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Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the
recurrent laryngeal nerves. Ortner’s Syndrome in the Modern Era: A Series of 7 Cases. Abdelnabi N.
Eshak Ibrahim M. Attia Mahmoud M. Abdelkader Y. Saleh A. Almaghraby Medicine
Echocardiography 2020 TLDR A case of Ortner's syndrome due to a large pulmonary artery
aneurysm in a woman with history of bilharziasis is reported. Tepedino Medicine International
Archives of Otorhinolaryngology 2015 TLDR Routine exam of the vocal folds in all patients with a
heart condition is suggested, and the use of imaging to reduce the number of emergency procedures
is suggested. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the
aortic arch, is more frequently involved than the right nerve, which passes around the subclavian
artery. Early management of underlying condition and advanced treatment of vocal cord palsy might
improve hoarseness of voice. Owing to the rarity of vocal fold paralysis in heart disease, the
importance of a constantly dilated pulmonary artery under tension has been stressed 22, 23. Indirect
laryngoscopy showed paralysed left vocal cord. Expand 9 Save Vocal cord paralysis associated with
pulmonary emboli. Robert E. Albertini Medicine Chest 1972 TLDR Perfusion lung scanning should
be a part of the evaluation of patients with paralysis of the left vocal cord, when recurrent pulmonary
embolization is a possibility. Hoarseness due to aortic aneurysm is a rare entity. However, over the
years, many authors in their studies, although unable to fully explain the mechanism of the
syndrome, emphasized importance of other factors besides atrial dilatation. It has been hypothesised
by some that patients with arteriosclerotic heart diseases suddenly suffered left recurrent laryngeal
nerve paralysis because rapid onset of left ventricular failure produced sudden pulmonary
hypertension with acute dilatation of the pulmonary vessels. Arango Guerra Carolaine Ortega-
Agamez Sebastian Naranjo-Restrepo Semantic Scholar Semantic Scholar's Logo Figure 1 of 2 Stay
Connected With Semantic Scholar Sign Up What Is Semantic Scholar. We believe the aneurysm
causes the left recurrent laryngeal nerve compression, resulting in unilateral vocal cord paralysis.
Objectives To discuss the pathogenesis of hoarseness resulting from cardiovascular disorders
involving the recurrent laryngeal nerve along with the findings of literature review. Other
cardiovascular abnormalities have been noted as important causes of Ortner's syndrome, including
aortic arch aneurysm, persistent ductus arteriosus, pulmonary artery aneurysm, Eisenmenger's
syndrome, primary pulmonary hypertension, and atrial and ventricular septal defects. Expand 19 PDF
1 Excerpt Save Vocal cord paralysis associated with pulmonary emboli. Robert E. Albertini Medicine
Chest 1972 TLDR Perfusion lung scanning should be a part of the evaluation of patients with
paralysis of the left vocal cord, when recurrent pulmonary embolization is a possibility. However,
because of rarity and lack of proper attention to changes in voice in a patient with cardiovascular or
other pathology, this is likely that some cases might be missed. The patient exhibited clinical features
of scoliosis, hoarseness, sensory and motor neurological deficit and vertical upbeat jerk nystagmus.
This page appears when Google automatically detects requests coming from your computer network
which appear to be in violation of the Terms of Service. Hasegawa Medicine Journal of the American
College of Cardiology 1985 32 PDF 1 Excerpt Save Ortner's syndrome: - case series and literature
review V. For all open access content, the Creative Commons licensing terms apply. CASE 2 A 17-
year old boy diagnosed to have rheumatic heart disease (mitral stenosis with mitral regurgitation)
was referred to the ENT clinic for hoarseness of voice of 7 months duration. Echocardiography
showed a dilated pulmonary artery with right ventricular hypertrophy. Malays J Med Sci. 2012;11
(2): 65-8. Free text at pubmed - Pubmed citation. Echocardiography revealed moderate mitral
stenosis, only mildly dilated left atrium (41 mm) and severe pulmonary hypertension (pulmonary
artery systolic pressure 92 mmHg). Learn more Sometimes you may be asked to solve the
CAPTCHA if you are using advanced terms that robots are known to use, or sending requests very
quickly. This page checks to see if it's really you sending the requests, and not a robot. His
investigations revealed: atrial fibrillation in ECG; severe mitral stenosis, mild mitral regurgitation,
moderate aortic regurgitation, dilated left atrium (52 mm) and PASP 72 mmHg in echocardiography.
