BILATERAL ABDUCTOR PARALYSIS COMPLICATED BY FRACTURED RIBS

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Abstract
BILATERAL abductor paralysis of the vocal cords is not encountered frequently and when associated with multiple rib fractures presents an interesting and unusual emergency. On Aug. 11, 1950, N. V., a white woman aged 51, entered Scott and White Hospital in a semiconscious state with severe dyspnea, laryngeal stridor, and indrawing of the sternum. The husband revealed that the patient had had a thyroidectomy elsewhere in 1938 and was rather hoarse for three months following surgery. Since that time she had had dyspnea on exertion, and for the past two months the dyspnea had been unusually severe. On examination paradoxical respiration was noted. Roentgenograms of the chest revealed a fracture of the left third, fourth, fifth, sixth, seventh, and eighth ribs in the posterior axillary line. Both vocal cords were fixed in the midline and approximated so as to obstruct seriously the air passage. An immediate tracheotomy was performed. When

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