Recurrent nerve palsy following post-traumatic aortic pseudoaneurysm. Report or a case and review or the literature [Paralisi ricorrenziale monolaterale da pseudoaneurisma aortico post-traumatico. Descrizione di un caso clinico e revisione della letteratura]

Blunt trauma to the neck or to the chest are increasingly observed in the emer-gency clinical practice. They usually follow motorvehicle accidents, or may be consequent to job or sport practice (bib). A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who had undergone a chest and neck blunt trauma: after twenty days he presented with hoarseness and dysphonia. The left recurrent laryngeal nerve palsy secondary to a post-traumatic aortic pseudoaneurysm was revealed. Male, 40 years-old, was referred to our observation presenting with hoarseness and dysphonia. Twenty days before he had sustained a car accident with trauma to the chest, the neck and the mandible. Direct laryngoscopy showed an immobile left vocal cord compatible with left recurrent laryngeal nerve palsy. Further otolaryngological examination showed no abnormality. In the potential suspect of an aortic injury, the patient underwent contrast material-enhanced spiral computed tomography (CT) of the chest. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed: concomitant compression of the left broncus was showed as well (Figg). The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later, and at the 3-years follow-up visit the hoarseness and the dysphonia had resolved completely.