Abstract
We report three cases of recurrent nerve paralysis which was associated with old pulmonary tuberculosis. We considered that the causes of these paralysis were not only due to fibrosis and shift of intrathoracic organs, but also due to pulmonary hypertension and dilatation of the pulmonary artery which had been caused by secondary pulmonary fibrosis.Many authors described old pulmonary tuberculosis as a cause of recurrent nerve paralysis. These authors have indicated that simple traction or compression of the recurrent nerve by fibrous changes in the thorax had been the sole cause of the recurrent nerve paralysis. But in our cases, it was most probable that dilatation of the pulmonary artery had compressed the left recurrent nerve against the aortic arch.In one autopsy case (74-year-old male), no fibrous changes along the left recurrent nerve and vagus nerve were seen. Instead, right atrial and ventricular enlargements were seen.In the second case (75-year-old female), dilatation of pulmonary artery was observed both in chest X-ray films and enhanced CT scan.In the third case (55-year-old male), left recurrent nerve paralysis appeared immediately after an acute heart failure. Only in this case, the nerve paralysis improved 4 months later.
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