A rare cause of hoarseness: Ortner Syndrome

<bold>Introduction:</bold> Hoarseness is a symptom usually associated with laryngeal or lung malignancies. Here we present a case of hoarseness that developed as a result of laryngeal nerve compression due to left atrium enlargement defined as Ortner Syndrome. CASE Presentation: A 72-year-old female, non-smoker patient presented to our outpatient clinic with a complaint of hoarseness and cough that had lasted for approximately 7 months. She had hypertension (HT) and mitral valve replacement surgery. On physical examination, the respiratory system was normal. Ear, nose and throat disease clinic evaluation revealed left vocal cord para-median paralysis. Laboratory results were normal except mildly elevated BNP level (389 ng/L, normal value <125 ng/L). Thoracic CT revealed an increased cardiothoracic ratio and biatrial dilation (Figure 1). <fig><object-id>erj;66/suppl_69/PA1976/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> On echocardiography, the left atrial diameter was measured at 11.3 cm (normal value:1.9-4 cm), and it was defined as a massive left atrium. Based on the current findings, no other etiological factor explaining the left vocal cord paralysis was identified, except for massive left atrial compression, and the patient was diagnosed with Ortner syndrome. <bold>Conclusion:</bold> Ortner syndrome, a rare cause of the hoarseness, is an important syndrome that should be considered, particularly in patients with a history of cardiovascular disease, for the planning of necessary diagnostic tests and making appropriate referrals to determine the underlying etiology.