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.

Keywords: Laryngeal nerve, dysphonia, Mediastinum