Ortners Syndrome: A Rare Cause of Hoarseness of Voice

Abstract

ABSTRACT-INTRODUCTION:Hoarseness of voice is a very common symptom seen in the ENT outpatient department. Vocal cord palsy due to cardiac diseases and conditions are very less reported .Ortners syndrome or cardiovocal syndrome is one of it, which constitutes hoarseness of voice due to left recurrent laryngeal nerve involvement in cardiovascular disease. CASE REPORT : A 40 year old lady was referred to ENT outpatient department by the physicians for hoarseness of voice. Patient had hoarseness since 10months; there was no history of smoking, alcohol abuse, voice abuse or upper respiratory tract infection. On complete ENT examination including the indirect laryngoscopy left vocal cord was found to be immobile. Other ENT examination was normal. DISCUSSION: Hoarseness of voice due to paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis was first discussed by Nobert Ortner, a Viennese physician, in1897. He explained that hoarseness was caused by compression of the left recurrent laryngeal nerve by the enlarged left atrium. Later it was described with other identifiable cardiovascular diseases associated either with left atrial enlargement including mitral regurgitation and atrial myxoma or severe pulmonary hypertension including congenital heart diseases. For this reason it is also known as cardiovocal syndrome. CONCLUSION: For an ENT surgeon, in a case of clinical fix, when all possible causes of the vocal cord palsy are ruled out, a complete cardiovascular examination should be sought.