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Case Reports
. 2012:2012:367873.
doi: 10.1155/2012/367873. Epub 2012 Apr 10.

Thoracic Saccular Aortic Aneurysm Presenting with Recurrent Laryngeal Nerve Palsy prior to Aneurysm Rupture: A Prodrome of Thoracic Aneurysm Rupture?

Masafumi Ohki  1
Affiliations
Case Reports

Thoracic Saccular Aortic Aneurysm Presenting with Recurrent Laryngeal Nerve Palsy prior to Aneurysm Rupture: A Prodrome of Thoracic Aneurysm Rupture?

Masafumi Ohki. Case Rep Otolaryngol. 2012.

Abstract

Left recurrent laryngeal nerve palsy rarely results from cardiac disease. We present 2 cases of left recurrent laryngeal nerve palsy caused by thoracic saccular aortic aneurysms. One patient suffered an aortic aneurysm rupture one month after the advent of hoarseness, necessitating emergency surgery with aortic arch replacement. The other patient underwent elective aortic arch replacement surgery. Both saccular aortic aneurysms protruded downward in the aortopulmonary window to compress the recurrent laryngeal nerves. This is only the 5th case report of the rare occurrence of acute recurrent laryngeal nerve palsy subsequent to saccular aneurysm rupture in the English literature. Recurrent laryngeal nerve palsy does not always indicate imminent aneurysm rupture, but should trigger awareness of a potential rupture in the near future. Left recurrent laryngeal nerve palsy might be a prodrome of aneurysm rupture.

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Figures

Figure 1
Figure 1
Transverse MRI (T2-weighted image) of the chest revealing a thoracic aortic saccular aneurysm protruding downward in the aortopulmonary window.
Figure 2
Figure 2
Transverse contrast-enhanced CT of the chest showing an enlarged aortic saccular aneurysm, protruding downward, surrounded by a hematoma in the aortopulmonary window.
Figure 3
Figure 3
Transverse CT of the chest showing an aortic saccular aneurysm, protruding downward, in the aortopulmonary window.
See this image and copyright information in PMC

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