A 42-year-old woman is admitted to the hospital with an inability to speak. The patient's personal history reveals that she has experienced hoarseness for the past month. A chest radiograph reveals a mass at the aortopulmonary window. Which of the following nerves is most likely compressed?
There is close proximity between the aortopulmonary window and the left recurrent laryngeal nerve. A mass within or adjacent to this window is thus likely to compress the left recurrent laryngeal nerve, resulting in the hoarseness for the patient. The greater and lesser thoracic splanchnic nerves arise inferior and posterior to the aortopulmonary window and are thus unlikely to be compressed. The thoracic splanchnic nerves are not involved in the innervation of the larynx. Though the vagus is responsible for innervation of the larynx, it passes dorsal to the area of the aortopulmonary window and is not likely to be compressed.
Vagus
Phrenic
Left recurrent laryngeal
Right recurrent laryngeal
Thorax