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  • Title: [Hybrid operation for a distal aortic arch aneurysm causing left recurrent nerve palsy - Ortner's syndrome].
    Author: Kopp R, Linn J, Stelter K, Weidenhagen R, Meimarakis G, Berndt J.
    Journal: Laryngorhinootologie; 2008 Oct; 87(10):723-7. PubMed ID: 18421648.
    Abstract:
    BACKGROUND: A left recurrent nerve palsy caused by left atrium hypertrophy, dilatation of the left pulmonary artery or a thoracic aortic arch aneurysma is named Ortner's syndrome. CASE REPORT: We report the case of a 84-year old male patient with a posttraumatic aneurysm of the distal aortic arch known for 20 years, which became symptomatic by new presentation of an acute hoarseness caused by a left sided recurrent nerve palsy due to rapid aneurysma expansion. Because of the aneurysma localization, the advanced age and the patient?s morbidity he was treated by a hybrid procedure with an extrathoracic reconstruction of the supraaortic arteries by a right to left carotid-carotid bypass and transposition of the left subclavian artery followed by endovascular implantation of aortic stent grafts for aneurysma exclusion. The left recurrent nerve palsy remained unchanged until now. CONCLUSIONS: Aneursms of the distal aortic have to be considered as a rare cause of a left-sided recurrent nerve palsy. Recent advances in endovascular therapy combined with supraaotic vascular reconstruction offers a less invasive therapeutic option for some of these patients.
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