Introduction
Recurrent laryngeal nerve injury caused by
cardiovascular disease is a rare condition, and often it is the only prominent sign of an imminent break of an aortic
artery aneurysm. Objective To
report left
laryngeal paralysis caused by a great
aortic arch aneurysm and to highlight the importance of an otorhinolaryngologic evaluation along with a thoracic radiologic study. Resumed
Report A 42-year-old man complained of thickness of his
voice and
dysphagia for 3 months, but no thoracic
pain or other relevant complaints. Video
laryngoscopy revealed immobility of his left
vocal fold in the paramedian position. Imaging was obtained for investigation, including
magnetic resonance imaging of his
thorax, which showed a
fusiform aneurysm in the
aortic arch, leading to recurrent compression of the left
laryngeal nerve. The
patient was successfully treated with endovascular repair of the
aneurysm. At 2-month follow-up, there was still no recovery of the laryngeal mobility. Conclusion An aortic
artery aneurysm can suddenly break, requiring
emergency heart surgery, and the results can be fatal in many cases. We suggest routine exam of the
vocal folds in all
patients with a
heart condition, and we
review the
literature and suggest the use of imaging to reduce the number of
emergency procedures. .