Cardiac apex was found in the left 5 th intercostal space, 1cm lateral to mid-clavicular line.
Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen
Institute for AI. Published in Cureus 2023 Ortner's Syndrome (Cardiovocal Syndrome): A Case
Report P. Mishra Medicine Saudi Journal for Health Sciences 2023 TLDR A case of 71 years male,
who presented with insidious onset hoarseness of voice, and two aneurysms from the arch of aorta
compressing on the left recurrent laryngeal nerve, which retained the diagnosis of Cardiovocal
syndrome. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the
aortic arch, is more frequently involved than the right nerve, which passes around the subclavian
artery. Expand 17 PDF Save Ortners Syndrome: A Rare Cause of Hoarseness of Voice A. The block
will expire shortly after those requests stop. Expand 248 Save Current aetiology of unilateral vocal
fold paralysis in a teaching hospital in the West of Scotland. S. Loughran C. Alves F. Macgregor
Medicine Journal of Laryngology and Otology 2002 TLDR In the hospital population in the West of
Scotland, there is a high rate of vocal fold palsy secondary to bronchogenic carcinoma, likely to be
associated with the high levels of smoking found in Scotland. Thoracoabdominal CT angiography
was performed to rule out an aortic dissection. Ears, nose and throat evaluation showed left vocal
cord palsy and CT scan revealed an aortic arch aneurysm. SJR uses a similar algorithm as the Google
page rank; it provides a quantitative and qualitative measure of the journal's impact. Hoarseness may
occur due to compression of the left recurrent laryngeal nerve by the aneurysm, though rare. His
investigations revealed: ESR 110 mm in first hour, Mantoux test positive (15 mm), acid fast bacilli in
bronchoalveolar lavage fluid, left hilar lesion in chest X-ray, and left vocal cord palsy in FOL. The
patient exhibited clinical features of scoliosis, hoarseness, sensory and motor neurological deficit and
vertical upbeat jerk nystagmus. Expand 56 PDF Save Ortner syndrome in infants Syed Ahmed Zaki
S. Asif P. Shanbag Medicine Indian Pediatrics 2010 TLDR It is believed that the dilated pulmonary
artery caused compression of the left recurrent laryngeal nerve resulting in hoarseness of voice.
Ortner’s syndrome is described as hoarseness of voice caused by compression of the left recurrent
laryngeal nerve of cardiovascular origin. While staying in the village, suddenly her condition
deteriorated and on the way to the hospital she expired. DISCUSSION: Hoarseness of voice due to
paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis was
first discussed by Nobert Ortner, a Viennese physician, in1897. Carlos Zamora J. M. Gomez Carrasco
A. Jurado Ramos Medicine BMJ Case Reports 2014 TLDR A 67-year-old man who was an active
smoker, with a clinical history of ischaemic cardiopathy, hypertension, who presented to the
emergency room with hoarseness of voice of 2?weeks duration, eventually resolved during the
following weeks. Since then, the term Ortner's syndrome has come to encompass any nonmalignant,
cardiac, intrathoracic process that results in embarrassment of either recurrent laryngeal nerve-usually
by stretching, pulling, or compression; and causes vocal fold paralysis. A rumbling mid-diastolic
murmur was heard in the apical area. CASE 3 A 66-year old male, on treatment for hypertension for
the last 20 years, presented to the ENT clinic complaining of hoarseness for over 8 months,
apparently precipitated by an attack of common cold. The clinical profile of the patients including
follow up has been presented. Aetiology The original description of Ortner syndrome is due to a
markedly distended left atrium secondary to mitral stenosis which has a reported incidence of 1.5%
to 6% 7. Other causes include 1-7. Expand 120 Save Chronic traumatic aneurysms of the thoracic
aorta A. Thevenet C. Cailar Medicine World Journal of Surgery 2005 TLDR Due to the lethal risk of
rupture, traumatic aneurysms of the thoracic aorta have to be looked for systematically and treated
surgically and died in the operating room before completion of the repair. She was on anti-TB drugs
for the presumptive diagnosis of pulmonary tuberculosis. To browse Academia.edu and the wider
internet faster and more securely, please take a few seconds to upgrade your browser. He was given
anti-TB treatment, and the patient is doing well now. Expand Save Unilateral recurrent nerve palsy
and cardiovascular disease - Ortner's syndrome. Expand 25 1 Excerpt Save Current Concepts in the
Management of Unilateral Recurrent Laryngeal Nerve Paralysis after Thyroid Surgery D. Hartl J.
