Introduction: Ortner syndrome (cardiovocal hoarseness) is characterized by recurrent laryngeal nerve paralysis secondary to a cardiovascular abnormality. Ortner syndrome caused by an aberrant right subclavian artery following a retroesophageal course without aneurysm formation is rare, with only 1 case reported in the literature. Cardiovascular abnormalities could be life-threatening and require early diagnosis and treatment. However, such abnormalities are not often considered by clinical practitioners when patients initially present with hoarseness.
Patient Concerns: A 34-year-old woman without any medical history presented to our outpatient department with hoarseness and mild dysphagia for 1 month.
Diagnosis: Upon stroboscopic examination, left vocal cord incomplete paralysis was noted. Contrast-enhanced computed tomography revealed an aberrant right subclavian artery arising from the left aortic arch, causing focal compression of the esophagus and, potentially, compression of the left recurrent laryngeal nerve compression. The patient was diagnosed as left recurrent laryngeal nerve paralysis caused by an aberrant right subclavian artery following a retroesophageal course without aneurysm formation.
Interventions: The patient was referred to a cardiovascular surgeon for resection and bypass surgery. Both the dysphagia and the hoarseness improved after the surgery.
Outcomes: Significant improvement of the left vocal cord paralysis and no vocal cord adduction were seen upon stroboscopic examination after 3 months. During the 5-year follow-up period, the patient remained well, and no signs of recurrence were noted.
Conclusion: This case can increase otolaryngologists' awareness of this etiology of hoarseness and consider it in their differential diagnosis.
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http://dx.doi.org/10.1097/MD.0000000000032272 | DOI Listing |
Aberrant anatomical variation of the vertebral artery (VA) from an internal carotid artery (ICA) is considered a rare finding. The incidence of this phenomenon can lead to patients suffering from posterior circulation neurological deficit if the ICA becomes significantly diseased. VA atypical anatomical origin is considered one of the rare pathologies, not only precipitating neurovascular incidents but equally leading to severe difficulty in VA dissection and surgical exposure, especially in carotid artery procedures.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Department of Pediatric Cardiovascular Surgery, Kanazawa Medical University, Ishikawaken, Japan.
Background: The study focuses on vascular compression of the main bronchus in the aortopulmonary space, examining potential contributors within the same axial plane. Its goal is to uncover mechanisms of bronchial compression in patients with intracardiac anomalies and review surgical outcomes, aiming to enhance future results.
Methods: The morphology and topology of structures within the axial plane of the aortopulmonary space were objectively analyzed, including the sternum, ascending aorta, heart, pulmonary artery, descending aorta, and other relevant elements.
Interdiscip Cardiovasc Thorac Surg
December 2024
Cardiovascular Surgery Department, Alain Sisteron Institute, Infirmerie Protestante de Lyon, Caluire-et-Cuire, France.
Managing an adult patient with aortic coarctation and associated anomalies presents a significant surgical challenge. We present a case of an adult male with aortic coarctation, pre-coarctation distal arch 7-cm aneurysm involving the origin of the left subclavian artery, and aberrant (lusoria) right subclavian artery. He was managed with one surgical approach, consisting of right carotid-subclavian bypass, exclusion of the right subclavian artery, proximal descending aortic replacement and reinsertion of left subclavian artery, using partial cardiopulmonary bypass.
View Article and Find Full Text PDFFour-dimensional flow magnetic resonance imaging (4D flow MRI) was utilized to analyze an aortic dissection with an aberrant right subclavian artery, revealing vortex formation and an increased oscillatory shear index (OSI), both indicative of variations in wall shear stress. An elevated OSI has been associated with an elevated risk of aortic dissection.
View Article and Find Full Text PDFAsian J Endosc Surg
January 2025
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
An aberrant right subclavian artery (ARSA) is a rare vascular anomaly accompanied by nonrecurrent inferior laryngeal nerve (NRILN). Here, we described the cervical-first approach in thoracoscopic esophagectomy for an esophageal cancer patient with ARSA using the intraoperative nerve monitoring (IONM) system. First, a left cervical procedure proceeded to expose the left vagus nerve to attach the APS electrode of the IONM system, and the left cervical paraesophageal lymph nodes was dissected separately.
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