CTICasesRecurrent Laryngeal Nerve Paralysis (Hoarseness) due to Thoracic Aortic Aneurysm
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Imaging findings
Chest radiograph showed a very tortuous thoracic aorta and a mass-like opacity in the region of the aortic arch. CT confirmed a large aneurysm of the thoracic aortic arch, presumably caused by a penetrating atherosclerotic ulcer. Asymmetry of the vocal cords was noted, with medial rotation of the arytenoid cartilage, consistent with recurrent laryngeal nerve paralysis.
Key takeaways
Recurrent laryngeal nerve paralysis, manifesting as hoarseness, can result from compression of the nerve by non-neoplastic thoracic pathology, such as a large thoracic aortic aneurysm. This case illustrates how vascular pathologies can directly impact nerve function due to their anatomical proximity. The imaging findings of vocal cord paralysis are consistent regardless of the underlying etiology.
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