RESUMEN
To highlight the occurrence of bilateral recurrent laryngeal nerve paralysis, a grave condition which is frequently overlooked, to reflect the author's personal experience with this condition over an 18-year period in Sudanese patients, and to identify the etiological factors involved in this condition. Patients and Hospital records of all cases [n=28] that presented to the ENT Department of Wad Medani Teaching Hospital in Central State of Sudan over a period of 18 years [1983 - 2001] with bilateral recurrent laryngeal nerve paralysis were reviewed. The total number of patients was 28. Twenty-five cases [25] were females while 3 were males. The female to male ratio was 8.3:10. Patients' ages ranged from 27-75 years with a mean age of 43.2 years. The symptom common to all patients was stridor on exertion. The main etiological factor was thyroidectomy [78.6%] followed in the order of frequency by malignant tumor invasion of the nerves [14.2%], neurological causes [3.6%], and trauma [3.6%]. The most common etiological factor of bilateral recurrent laryngeal nerve paralysis was found to be thyroid surgery [78.6%], followed by malignant tumor invasion of the nerves [14.2%], neurological causes [3.6%] and trauma [3.6%]. Patients undergoing thyroid surgery should have voice and vocal cord mobility assessed by a lamyngologist before and after surgery