Klee Katharina, Eick Christian, Witlandt Raphael, Gawaz Meinrad, Didczuneit-Sandhop Birgit
Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls Universität Tübingen, Tübingen, Germany.
HNO, Gesichts- und Halschirurgie, Städtisches Klinikum Brandenburg, Brandenburg an der Havel, Germany.
J Cardiol Cases. 2016 Dec 8;15(3):88-90. doi: 10.1016/j.jccase.2016.10.018. eCollection 2017 Mar.
Recurrent laryngeal palsies are relatively common. Frequently, surgical procedures precede paresis. In rare cases a compression of the recurrent laryngeal nerve can be caused by enlarged cardiovascular structures. The phenomenon of compression of the left recurrent laryngeal nerve is explicitly designated as Ortner's syndrome, first described in 1897 by Norbert Ortner. Nowadays the compression of the right recurrent laryngeal nerve by cardiovascular structures is also associated with Ortner's syndrome. We report two cases of an 82- and a 71-year-old patient who presented with hoarseness and each right- and left-sided vocal cord paralysis for further diagnosis. The ear, nose, and throat (ENT) examinations revealed no clarifying findings besides the vocal cord palsy, so extensive imaging techniques were used. The cause of left-sided recurrent laryngeal nerve palsy was a penetrated aortic ulcer caused by large thrombosed aneurysm of the aortic arch. The right-sided paresis arose due to aneurysmal enlargement of the brachiocephalic trunk and an aneurysm of right subclavian artery. These cases demonstrate that interdisciplinary medical work is important. The internal medical presentation of a patient with hoarseness without ENT medical findings should be considered. < Ortner's syndrome is described as the compression of the recurrent laryngeal nerve of pathologically enlarged cardiac structures such as left atrium in mitral stenosis, aortic aneurysm, and others. It is a rare cause of vocal cord paralysis and thus hoarseness but should be considered as a differential diagnosis, particularly if the patient has a cardiac history.>.
喉返神经麻痹相对常见。通常，手术操作先于麻痹出现。在罕见情况下，心血管结构增大可导致喉返神经受压。左喉返神经受压现象被明确称为奥尔特纳综合征，由诺伯特·奥尔特纳于1897年首次描述。如今，心血管结构对右喉返神经的压迫也与奥尔特纳综合征相关。我们报告了两例患者，分别为82岁和71岁，均因声音嘶哑以及右侧和左侧声带麻痹前来进一步诊断。耳鼻喉科检查除声带麻痹外未发现明确结果，因此采用了广泛的成像技术。左侧喉返神经麻痹的原因是主动脉弓巨大血栓性动脉瘤导致的穿透性主动脉溃疡。右侧麻痹是由于头臂干动脉瘤样扩张和右锁骨下动脉动脉瘤引起的。这些病例表明跨学科医疗工作很重要。对于声音嘶哑但无耳鼻喉科检查结果的患者，应考虑内科表现。<奥尔特纳综合征被描述为病理性增大的心脏结构（如二尖瓣狭窄时的左心房、主动脉瘤等）对喉返神经的压迫。它是声带麻痹进而导致声音嘶哑的罕见原因，但应作为鉴别诊断予以考虑，特别是当患者有心脏病史时。>
