Postintubation Vocal Cord Paralysis in Critically Ill Patients: A Multidisciplinary Case Series

Vocal cord paralysis (VCP) is an uncommon but clinically significant complication of prolonged or repeated intubation in critically ill patients. Bilateral cases may cause acute stridor and airway compromise, whereas unilateral cases present with hoarseness or aspiration, often delaying recognition and increasing morbidity. We report 4 intensive care unit (ICU) patients with postintubation VCP diagnosed by fiberoptic laryngoscopy. Presentations ranged from bilateral injury resulting in stridor to unilateral dysfunction, with management strategies including observation, tracheostomy, and posterior cordotomy. This series underscores the diagnostic challenges, anatomical vulnerability of the recurrent laryngeal nerve, and need for early multidisciplinary evaluation to optimize outcomes and prevent long-term impairment.