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Vocal cord paralysis due to thoracic aortic pseudoaneurysm

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Discomfort in the throat and hoarseness for 4 months.

Patient Data

Age: 70 years
Gender: Male

CT scan selected images showing a 3.0 cm vascular lesion extending anteriorly and inferiorly from the distal portion of the aortic arch, along the course of the left recurrent laryngeal nerve. In the neck, there is displacement of the thickened aryepiglottic fold and a medial position of the left vocal cord margin (Vocal cord paralysis). 

Case Discussion

The inferior course of the recurrent laryngeal nerve below the vocal cords demands CT imaging protocols that include the extralaryngeal region, like in this case, with the upper mediastinum study. 

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