Mediastinal traction injury to the recurrent laryngeal nerve: An unusual cause for a hoarse voice

BACKGROUND Chest wall trauma is a frequent cause for emergency department presentations, with traumatic pneumathoraces a relatively common occurance. Vocal cord paralysis however, is uncommon. CASE REPORT A 44 year old man presented with a traumatic pneumothorax following a fall. A weak and hoarse voice was noted and vocal cord palsy demonstrated on indirect laryngoscopy. CT chest was unremarkable for mediastinal lesions. CONCLUSIONS Clinicians need be mindful of traction injuries to mediastinal structures when examining those with chest wall injuries.