Kommerell's diverticulum: rare cause of unilateral vocal cord palsy. 2019

Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.

Kommerell's diverticulum is a relatively rare congenital aortic arch anomaly. A 56-year-old man presented with complaint of gradually progressive hoarseness of voice since 6 months. Clinical examination revealed no evidence of palpable neck mass or cervical lymphadenopathy. Indirect laryngoscopy showed right vocal cord in median position and was immobile during phonation with normal left vocal cord. This was followed by contrast-enhanced CT (CECT) of the neck and upper chest for further evaluation. CT scan showed features of right vocal cord palsy. CECT also showed right-sided aortic arch with aberrant origin of the left subclavian artery. Aneurysmal dilatation of the aortic arch was noted at the take off of aberrant left subclavian artery suggesting Kommerell's diverticulum. Therefore, diagnosis of right vocal cord palsy due to compression of the right recurrent laryngeal nerve (RLN) by Kommerell's diverticulum was kept. Left RLN palsy did not occur in this case because the left RLN likely courses around the normal segment of the aortic arch just proximal to the origin of the left subclavian artery. As the patient was mildly symptomatic, he was kept on conservative treatment with close follow-up. The present case report highlights importance of the inclusionn of the superior mediastinum on CT scan in case of suspected vocal cord palsy to exclude vascular causes of RLN paralysis.

UI MeSH Term Description Entries
D008297 Male Males
D008482 Mediastinum A membrane in the midline of the THORAX of mammals. It separates the lungs between the STERNUM in front and the VERTEBRAL COLUMN behind. It also surrounds the HEART, TRACHEA, ESOPHAGUS, THYMUS, and LYMPH NODES.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001013 Aorta, Thoracic The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA. Aorta, Ascending,Aorta, Descending,Aortic Arch,Aortic Root,Arch of the Aorta,Descending Aorta,Sinotubular Junction,Ascending Aorta,Thoracic Aorta,Aortic Roots,Arch, Aortic,Ascending Aortas,Junction, Sinotubular,Root, Aortic,Sinotubular Junctions
D001015 Aortic Arch Syndromes Conditions resulting from abnormalities in the arteries branching from the ASCENDING AORTA, the curved portion of the aorta. These syndromes are results of occlusion or abnormal blood flow to the head-neck or arm region leading to neurological defects and weakness in an arm. These syndromes are associated with vascular malformations; ATHEROSCLEROSIS; TRAUMA; and blood clots. Aortic Arch Syndrome,Syndrome, Aortic Arch,Syndromes, Aortic Arch
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D014826 Vocal Cord Paralysis Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA. Laryngeal Nerve Palsy, Recurrent,Laryngeal Paralysis,Acquired Vocal Cord Palsy,Bilateral Vocal Cord Paresis,Congenital Vocal Cord Palsy,Paralysis, Unilateral, Vocal Cord,Paralysis, Vocal Cord, Unilateral,Partial Paralysis (Paresis) Vocal Cords,Recurrent Laryngeal Nerve Palsy,Total Vocal Cord Paralysis,Unilateral Paralysis, Vocal Cord,Unilateral Vocal Cord Paralysis,Unilateral Vocal Cord Paresis,Vocal Cord Palsy,Vocal Cord Palsy, Congenital,Vocal Cord Paralysis, Unilateral,Vocal Cord Paresis,Vocal Fold Palsy,Laryngeal Paralyses,Palsies, Vocal Cord,Palsies, Vocal Fold,Palsy, Vocal Cord,Palsy, Vocal Fold,Paralyses, Laryngeal,Paralyses, Vocal Cord,Paralysis, Laryngeal,Paralysis, Vocal Cord,Pareses, Vocal Cord,Paresis, Vocal Cord,Vocal Cord Palsies,Vocal Cord Paralyses,Vocal Cord Pareses,Vocal Fold Palsies

Related Publications

Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
January 2023, Annals of the Royal College of Surgeons of England,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
July 2004, Respiratory medicine,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
January 2015, The Journal of the Association of Physicians of India,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
January 2002, Duodecim; laaketieteellinen aikakauskirja,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
October 1977, Anesthesiology,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
November 2019, The Korean journal of internal medicine,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
May 2024, ANZ journal of surgery,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
September 2021, International journal of surgery case reports,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
March 2023, Cureus,
Pawan Kumar, and Anuradha Singh, and Sheragaru Hanumanthappa Chandrashekhara
July 2001, Anaesthesia,
Copied contents to your clipboard!