Transient vocal paralysis following strangulation injury

Blunt trauma to the larynx, as a source of vocal paralysis, has become an important consideration for the laryngologist. Direct neurologic injury from strangulation by hand is explored with presentation of 4 patients. Three of these had unilateral paralysis; the fourth had bilateral paralysis on two separate occasions of strangulation. All patients recovered in 4 to 20 days. Correlation is made with other acute nerve compression syndromes, and the pathophysiology discussed in light of experimental evidence. Awareness and recognition of this problem in evaluation and treatment of strangulation assault injuries is stressed.