Saturday, July 27, 2019

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Overview

Left sided unilateral vocal cord paralysis associated with intrathoracic compression of the left recurrent laryngeal nerve from cardiovascular abnormality was described by Norbert Ortner in 1897 (Klee 2016). Ortner was an Austrian physician who described left recurrent laryngeal paralysis in a patient with mitral valve disease (mitral stenosis and left atrial enlargement) (Subramaniam 2011). Ortner identified 3 cases of mitral stenosis associated with hoarseness which he deduced as arising from compression of the left recurrent laryngeal nerve from an enlarged left atrium.

This disorder has been termed "cardiovocal syndrome" with responsible cardiopulmonary abnormalities including cor pulmonale with secondary pulmonary hypertension and aneurysm of the aortic arch.

References

Klee K, Eick C, Witlandt R, Gawaz M, Didczuneit-Sandhop B.: Unilateral recurrent nerve palsy and cardiovascular disease - Ortner's syndrome. J Cardiol Cases. 2016 Dec 8;15(3):88-90. doi: 10.1016/j.jccase.2016.10.018. eCollection 2017 Mar.

Ortner N. Recurrenslähmung bei Mitrastenose. Wien Klin Wochenschr. 1897;10:753–755. [ Ortner N. Recurrent nerve palsy in patient with mitral stenosis (in German). Wien Klin Wochenschr. 1897;10:753-5]

Acharya MN, Bahrami T, Popov AF, Kishore Bhudia S.: Rapid resolution of Ortner's syndrome with giant left atrium after double-valve replacement surgery. Interact Cardiovasc Thorac Surg. 2017 Oct 1;25(4):663-664. doi: 10.1093/icvts/ivx166. Review.

Subramaniam V1, Herle A, Mohammed N, Thahir M.: Ortner's syndrome: case series and literature review. Braz J Otorhinolaryngol. 2011 Sep-Oct;77(5):559-62.[Article in English, Portuguese]