Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility

Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a terti...

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Main Authors: Sharon H. Gnagi, Brittany E. Howard, Joseph M. Hoxworth, David G. Lott
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2015/219090
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author Sharon H. Gnagi
Brittany E. Howard
Joseph M. Hoxworth
David G. Lott
author_facet Sharon H. Gnagi
Brittany E. Howard
Joseph M. Hoxworth
David G. Lott
author_sort Sharon H. Gnagi
collection DOAJ
description Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner’s syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.
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spelling doaj-art-e0ba272773c84e46b4e2975a6ee739df2025-02-03T00:59:58ZengWileyCase Reports in Otolaryngology2090-67652090-67732015-01-01201510.1155/2015/219090219090Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold ImmobilitySharon H. Gnagi0Brittany E. Howard1Joseph M. Hoxworth2David G. Lott3Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Radiology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Otolaryngology-Head and Neck Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAObjective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner’s syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.http://dx.doi.org/10.1155/2015/219090
spellingShingle Sharon H. Gnagi
Brittany E. Howard
Joseph M. Hoxworth
David G. Lott
Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
Case Reports in Otolaryngology
title Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
title_full Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
title_fullStr Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
title_full_unstemmed Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
title_short Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility
title_sort acute contained ruptured aortic aneurysm presenting as left vocal fold immobility
url http://dx.doi.org/10.1155/2015/219090
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AT josephmhoxworth acutecontainedrupturedaorticaneurysmpresentingasleftvocalfoldimmobility
AT davidglott acutecontainedrupturedaorticaneurysmpresentingasleftvocalfoldimmobility