Evaluation of recurrent nerve paralysis due to thoracic aortic aneurysm and aneurysm repair.
OBJECTIVE
We sought to clarify the relationship between the outcome of recurrent laryngeal nerve paralysis with the characteristics of the thoracic aortic aneurysm and the surgical procedure used in each patient.


METHODS
Nine patients who developed recurrent nerve paralysis (nonsurgical paralysis) due to a thoracic aortic aneurysm alone and 14 patients who underwent artificial vessel replacement for thoracic aortic aneurysm and developed recurrent nerve paralysis postoperatively (surgical paralysis) were evaluated.


RESULTS
In the patients with nonsurgical paralysis, the aneurysms were similar in size to those of other patients who underwent surgery of the thoracic aorta and were invariably located near the aortic arch. Aneurysm shape was not associated with nerve paralysis. Surgical paralysis was alleviated in two patients. Surgical paralysis was observed in 9% of those who underwent surgery of the thoracic aorta. Vocal cord mobility recovered in 4 of the 11 patients with surgical paralysis who underwent follow-up. Symptoms were alleviated by rehabilitation in many patients who did not recover vocal cord mobility. The positions of the artificial vessel anastomoses are thought to be closely related to the outcome of paralysis.


CONCLUSIONS
Recurrent nerve paralysis reduced not only the patient's quality of life but also survival by leading to disorders including aspiration pneumonia. Therefore, early rehabilitation should be performed, and surgical treatment should be considered, if necessary, for patients with recurrent nerve paralysis.
Ishii
Kosuke
K
Department of Otorhinolaryngology, Omiya Medical Center, Jichi Medical School, 1-847 Amanuma-cho, Saitama-shi, Saitama 330-8503, Japan. k-ishii@jichi.ac.jp
Adachi
Hideo
H
Tsubaki
Keiju
K
Ohta
Yasushi
Y
Yamamoto
Masanori
M
Ino
Takashi
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011859:Radiography; D012009:Recurrent Laryngeal Nerve; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation