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Unilateral vocal cord paralysis (UVCP) is a major cause of dysphonia and can be diagnosed during laryngoscopic examination. UVCP is secondary to several causes. Idiopathic left recurrent laryngeal nerve (RLN) paralysis is a relative common clinical entity. In certain cases, a mediastinal cause can be identified. When a patient presents with vocal cord palsy, physicians should never overlook a cardiovascular...