Idiopathic bilateral vocal fold weakness

Objective: To describe an unrecognized clinical entity, idiopathic bilatera l vocal fold weakness, and propose recommendations regarding the diagnosis and management of these cases, Study Design: Retrospective, nonrandomized c ase study, Methods: All cases of bilateral vocal fold weakness evaluated at the University of Washington Voice Disorders Clinic between 1991 to 1998 w ere reviewed. Results: Four patients with bilateral laryngeal weakness were determined to have idiopathic bilateral vocal fold paresis following exhau stive workups, including videostroboscopy, bilateral laryngeal electromyogr aphy (EMG), neurological consultation, and other pertinent studies. Conclus ions: Performing bilateral laryngeal EMG is an essential aspect of the work up of any laryngeal weakness case, particularly if the etiology is unknown on presentation, Idiopathic bilateral vocal fold weakness is an underrecogn ized but real clinical diagnosis that will become more familiar with the in creasing utilization of laryngeal EMG in clinical situations.