Zamora Mestre S, Ladrón de Guevara Bravo F, Acosta Varo M
Unidad de Cardiología, Hospital del SAS. La Línea de la Concepción, Cádiz.
Rev Esp Cardiol. 1997 Dec;50(12):902-3. doi: 10.1016/s0300-8932(97)74696-7.
The paralysis of the left laryngeal nerve secondary to mitral valvular disease (Ortner's syndrome) is quite rare. Ortner believed that the paralysis was due to the compression of the nerve by the enlargement of the left atrium. Other authors have shown, by observation at operation, that this compression is produced between enlarged, tense pulmonary artery and the aorta at the ligamentum arteriosum. This complication has also been described in different cardiovascular pathologies which also have pulmonary hypertension. Cases have been described in the literature of vocal cord function recovery after a pulmonary hypertension decrease. We present a case of hoarseness secondary to the paralysis of the left recurrent laryngeal nerve within a context of a mitral periprosthetic insufficiency with severe pulmonary hypertension and its disappearance after the valvular change, coinciding with a significant artery pulmonary estimated pressure decrease, confirmed by cardiac Eco-Doppler.
二尖瓣疾病继发左喉返神经麻痹（奥尔特纳综合征）相当罕见。奥尔特纳认为，这种麻痹是由于左心房扩大压迫神经所致。其他作者通过手术观察表明，这种压迫是在扩大、紧张的肺动脉与动脉韧带处的主动脉之间产生的。这种并发症也在其他伴有肺动脉高压的心血管疾病中被描述过。文献中曾有肺动脉高压降低后声带功能恢复的病例报道。我们报告一例在二尖瓣人工瓣膜功能不全伴严重肺动脉高压情况下继发左喉返神经麻痹导致声音嘶哑的病例，瓣膜置换术后声音嘶哑消失，同时经心脏超声多普勒证实肺动脉估计压力显著降低。
