Summary

The authors report an unusual case of post extubation stridor resulting in insertion of a tracheostomy. Regional anaesthesia using interscalene nerve blockade in the presence of an unrecognised contralateral recurrent laryngeal nerve palsy resulted in bilateral recurrent laryngeal nerve palsies. The authors discuss the differential causes of stridor and recurrent laryngeal nerve palsy, their importance and way of identification on preoperative assessment.