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Old 11-03-2010
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Anatomy left recurrent laryngeal nerve and a hoarse voice

Aneurysm of arch of aorta may cause a hoarse voice because of stretch it cause to recurrent laryngeal nerve. This will lead left vocal cord paresis. This is seen in indirect laryngoscopy when patient is told to phonate.
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Old 11-03-2010
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aortic aneurysm will cause damage to either left or right recurrent laryngeal nerve
the most common cause of left recurrent laryngeal nerve is bronchogenic carcinoma thats why we do x-ray or ct scan chest first to exlucde carcinoma
otherwise major causes are thyroid surgery and diseases
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Old 11-03-2010
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Quote:
Originally Posted by pakbrain View Post
aortic aneurysm will cause damage to either left or right recurrent laryngeal nerve
the most common cause of left recurrent laryngeal nerve is bronchogenic carcinoma thats why we do x-ray or ct scan chest first to exlucde carcinoma
otherwise major causes are thyroid surgery and diseases
Left recurrent laryngeal nerve will go under the arch of the aorta and that is why aneurysm will stretch left recurrent laryngeal nerve. On the other hand right will make U-turn in upper level. More commonly aneurysm will affect left side.

But many upper mediastinum and neck masses will affect to these nerves so hoarse voice with vocal cord paralysis is always red sign.
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Old 11-03-2010
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treatment will be done on the basis of positioning of the vocal cords , if its unilateral then most likely the healthy cord will cross the midline to approximate the paralysed one so we dont do any RX for tht becuz at first there will be mild hoarsness which will recover with approximation , in case of bilateral , paralysed cords are far away from midline so there is hoarsness alongwith aspiration through glottis and respiratory obstruction so we perform tracheostomy and lateralization of cord
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Old 11-04-2010
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Originally Posted by fin-84 View Post
Left recurrent laryngeal nerve will go under the arch of the aorta and that is why aneurysm will stretch left recurrent laryngeal nerve. On the other hand right will make U-turn in upper level. More commonly aneurysm will affect left side.

But many upper mediastinum and neck masses will affect to these nerves so hoarse voice with vocal cord paralysis is always red sign.
The right recurrent laryngeal wraps around the right subclavian artery, so it is more like to be damaged with upper mediastinal and neck masses than aortic aneurysm. It can also be affected in thyroid disease.
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