Ortner-Syndrom 1 - cardiovokales Syndrom
A radiologic
review of hoarse voice from anatomic and neurologic perspectives. Representative coronal (a) and axial (b, c) illustrations demonstrating the normal course of the bilateral vagus and recurrent laryngeal nerves. The right recurrent laryngeal nerve loops posteromedially under the right subclavian artery (a, b), and the left recurrent laryngeal nerve loops posteromedially beneath the aortic arch (a, c)
Ortner"s
Syndrome. NCCT chest axial section showing cardiomegaly with grossly dilated left atrium
Ortner’s
syndrome presenting as thoracic aortic aneurysm mimicking thoracic malignancy: a case report. Chest X-ray showing a left side mediastinal mass. A homogeneous, soft tissue, dense, well-defined lesion in the left lung (white arrow) extending from the aortic knuckle to the left hemidiaphragm. Its medial margin merges with the mediastinum and there is a left-sided mild to moderate pleural effusion (black arrow)
Ortner’s
syndrome presenting as thoracic aortic aneurysm mimicking thoracic malignancy: a case report. Computed tomography aortography showing ascending (black arrow) and descending (large white arrow) aortic aneurysm with left-sided pleural effusion (small white arrow)
Ortner’s
syndrome presenting as thoracic aortic aneurysm mimicking thoracic malignancy: a case report. Volume-rendered image showing fusiform dilatation of the aorta (white arrow) from the aortic root to the bifurcation
A radiologic
review of hoarse voice from anatomic and neurologic perspectives. Endocarditis. A 41-year-old previously healthy man presents with intermittent hoarse voice and unexpected weight loss. Axial contrast-enhanced CT images through the larynx (a) and mediastinum (b) reveal left vocal fold rotation (white arrow) and lymphadenopathy surrounding the left carotid and subclavian arteries (white arrowheads). A coronal CTA image (c) reveals an ascending aortic aneurysm (black arrows). Echocardiogram (d) reveals a bicuspid valve with vegetations (gray arrow) and severe aortic stenosis. Overall, findings are consistent with compression/stretching of the left recurrent laryngeal nerve due to reactive lymphadenopathy and a dilated aortic arch in the setting of endocarditis
A radiologic
review of hoarse voice from anatomic and neurologic perspectives. Pulmonary artery aneurysm. A 78-year-old man with advanced congestive heart failure secondary to congenital pulmonary artery stenosis status post multiple corrective surgeries, now presenting with progressive shortness of breath and speaking difficulty despite adequate management of heart failure. Axial CTA image (a) through the mediastinum reveals aneurysmal dilatation of the left pulmonary artery (white arrows). An axial CTA image through the larynx (b) reveals thickening of the left aryepiglottic fold (white arrowhead) and dilatation of the left piriform sinus (black arrow). A coronal CTA image (c) demonstrates effacement of the aortopulmonary window (black arrows) by the pulmonary artery aneurysm (white arrows) with presumed compression of the left recurrent laryngeal nerve
A radiologic
review of hoarse voice from anatomic and neurologic perspectives. Carotid space trauma. A 33-year-old woman who sustained a stab wound to the neck, subsequently noted to have a weak voice; laryngoscopy confirmed vocal cord paralysis. Axial CTA of the neck (a) reveals a radiopaque marker at the entry site (white arrow); air is seen within the deep soft tissues anterior to the left carotid sheath contents (white arrowhead), indicating violation of the left carotid space. 3D-volume-rendered CTA image (b) of the left carotid artery shows irregular caliber and focal outpouching of the distal left common carotid artery (black arrowheads), representing pseudoaneurysm. Findings are consistent with left vocal cord paralysis due to vagal nerve injury
Ortner"s
Syndrome. Coronal NCCT section of the neck reveals dilatation of left pyriform sinus and laryngeal ventricle.
Ortner"s
Syndrome. Axial NCCT section reveals Left vocal cord palsy with overadduction of the right vocal cord with medial convex border
Ortner"s
Syndrome. Coronal NCCT section of the neck reveals flattening of the subglottic arch (arrow) and dilatation of the left pyriform sinus.
nicht verwechseln mit: Ortner's syndrome IIOrtner syndrome, also known as cardiovocal syndrome, is characterized by hoarse voice resulting from left recurrent laryngeal nerve palsy secondary to a cardiovascular disorder.
Pathology
Left recurrent laryngeal nerve palsy in this condition is due to traction or compression of the nerve between the thoracic aorta and pulmonary artery . The left recurrent laryngeal nerve arises from the left vagus (X) nerve and passes underneath the aortic arch posterior to the ligamentum arteriosum before it ascends into the left tracheoesophageal groove to reach the larynx .
Etiology
The original description of Ortner syndrome is due to a markedly distended left atrium secondary to mitral stenosis which has a reported incidence of 1.5% to 6% .
Other causes include :
- aortic pathologies (e.g. thoracic aortic aneurysm)
- patent ductus arteriosus
- atrial septal defect
- ventricular septal defect
- recurrent pulmonary embolism
- Eisenmenger syndrome
- primary pulmonary hypertension
History and etymology
It is named after Norbert Ortner (1865-1935), an Austrian physician .
Siehe auch:
- Nervus laryngeus recurrens
- Ortner's syndrome: Ductus Arteriosus aneurysm as a cause of left vocal cord palsy
- Heiserkeit
- Rekurrensparese
und weiter:
Assoziationen und Differentialdiagnosen zu Ortner-Syndrom 1 - cardiovokales Syndrom: 
