Three-dimensional Computed Tomography Features of Recurrent Laryngeal Nerve Paralysis Due to Aortic Aneurysm

Abstract

Detailed reports on the stretching and compression of the recurrent laryngeal nerve by aortic aneurysms are unavailable. Therefore, we evaluated three-dimensional computed tomography images of patients with aortic aneurysm-associated recurrent laryngeal nerve paralysis. We enrolled patients with vocal-fold paralysis without aortic aneurysms (control group), vocal-fold paralysis before aortic aneurysm surgery (preoperative group), and vocal-fold paralysis after aortic aneurysm surgery (postoperative group). Using image reconstruction software, three-dimensional computed tomography images were constructed and cross-sections along the recurrent laryngeal nerve were obtained. Compression of the pulmonary artery by the aortic aneurysm was evaluated, and the aortic circumference in the cross-sections was compared between the groups. All cases in the preoperative group showed pulmonary artery and surrounding tissue compression. The aortic aneurysm circumference in the preoperative group was significantly greater than that in other groups. In patients with aortic aneurysms, three-dimensional computed tomography along the recurrent laryngeal nerve is useful for assessing the risk of recurrent laryngeal nerve paralysis.