Travagli S. Leboulleux E. Baudin D. Brasnu M. Schlumberger Medicine 2005 TLDR An update on
the pathophysiological concepts and patient management in a common complication of thyroid
surgery, unilateral recurrent laryngeal nerve paralysis (URLNP), which is frequently well tolerated
but may be life threatening by inducing aspiration pneumonia. Keywords: cardiovascular diseases
hoarseness recurrent laryngeal nerve.
Indirect laryngoscopy revealed a paralysed left vocal fold. Owing to the rarity of vocal fold paralysis
in heart disease, the importance of a constantly dilated pulmonary artery under tension has been
stressed 22, 23. Ortner syndrome. Reference article, Radiopaedia.org (Accessed on 22 Feb 2024).
By submitting the manuscript to this journal, the authors agree to these terms. All manuscripts must
be submitted in English. Benninger John B. Gillen Jerald S. Altaian Medicine The Laryngoscope
1998 TLDR Data indicate a changing etiology of vocal fold immobility, with growing percentages of
extralaryngeal malignancies and surgery?related injuries, and implications for the timing and method
of management based on anticipated outcome. There was clinical improvement, however, the
hoarseness of voice did not change significantly. Chest X-ray PA view showing well- defined
lobulated mediastinal lesion on the left side. He explained that hoarseness was caused by
compression of the left recurrent laryngeal nerve by the enlarged left atrium. Arango Guerra
Carolaine Ortega-Agamez Sebastian Naranjo-Restrepo Semantic Scholar Semantic Scholar's Logo
Figure 1 of 2 Stay Connected With Semantic Scholar Sign Up What Is Semantic Scholar.
Availability of FOL has eased the confirmation of vocal cord palsy, as is the issue in our series.
Tuberculosis may be an important aetiology in endemic zone. Keywords: cardiovascular diseases
hoarseness recurrent laryngeal nerve. However, during the period of observation, hoarseness of voice
did not improve in any patient. Echocardiography showed a dilated left atrium with tight mitral
stenosis and mitral regurgitation. His investigations revealed: atrial fibrillation in ECG; severe mitral
stenosis, mild mitral regurgitation, moderate aortic regurgitation, dilated left atrium (52 mm) and
PASP 72 mmHg in echocardiography. Chest X-ray Posteroanterior (PA) view showed cardiomegaly.
Todos os manuscritos devem ser submetidos em ingles. Expand 11 Save Left vocal-cord paralysis
associated with hypertensive heart disease. W. Diefenbach Medicine The New England journal of
medicine 1949 TLDR Vocal-cord paralysis is frequently observed in various forms of intrathoracic
disease, such as aortic aneurysm, mediastinal tumors, pleuritic thickening and pulmonary
tuberculosis, and its occurrence in only a small percentage of cardiac conditions is not clear. This
case may also be accepted as a different cause of cardiovocal syndrome. Vybrane otazky na prikladu
pokoncilnich eucharistickych modliteb rimske liturgie (Anafora jako tekst teologiczny. The left
recurrent laryngeal nerve arises from the left vagus (X) nerve and passes underneath the aortic arch
posterior to the ligamentum arteriosum before it ascends into the left tracheoesophageal groove to
reach the larynx 8. Chest examination was essentially normal and cardiovascular examination was
suggestive of aortic regurgitation. In the meantime, solving the above CAPTCHA will let you
continue to use our services. In this paper, the authors present a rare case of left vocal cord paralysis
as the presenting sign of an aortic arch aneurysm, in order to draw attention to the clinical
manifestations of the underlying pathology and to highlight the importance of a. Objectives To
discuss the pathogenesis of hoarseness resulting from cardiovascular disorders involving the
recurrent laryngeal nerve along with the findings of literature review. We believe the aneurysm
causes the left recurrent laryngeal nerve compression, resulting in unilateral vocal cord paralysis. You
will be able to get a quick price and instant permission to reuse the content in many different ways.
This traffic may have been sent by malicious software, a browser plug-in, or a script that sends
automated requests. Ortner's syndrome. Indian Heart J. 1972;24 (1): 43-6. Pubmed citation. Rathi
Vinod Gite Kanchan Tadke Medicine 2016 TLDR A case of 40 yr female with hoarseness of voice
due to severe mitral stenosis is reported and literature for possible cardiovascular causes of cardio
vocal syndrome is reviewed.
