Question:
Hoarseness secondary to bronchogenic carcinoma is usually due to extension of the tumour into
Hoarseness secondary to bronchogenic carcinoma is usually due to extension of the tumour into
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Think about which recurrent laryngeal nerve travels longest inside the chest.
Updated On: Jul 7, 2026
- Vocal cord
- Superior laryngeal nerve
- Left recurrent laryngeal nerve
- Right vagus nerve
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The Correct Option is C
Solution and Explanation
Step 1: Understanding the Question:
We need to find which structure a bronchogenic carcinoma (lung cancer) most often invades to produce hoarseness of voice.
Step 2: Key Formula or Approach:
Hoarseness in lung cancer comes from vocal cord palsy, and vocal cord palsy from lung cancer happens when the tumour or its enlarged mediastinal lymph nodes trap and damage the nerve that supplies the vocal cords, the recurrent laryngeal nerve. So we need to know its path on each side.
Step 3: Detailed Explanation:
The recurrent laryngeal nerve is a branch of the vagus nerve that loops back up into the neck to supply the vocal cords.
On the right side, the right recurrent laryngeal nerve loops around the right subclavian artery, high up near the root of the neck, away from the chest where lung tumours grow.
On the left side, the left recurrent laryngeal nerve travels much lower, looping under the arch of the aorta inside the chest, right next to the structures a bronchogenic carcinoma or its mediastinal lymph nodes can invade.
Because of this longer intrathoracic course, the left recurrent laryngeal nerve is far more often stretched, compressed, or invaded by lung cancer than the right one.
The vocal cord itself is not directly invaded in most cases, the nerve supplying it is damaged instead. Superior laryngeal nerve palsy gives voice fatigue and a change in pitch, not the classic hoarseness of lung cancer. Involvement of the vagus trunk on the right is less common and would also bring other problems, like changes in heart rhythm.
Step 4: Final Answer:
So hoarseness from bronchogenic carcinoma is usually due to invasion of the left recurrent laryngeal nerve, because of its long course under the aortic arch inside the chest.
We need to find which structure a bronchogenic carcinoma (lung cancer) most often invades to produce hoarseness of voice.
Step 2: Key Formula or Approach:
Hoarseness in lung cancer comes from vocal cord palsy, and vocal cord palsy from lung cancer happens when the tumour or its enlarged mediastinal lymph nodes trap and damage the nerve that supplies the vocal cords, the recurrent laryngeal nerve. So we need to know its path on each side.
Step 3: Detailed Explanation:
The recurrent laryngeal nerve is a branch of the vagus nerve that loops back up into the neck to supply the vocal cords.
On the right side, the right recurrent laryngeal nerve loops around the right subclavian artery, high up near the root of the neck, away from the chest where lung tumours grow.
On the left side, the left recurrent laryngeal nerve travels much lower, looping under the arch of the aorta inside the chest, right next to the structures a bronchogenic carcinoma or its mediastinal lymph nodes can invade.
Because of this longer intrathoracic course, the left recurrent laryngeal nerve is far more often stretched, compressed, or invaded by lung cancer than the right one.
The vocal cord itself is not directly invaded in most cases, the nerve supplying it is damaged instead. Superior laryngeal nerve palsy gives voice fatigue and a change in pitch, not the classic hoarseness of lung cancer. Involvement of the vagus trunk on the right is less common and would also bring other problems, like changes in heart rhythm.
Step 4: Final Answer:
So hoarseness from bronchogenic carcinoma is usually due to invasion of the left recurrent laryngeal nerve, because of its long course under the aortic arch inside the chest.
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