 days post-procedure.

Conclusions:

  • Life-threatening cardiovascular conditions, such as aortic pseudoaneurysm, can present with neurological symptoms like hoarseness.
  • Recurrent laryngeal nerve palsy secondary to cardiovascular pathology is potentially correctable.
  • Prompt diagnosis and treatment of aortic pseudoaneurysm can lead to recovery of vocal function.