Expect the Unexpected: A Unique Association of Bicuspid Aortic Valve, with Severe Aortic Stenosis and Dilation of Ascending Aorta, with Cervical Vagus Nerve Schwannoma
Author(s)
Shivanand Patil,
Rangaraj Ramalingam,
Kasamshetty Subramanyam,
Deepak Pujar,
Cholenahally Nanjappa Manjunath
Affiliation(s)
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
ABSTRACT
Hoarseness of voice is a common symptom of many laryngeal and extralaryngeal conditions. It is very crucial to identify the culprit behind it, keeping in mind all the various differentials. We re-port a case of a 35-year-old woman presenting with complaint of hoarseness of voice. Upon car-diac evaluation, the patient was diagnosed with bicuspid aortic valve, with severe aortic stenosis and dilation of ascending aorta. We suspected that the plausible reason for hoarseness of voice was compression of recurrent laryngeal nerve due to dilation of aorta, i.e., Ortner’s syndrome. But to our surprise, CT of aorta and neck revealed extensive elongated cervical vagus nerve schwannoma. Such type of association is unique and new to voluminous medical literature.
Cite this paper
Patil, S. , Ramalingam, R. , Subramanyam, K. , Pujar, D. and Manjunath, C. (2015) Expect the Unexpected: A Unique Association of Bicuspid Aortic Valve, with Severe Aortic Stenosis and Dilation of Ascending Aorta, with Cervical Vagus Nerve Schwannoma. International Journal of Clinical Medicine, 6, 281-284. doi: 10.4236/ijcm.2015.64035.
Patil, S. , Ramalingam, R. , Subramanyam, K. , Pujar, D. and Manjunath, C. (2015) Expect the Unexpected: A Unique Association of Bicuspid Aortic Valve, with Severe Aortic Stenosis and Dilation of Ascending Aorta, with Cervical Vagus Nerve Schwannoma. International Journal of Clinical Medicine, 6, 281-284. doi: 10.4236/ijcm.2015.64035.
References
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http://dx.doi.org/10.1017/S0022215107008110 [2] Subramaniam, V., Herle, T., Mohammed, N. and Thahir, M. (2011) Ortner’s Syndrome: Case Series and Literature Review. Brazilian Journal of Otorhinolaryngology, 77, 559-562.
http://dx.doi.org/10.1590/S1808-86942011000500004 [3] Shahul, H.A., Manu, M.K., Mohapatra, A.K. and Magazine, R. (2014) Ortner’s Syndrome. BMJ Case Reports, 2014.
http://dx.doi.org/10.1136/bcr-2013-200950 [4] Saha, S., Bastiaenen, R., Hayward, M. and McEwan, J.R. (2007) An Undiagnosed Bicuspid Aortic Valve Can Result in Severe Left Ventricular Failure. BMJ: British Medical Journal, 334, 420.
http://dx.doi.org/10.1136/bmj.39065.624815.80 [5] Tzemos, N., Therrien, J., Yip, J., Thanassoulis, G., Tremblay, S., Jamorski, M.T., et al. (2008) Outcomes in Adults with Bicuspid Aortic Valves. JAMA, 300, 1317-1325.
http://dx.doi.org/10.1001/jama.300.11.1317 [6] Colreavy, M., Lacy, P., Hughes, J., Bouchier-Hayes, D., Brennan, P., O’Dwyer, A., et al. (2000) Head and Neck Schwannomas—A 10 Year Review. Journal of Laryngology & Otology, 114, 119-124.
http://dx.doi.org/10.1258/0022215001905058 [7] Sreevatsa, M. and Srinivasarao, R.V. (2011) Three Cases of Vagal Nerve Schwannoma and Review of Literature. Indian Journal of Otolaryngology and Head & Neck Surgery, 63, 310-312.
http://dx.doi.org/10.1007/s12070-011-0220-z [8] Sérémé, M., Ouédraogo, A., Gyébré, Y. and Ouoba, K. (2014) Cervical Vagal Schwannoma: Difficulty of Diagnosis and Particularity of Treatment. The Internet Journal of Otorhinolaryngology, 16. [9] Gibber, M.J., Zevallos, J.P. and Urken, M.L. (2012) Enucleation of Vagal Nerve Schwannoma Using Intraoperative Nerve Monitoring. The Laryngoscope, 122, 790-792.
http://dx.doi.org/10.1002/lary.22485
[1] Fennessy, B., Sheahan, P. and McShane, D. (2008) Cardiovascular Hoarseness: An Unusual Presentation to Otolaryngologists. The Journal of Laryngology & Otology, 122, 327-328.
http://dx.doi.org/10.1017/S0022215107008110 [2] Subramaniam, V., Herle, T., Mohammed, N. and Thahir, M. (2011) Ortner’s Syndrome: Case Series and Literature Review. Brazilian Journal of Otorhinolaryngology, 77, 559-562.
http://dx.doi.org/10.1590/S1808-86942011000500004 [3] Shahul, H.A., Manu, M.K., Mohapatra, A.K. and Magazine, R. (2014) Ortner’s Syndrome. BMJ Case Reports, 2014.
http://dx.doi.org/10.1136/bcr-2013-200950 [4] Saha, S., Bastiaenen, R., Hayward, M. and McEwan, J.R. (2007) An Undiagnosed Bicuspid Aortic Valve Can Result in Severe Left Ventricular Failure. BMJ: British Medical Journal, 334, 420.
http://dx.doi.org/10.1136/bmj.39065.624815.80 [5] Tzemos, N., Therrien, J., Yip, J., Thanassoulis, G., Tremblay, S., Jamorski, M.T., et al. (2008) Outcomes in Adults with Bicuspid Aortic Valves. JAMA, 300, 1317-1325.
http://dx.doi.org/10.1001/jama.300.11.1317 [6] Colreavy, M., Lacy, P., Hughes, J., Bouchier-Hayes, D., Brennan, P., O’Dwyer, A., et al. (2000) Head and Neck Schwannomas—A 10 Year Review. Journal of Laryngology & Otology, 114, 119-124.
http://dx.doi.org/10.1258/0022215001905058 [7] Sreevatsa, M. and Srinivasarao, R.V. (2011) Three Cases of Vagal Nerve Schwannoma and Review of Literature. Indian Journal of Otolaryngology and Head & Neck Surgery, 63, 310-312.
http://dx.doi.org/10.1007/s12070-011-0220-z [8] Sérémé, M., Ouédraogo, A., Gyébré, Y. and Ouoba, K. (2014) Cervical Vagal Schwannoma: Difficulty of Diagnosis and Particularity of Treatment. The Internet Journal of Otorhinolaryngology, 16. [9] Gibber, M.J., Zevallos, J.P. and Urken, M.L. (2012) Enucleation of Vagal Nerve Schwannoma Using Intraoperative Nerve Monitoring. The Laryngoscope, 122, 790-792.
http://dx.doi.org/10.1002/lary.22485