Hoarseness Caused by a Penetrating Proximal Descending Thoracic Aortic Ulcer and Pseudoaneurysm
| Autor: | Jaideep Das Gupta, Nida Shahab Bham, Sundeep Guliani, John Marek, Garth T. Olson, Muhammad Ali Rana, Robin Osofsky |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Palsy Ligamentum arteriosum business.industry General Medicine 030204 cardiovascular system & hematology medicine.disease 030218 nuclear medicine & medical imaging New onset Surgery 03 medical and health sciences Pseudoaneurysm 0302 clinical medicine Landing zone medicine.artery medicine.ligament cardiovascular system Etiology Medicine Thoracic aorta cardiovascular diseases Differential diagnosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular and Endovascular Surgery. 54:288-291 |
| ISSN: | 1938-9116 1538-5744 |
| DOI: | 10.1177/1538574419895371 |
| Popis: | We present a case of an 87-year-old female with new-onset hoarseness of unclear etiology. Imaging demonstrated a penetrating aortic ulcer (PAU) in the proximal descending thoracic aorta with an associated pseudoaneurysm that enlarged to a depth of 32 mm over 2 years. This patient was diagnosed with hoarseness being secondary to left recurrent laryngeal nerve (LRLN) palsy, a variant of Ortner syndrome. Patient was treated with endovascular stent-grafting successfully covering of the PAU and pseudoaneurysm with zone 3 proximal landing zone. The patient had moderate improvement in hoarseness after 1 year of follow-up. Endovascular repair is indicated for symptomatic patients with PAUs complicated by enlarging pseudoaneurysms or rupture. Endovascular treatment is effective with low procedural morbidity and mortality. In this case, the PAU and associated pseudoaneurysm at the level of the ligamentum arteriosum caused compression on the LRLN, resulting in a nerve palsy and hoarseness. This case highlights the importance of vascular imaging for patients presenting with unclear etiology of hoarseness or other signs of LRLN palsy. Therefore, aortic arch abnormalities, a variant of Ortner syndrome, even though rare, should be on the differential diagnosis of new onset hoarseness. |
| Databáze: | OpenAIRE |
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