Aortic arch compliance and idiopathic unilateral vocal fold paralysis

Unilateral vocal fold paralysis (UVP) occurs related to recurrent laryngeal nerve (RLN) impairment associated with impaired swallowing, voice production, and breathing functions. The majority of UVP cases occur subsequent to surgical intervention with approximately 12-42% having no known cause for the disease (i.e., idiopathic). Approximately 2/3 of those with UVP exhibit left-sided injury with the average onset at 50 years of age or older in those diagnosed as idiopathic. Given the association between the RLN and the subclavian and aortic arch vessels, we hypothesized that changes in vascular tissues would result in increased aortic compliance in idiopathic left-sided UVP patients compared to those without UVP. Gated MRI data enabled aortic arch diameter measures normalized to blood pressure across the cardiac cycles to derive aortic arch compliance. Compliance was compared between individuals with left-sided idiopathic UVP and age- and gender-matched normal controls. Three-way factorial ANOVA test showed that aortic arch compliance (p=0.02) and aortic arch diameter change in one cardiac cycle (p=0.04) are significantly higher in idiopathic left-sided UVP patients compared to the controls. As previously demonstrated by other literature, our finding confirmed that compliance decreases with age (p<0.0001) in both healthy and idiopathic UVP patients. Future studies will investigate parameters of aortic compliance change as a potential contributor to the onset of left-sided UVP.

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