Vocal cord paralysis due to thoracic aortic pseudoaneurysm
Discomfort in the throat and hoarseness for 4 months.
CTA Neck and chest
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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).
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.