Hoarseness Due to Right Vocal Cord Paralysis Associated with Aortic Diverticulum from Right Aortic Arch—A Rare and Unusual Vascular Etiology of Right Vocal Cord Paralysis

Produl Hazarika^1*, Seema E. Punnoose¹, Sanjay Arora¹, Ramagowdanapura Sadashivan Diesh², Raghavendra K. Itgampalli³, Rohit Singh⁴

¹Department of ENT, NMC Specialty Hospital, Abu Dhabi, UAE.
²Department of Cardiothoracic Surgery, NMC Specialty Hospital, Abu Dhabi, UAE.
³Department of Radiology, NMC Specialty Hospital, Abu Dhabi, UAE.
⁴Department of ENT & Head-Neck Surgery, Kasturba Medical College, Manipal, India.

DOI: 10.4236/ijohns.2015.42018                

Abstract

Right vocal cord paralysis in our present case was diagnosed on clinical and radiological examination which is precipitated by an anomalous right aortic arch with diverticulum. This is a very uncommon vascular etiology of hoarseness and is extremely rare. Because of this rarity, the practicing otolaryngologist may miss this finding while evaluating a case of idiopathic right vocal cord paralysis. Thus, the authors feel that idiopathic or unexplained right vocal cord paralysis should be routinely investigated with a CT or MRI of neck and chest with or without contrast to avoid such shortcomings. There is only one such case of right vocal cord paralysis by right aortic which has been reported earlier in literature.

Keywords

Hoarseness, Vocal Cord Paralysis, Right Aortic Arch, CT Scan Neck and Chest

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Titche, L.L. (1976) Causes of Recurrent Laryngeal Nerve Paralysis. Archives of Otolaryngology, 102, 259-261. http://dx.doi.org/10.1001/archotol.1976.00780100045002
[2]	Omer, K., Hakan, B., Umit, A., Ozeyir, Y., Turan, I. and Burak, A. (2013) Recurrent Vocal Cord Paralysis Associated with Right Aortic Arch. KBB-Forum, 12.
[3]	Annema, J.T., Brahim, J.J. and Rabe, K.F. (2004) A Rare Case of Ortners Syndrome (Cardiovocal Hoarseness). Thorax, 59, 636-637. http://dx.doi.org/10.1136/thx.2003.020503
[4]	Zaki, S.A., Asif, S. and Shanbag, P. (2010) Ortner Syndrome in Infants. Indian Pediatrics, 47, 351-353. http://dx.doi.org/10.1007/s13312-010-0053-y
[5]	Song, S.W., Jun, B.C., Cho, K.J., Lee, S., Kim, Y.J. and Park, S.H. (2011) CT Evaluation of Vocal Cord Paralysis Due to Thoracic Diseases: A 10 Years Retrospective Study. Yonsei Medical Journal, 52, 831-837. http://dx.doi.org/10.3349/ymj.2011.52.5.831
[6]	Moosman, D.A. and DeWeese, M.S. (1968) The External Laryngeal Nerve as Related to Thyroidectomy. Surgery, Gynecology Obstetrics, 127, 1101.
[7]	Aniruddha, S. (2012) A Case Report of Abnormal Origin of Right Recurrent Laryngeal Nerve from Right Vagus in Thorax. IJCRI, 3, 4-7. http://dx.doi.org/10.5348/ijcri-2012-03-97-CR-2
[8]	Ballotta, E., Mion, E. and Bardini, R. (2003) Right Sided Aortic Arch and Aberrant Left Subclavianartery. Journal of Cardiovascular Surgery (Torino), 44, 783-784.
[9]	Felson, W. and Palayew, M.J. (1963) Two Types of Right Aortic Arch. Radiology, 81, 745-759. http://dx.doi.org/10.1148/81.5.745
[10]	McElhinney, D.B., Hoydu, A.K., Gaynor, J.W., Spray, T.L., Goldmuntz, E. and Weinberg, P.M. (2001) Patterns of Right Aortic Arch and Mirror-Image Branching of the Brachiocephalic Vessels without Associated Anomalies. Pediatric Cardiology, 22, 285-291. http://dx.doi.org/10.1007/s002460010231