Abstract
AbstractMore than a century ago, Ortner described a case of cardiovocal syndrome wherein he attributed a case of left vocal fold immobility to compression of the recurrent laryngeal nerve by a dilated left atrium in a patient with mitral valve stenosis. Since then, the term Ortner's syndrome has come to encompass any nonmalignant, cardiac, intrathoracic process that results in embarrassment of either recurrent laryngeal nerve-usually by stretching, pulling, or compression; and causes vocal fold paralysis. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the aortic arch, is more frequently involved than the right nerve, which passes around the subclavian artery. ObjectivesTo discuss the pathogenesis of hoarseness resulting from cardiovascular disorders involving the recurrent laryngeal nerve along with the findings of literature review. Materials and methodsThis paper reports a series of four cases of Ortner's syndrome occurring due to different causes. DesignCase study. ResultOrtner's syndrome could be a cause of hoarseness of voice in patients with cardiovascular diseases. ConclusionAlthough hoarseness of voice is frequently encountered in the Otolaryngology outpatient department, cardiovascular- related hoarseness is an unusual presentation. Indirect laryngoscopy should be routinely performed in all cases of heart disease.
Highlights
Hoarseness of voice due to left recurrent laryngeal nerve paralysis was first described in 1897 by Norbert Ortner, an Austrian physician, in a patient with mitral valve disease
Conclusion: hoarseness of voice is frequently encountered in the Otolaryngology outpatient department, cardiovascular- related hoarseness is an unusual presentation
In 1897, Ortner described a series of 3 cases of mitral stenosis suffering from hoarseness of voice because of left recurrent laryngeal nerve palsy
Summary
Hoarseness of voice due to left recurrent laryngeal nerve paralysis was first described in 1897 by Norbert Ortner, an Austrian physician, in a patient with mitral valve disease (mitral stenosis and left atrial enlargement). Various cardiopulmonary conditions associated with left recurrent laryngeal nerve palsy, have been described, over the last 100 years. The syndrome is termed as cardiovocal syndrome. A series of four different case reports of Ortner’s syndrome occurring due to mitral stenosis, combined mitral stenosis with mitral regurgitation, corpulmonale with secondary pulmonary hypertension and aneurysm of the arch of aorta are presented. The findings of review of literature relating to cardiovascular disorders affecting the recurrent laryngeal nerve and the pathogenesis of hoarseness are discussed.
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