(A728) Ortner's Syndrome and Dysphagia Aortica: The Importance of a Comprehensive Swallow Evaluation

Introduction: Ortner's Syndrome and dysphagia aortica are both rare causes of vocal fold paralysis and dysphagia, respectively. However, awareness of these two conditions is important for the otolaryngologist. We present a case in which a patient presented with both rare conditions and initial cause of dysphagia masked by presence of her vocal fold paralysis.

Methods: A case report of an unusual case of Ortner's Syndrome and dysphagia aortica in the same patient.

Results: A 90yoF presented previously with dysphonia diagnosed as vocal fold paralysis secondary to an aortic arch aneurysm. She underwent injection medialization of the left vocal fold with improved glottic efficiency. However, she continued to complain of dysphagia and chronic pharyngeal symptoms such as throat clearing for two years. A MBSS was completed which showed age appropriate penetration to thin liquids not correlating with throat clearing during the exam. An esophageal sweep was done which showed external compression of the mid-esophagus consistent with her known aneurysm. Due to its enlargement over time, patient underwent endovascular repair with subjective improvement in symptoms despite stable fluoroscopy images.

Conclusions: Otolaryngologists see patients for complaints of dysphagia often oropharyngeal in origin as in the case of vocal fold paralysis and presbylarynx. However, it is important to remember esophageal dysphagia can present with pharyngeal symptoms such as throat clearing and fluoroscopy including esophageal sweep is a key component to identifying it.