Acute stridor as a presentation of bilateral abductor vocal cord paralysis

We report the case of a 48-year-old woman, referred to the Intensive Care Unit with community-acquired pneumonia, who was noted to have stridor of acute onset. Subsequent indirect laryngoscopy revealed bilateral abductor vocal cord paralysis, secondary to unsuspected carcinoma of the oesophagus, requiring immediate tracheostomy. We highlight the importance of visualisation of the vocal cords in cases of stridor of uncertain aetiology.