Vocal cord paralysis due to aortic arch pseudoaneurysm

Case contributed by Keshaw Kumar
Diagnosis certain


Hoarseness of voice

Patient Data

Age: 75 years
Gender: Male

There is abduction of left vocal cord with mildly enlarged left pyriform sinus, medialization & thickening of the left aryepiglottic fold and enlarged laryngeal ventricle (sail sign), suggestive of left vocal cord paralysis.

Small pseudoaneurysm with hypodense mural thrombus, anteriorly and inferiorly from the distal portion of the aortic arch, along the course of the left recurrent laryngeal nerve.

Case Discussion

Findings are suggestive left vocal cord paralysis due to aortic arch pseudoaneurysm (Ortner syndrome).

In case of vocal cord paralysis, cause should be actively searched along the course of the recurrent laryngeal nerve from its origin in the brainstem, neck, and should always include the superior mediastinum.

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