Congenital upper airway obstruction is a relatively rare but important cause of major respiratory problems in the neonatal period. Vocal cord paralysis is the second most common cause of congenital airway obstruction presenting with neonatal stridor. Vocal cord palsy is usually unilateral and most often linked with birth trauma. Bilateral palsy can be associated with other congenital anomalies especially central nervous system inculuding Arnold-Chiari malformation. The current report describes a case of idiopathic congenital bilateral vocal cord paralysis and severe enough to require tracheostomy.
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