Isolated bilateral vocal cord paralysis without structural injury following blunt neck trauma: A case report

Bilateral vocal cord paralysis (BVCP) following blunt neck trauma is an exceptionally rare and potentially life-threatening condition. It usually involves structural injuries to the larynx or cervical spine. Isolated BVCP without structural injury is extremely rare. This case demonstrates delayed airway compromise caused by aspiration, rather than fixed glottic obstruction.

We report the case of a young male who sustained a motorcycle accident in which his neck became entangled in barbed wire. He initially developed aphonia without respiratory distress and was admitted to a district hospital, where he remained stable for nine days. On day ten, he developed progressive dyspnoea and was referred to a tertiary centre. Imaging revealed bilateral aspiration changes, while flexible laryngoscopy demonstrated bilateral vocal cord paralysis in the paramedian position. The patient was managed with elective tracheostomy, bilateral intercostal drains, antibiotics, and supportive care. Remarkably, repeat laryngoscopy on day 21 showed complete recovery of cord mobility, and the tracheostomy was successfully decannulated the following day.

Isolated traumatic BVCP is rare and may present with delayed airway compromise due to aspiration. Early airway protection and laryngoscopy are crucial. Recovery may occur with conservative care.