title: Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm.
abstract: Blunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved. Hoarseness associated with a dilated left atrium in a patient with mitral valve stenosis was initially described by Ortner more than a century ago. Since then several non malignant, cardiovascular, intrathoracic disease that results in embarrassment from recurrent laryngeal nerve palsy usually by stretching, pulling or compression; thus, the correlations of these pathologies was termed as cardiovocal syndrome or Ortner's syndrome. The reported case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.
authors.affiliation: Department of Neuros-cience Reproductive and Dentistry Sciences, Otholaryngology Unit; University of Naples "Federico II", Naples - Italy. Via G. Filangieri 36, 80121 Napoli, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mesolella
authors.affiliation: Department of Neuroscience Reproductive and Dentistry Sciences, Otholaryngology Unit; University of Naples "Federico II", Naples, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Ricciardiello
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology, Head and Neck Surgery Unit; Second University of Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Varriale
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences; Otolaryngology, Head and Neck Surgery Unit; Second University of Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Testa
keywords: Ortner’s syndrome; Recurrent nerve paralysis; aortic pseudoaneurysm; cardiovocal syndrome