Cardiovocal Syndrome – An Aortic Arch Aneurysm As A Rare Cause Of Vocal Cord Paralysis

Abstract

Introduction: Cardiovocal or Ortner’s syndrome is a rare cause of vocal cord paralysis. Damage to the left recurrent laryngeal nerve may be caused by an aortic arch aneurysm, in even rarer cases.

Clinical case: A 60-year-old woman presented with hoarseness lasting for six months. Paralysis of the left vocal cord was confirmed with laryngoscopy and an aortic arch aneurysm was diagnosed on chest CT. Despite correction of the aortic aneurysm, her hoarseness did not improve.

Discussion: Mediastinal disease may cause vocal cord paralysis, due to the intrathoracic course of the recurrent laryngeal nerve. The assessment of the superior mediastinum on CT is mandatory in these cases. In cardiovocal syndrome, cardiovascular diseases damage the recurrent laryngeal nerve. Aortic aneurysms are a rare cause of Ortner’s, especially when they affect the distal portion of the aortic arch and stretch the left recurrent laryngeal nerve at the aortopulmonary window.