Reversible compression of left recurrent laryngeal nerve (ortner’s syndrome) in acute pulmonary embolism

AbstractHoarseness of voice due to paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis as discussed by Ortner, is a subject of controversy. Different authors have cited different mechanisms as explanation. A variety of cardiac problems such as primary pulmonary hypertension, ischaemic heart disease, various congenital heart disorders can all lead to paralysis of the left recurrent laryngeal nerve. Most authors believe that pressure in the pulmonary artery causes the nerve compression. In Papua New Guinea cor pulmonale and rheumatic heart disease are the commonest cardiac disorders seen. Ortner's syndrome is a rarity and has never been reported from here before. Here three different case reports are presented with mitral stenosis, primary pulmonary hypertension and combined mitral stenosis and regurgitation and the pathogenesis of hoarseness is discussed.

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Cardiovocal Syndrome (Ortner's Syndrome) Associated with Chronic Thromboembolic Pulmonary Hypertension and Giant Pulmonary Artery Aneurysm: Case Report and Review of the Literature

Case Reports in Medicine ◽

10.1155/2012/230736 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Jaakko Heikkinen ◽

Katrin Milger ◽

Enrique Alejandre-Lafont ◽

Christian Woitzik ◽

Detlef Litzlbauer ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Laryngeal Nerve ◽

Laryngeal Nerve Palsy ◽

Thromboembolic Pulmonary Hypertension ◽

Left Recurrent Laryngeal Nerve ◽

Ortner’S Syndrome

Cardiovocal syndrome or Ortner's syndrome is hoarseness due to left recurrent laryngeal nerve palsy caused by mechanical affection of the nerve from enlarged cardiovascular structures. Chronic thromboembolic pulmonary hypertension is extremely rarely found to cause this syndrome. We describe a case of a 56-year-old patient with sudden onset of hoarseness. The patient had known long standing severe pulmonary hypertension. Fiberoptic laryngoscopy showed left vocal cord palsy. Computed tomography of the neck and chest revealed extensive enlargement of the pulmonary arteries and excluded a malignant tumor. The diagnosis of cardiovocal syndrome was retained. It is important for the radiologist to be aware of this possible etiology causing left recurrent laryngeal nerve palsy and to understand its mechanism.

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Ortner’s syndrome: a case report and literature review

Radiologia Brasileira ◽

10.1590/0100-3984.2013.1836 ◽

2015 ◽

Vol 48 (4) ◽

pp. 260-262 ◽

Cited By ~ 4

Author(s):

Bruno Landim Dutra ◽

Lenilton da Costa Campos ◽

Hélder de Castro Marques ◽

Vagner Moysés Vilela ◽

Rodolfo Elias Diniz da Silva Carvalho ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Literature Review ◽

Recurrent Laryngeal Nerve ◽

Aortic Arch ◽

Vocal Cord Paralysis ◽

Laryngeal Nerve ◽

Inferior Wall ◽

Left Recurrent Laryngeal Nerve ◽

Ortner’S Syndrome

Abstract The authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

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Ortner’s syndrome secondary to thoracic aortic aneurysm: a case series

10.21203/rs.3.rs-245550/v1 ◽

2021 ◽

Author(s):

Zhiwen Zhang ◽

Hai Feng ◽

Xueming Chen ◽

Wenrui Li

Keyword(s):

Aortic Aneurysm ◽

Recurrent Laryngeal Nerve ◽

Thoracic Aortic Aneurysm ◽

Case Series ◽

Thoracic Endovascular Aortic Repair ◽

Laryngeal Nerve ◽

Endovascular Aortic Repair ◽

Aortic Repair ◽

Left Recurrent Laryngeal Nerve ◽

Ortner’S Syndrome

Abstract Background: Ortner syndrome refers to vocal cord paralysis resulting from compression of the left recurrent laryngeal nerve by abnormal mediastinal vascular structures. This retrospective case series details our experience with Ortner’s syndrome due to thoracic aortic aneurysm. Methods: This study was a retrospective analysis of a case series. A total of 4 patients (mean age, 65.5 years) with Ortner’s syndrome due to thoracic aortic aneurysm who underwent thoracic endovascular aortic repair from July 2014 to May 2020. The patients’ demographics, comorbidities, initial symptoms, time from hoarseness to treatment, aneurysm shape and size, surgical procedures and outcome were summarized. Results: A total of 4 patients with Ortner’s syndrome due to thoracic aortic aneurysm were analyzed. All of them underwent thoracic endovascular aortic repair with no complication during hospitalization period. At a mean follow-up of 26.8 (8-77) months, 3 patients’ hoarseness had completely resolved or improved, one patient’s symptoms had not progressed. Conclusions: Hoarseness due to left recurrent laryngeal nerve palsy can be the presenting symptom of thoracic aortic aneurysm. Early diagnosis leads to timely treatment of these patient which may be helpful to functional recovery of the symptoms.

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Ortner's syndrome: a centenary review of unilateral recurrent laryngeal nerve palsy secondary to cardiothoracic disease

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138848 ◽

1997 ◽

Vol 111 (9) ◽

pp. 869-871 ◽

Cited By ~ 21

Author(s):

Andrea Simone Thirlwall

Keyword(s):

Recurrent Laryngeal Nerve ◽

Cardiac Disease ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Clinical Entity ◽

Thoracic Aneurysm ◽

Laryngeal Nerve Palsy ◽

Left Recurrent Laryngeal Nerve ◽

Ortner’S Syndrome

AbstractOrtner's Syndrome (described 100 years ago in 1897) is a clinical entity with hoarseness due to a left recurrent laryngeal nerve (LRLN) palsy caused by cardiac disease. A 35-year-old woman presented with a LRLN palsy due to a huge thoracic aneurysm. The anatomy of the LRLN and the cardiothoracic complaints which may cause the palsy are discussed.

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