Ortner's syndrome. Indian Heart J. 1972;24 (1): 43-6. Pubmed citation. You can either rephrase your
question or wait until it is less busy. Semantic Scholar is a free, AI-powered research tool for
scientific literature, based at the Allen Institute for AI. Expand 25 1 Excerpt Save Unilateral vocal
cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngeal
nerves. He was offered anti-TB drugs, but while on anti-TB therapy, the patient developed huge
pericardial effusion. Published in Cureus 2023 Ortner's Syndrome (Cardiovocal Syndrome): A Case
Report P. Monwarul Islam AKM, Shimu IJ, Ananya KF, Sultana R, Alam S (2018) Ortner’s
Syndrome in the Modern Era: A Series of 7 Cases. The nerve injury is commonly caused by the
pressure effect on the nerve by the dilated left atrium in mitral stenosis. He deduced the cause to be
compression of the left recurrent laryngeal nerve by an enlarged left atrium 2. In our series, we found
aneurysm of the arch of the aorta in 1 case. Keywords: cardiovascular diseases hoarseness recurrent
laryngeal nerve. Prognosis is mainly determined by underlying condition. American journal of
neuroradiology 2001 TLDR A patient with long-standing patent ductus arteriosus (PDA) in whom
CT studies obtained before and after paralysis developed showed an interval increase in size of the
pulmonary trunk. Rathi Vinod Gite Kanchan Tadke Medicine 2016 TLDR A case of 40 yr female
with hoarseness of voice due to severe mitral stenosis is reported and literature for possible
cardiovascular causes of cardio vocal syndrome is reviewed. She was given rheumatic fever
prophylaxis, additional antibiotics, chest physiotherapy, bronchodilators, diuretics and nifedipine.
Mitral stenosis is a well-recognized cause; however, because of control of rheumatic fever and
rheumatic heart disease in many parts of the world, there may be a shift of the underlying aetiology
to other cardiac and non-cardiac conditions. While staying in the village, suddenly her condition
deteriorated and on the way to the hospital she expired. Expand 17 PDF Save Ortners Syndrome: A
Rare Cause of Hoarseness of Voice A. Pathology Left recurrent laryngeal nerve palsy in this
condition is due to traction or compression of the nerve between the thoracic aorta and pulmonary
artery 1-7. High degree of clinical suspicion is essential for making the diagnosis. HS Glazer DJ
Aronberg JK Lee SS Sagel Medicine AJR. Pericardial effusion appears to be an important cause, and
it was found in 2 cases presented here. Indirect laryngoscopy should be routinely performed in all
cases of heart disease. Expand 56 PDF 1 Excerpt Save Ortner’s syndrome: a case report and review
of the literature A. R. Hurtarte Sandoval R. Subsequently, the syndrome has been described in adult
patients with various cardiovascular diseases. Bailey Medicine The American surgeon 1993 TLDR It
is concluded that patients who have previously had aortic or cardiac surgery or a history of blunt
chest trauma presenting with unusual cardiorespiratory symptoms should be aggressively evaluated
for PTA. Ortner's syndrome in association with mitral valve prolapse. Physical examination showed a
normal pulse and blood pressure. Download Free PDF View PDF RECURRENT VOCAL CORD
PARALYSIS ASSOCIATED WITH RIGHT AORTIC ARCH Omer Karakoc We report the first
case of right recurrent vocal cord paralysis associated with right aortic arch. Expand 65 2 Excerpts
Save Left vocal cord paralysis associated with long-standing patent ductus arteriosus. M. Nakahira
H. Nakatani T. Takeda Medicine AJNR.
Gibbs Medicine Pulmonary Circulation 2015 TLDR 2 cases of tracheobronchial compression are
reported: first, anAdult patient with idiopathic pulmonary arterial hypertension who presents with
symptomatic left main bronchus compression, and second, an adult patient with Eisenmenger
ventricular septal defect and right-sided aortic arch, with progressive intermedius and right middle
lobe bronchi compression in association with enlarged pulmonary arteries. Nerve compression
between the aorta and tense pulmonary artery is a constant factor in all cases. Expand PDF Save
Lessons of the month: A forgotten classic: Delayed diagnosis of mitral stenosis presenting initially as
Ortner's syndrome. R. Shariff H. A. Abidin S. Kasim Medicine Clinical medicine 2020 TLDR It
remains pertinent for clinicians to be aware of clinical features linked to mitral stenosis including its
more uncommon presentations, such as in this case, as earlier intervention may improve prognosis.
Expand 11 Save Left vocal-cord paralysis associated with hypertensive heart disease. W. Diefenbach
Medicine The New England journal of medicine 1949 TLDR Vocal-cord paralysis is frequently
observed in various forms of intrathoracic disease, such as aortic aneurysm, mediastinal tumors,
pleuritic thickening and pulmonary tuberculosis, and its occurrence in only a small percentage of
cardiac conditions is not clear. On auscultation, the first heart sound and the pulmonary component
of the second heart sound were loud. Download Free PDF View PDF RECURRENT VOCAL
CORD PARALYSIS ASSOCIATED WITH RIGHT AORTIC ARCH Omer Karakoc We report the
first case of right recurrent vocal cord paralysis associated with right aortic arch. By submitting the
manuscript to this journal, the authors agree to these terms. All manuscripts must be submitted in
English. Thus, the syndrome is now also termed as cardiovocal syndrome. No other neurological or
cardiorespiratory symptoms were found. In our observation, left atrium was, in fact, of normal
diameter (. Expand 13 2 Excerpts Save Cardiovocal syndrome: a systematic review. S. Mulpuru B.
Vasavada G. Punukollu Ashit G. Patel Medicine Heart, Lung and Circulation 2008 97 Save Ortner's
syndrome: - case series and literature review V. The patient was offered 6 cycles of palliative
chemotherapy. Though mitral stenosis is the classical cause, other cardiac and non-cardiac causes are
being increasingly recognized. Various cardiopulmonary conditions associated with left recurrent
laryngeal nerve palsy, have been described, over the last 100 years. Indirect laryngoscopy revealed a
paralysed left vocal cord in paramedian position. Other cardiovascular abnormalities have been noted
as important causes of Ortner's syndrome, including aortic arch aneurysm, persistent ductus
arteriosus, pulmonary artery aneurysm, Eisenmenger's syndrome, primary pulmonary hypertension,
and atrial and ventricular septal defects. This page appears when Google automatically detects
requests coming from your computer network which appear to be in violation of the Terms of
Service. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and
qualitative measure of the journal's impact. See Full PDF Download PDF See Full PDF Download
PDF Related Papers Ortners Syndrome: A Rare Cause of Hoarseness of Voice SSR Institute of
International Journal of Life Sciences INTRODUCTION: Hoarseness of voice is a very common
symptom seen in the ENT outpatient department. Aortic diseases and pericardial effusion as the
cause of OS, are being increasingly recognized. Tuberculosis is a common cause of pericardial
effusion in South Asia, so, this infectious disease may be an important cause of OS regionally.
Tepedino Medicine International Archives of Otorhinolaryngology 2015 TLDR Routine exam of the
vocal folds in all patients with a heart condition is suggested, and the use of imaging to reduce the
number of emergency procedures is suggested. Expand 1 PDF Save Ortner’s Syndrome in an Infant
With Congenital Heart Disease Marcelino Murillo-Deluquez C. Expand Save Unilateral recurrent
nerve palsy and cardiovascular disease - Ortner's syndrome. Chest X-ray PA view showing well-
defined lobulated mediastinal lesion on the left side. Fine-needle aspiration cytology (FNAC) of
cervical lymph nodes established the diagnosis of metastatic adenocarcinoma. Expand 248 Save
Current aetiology of unilateral vocal fold paralysis in a teaching hospital in the West of Scotland. S.
Loughran C. Alves F. Macgregor Medicine Journal of Laryngology and Otology 2002 TLDR In the
hospital population in the West of Scotland, there is a high rate of vocal fold palsy secondary to
bronchogenic carcinoma, likely to be associated with the high levels of smoking found in Scotland.
Expand 56 PDF Save Ortner syndrome in infants Syed Ahmed Zaki S. Asif P. Shanbag Medicine
Indian Pediatrics 2010 TLDR It is believed that the dilated pulmonary artery caused compression of
the left recurrent laryngeal nerve resulting in hoarseness of voice. However, because of rarity and lack
of proper attention to changes in voice in a patient with cardiovascular or other pathology, this is
likely that some cases might be missed. By visiting this site you agree to the foregoing terms and
conditions.