Respiratory distress is seen in-

Ans. is 'a' i.e., Bilateral abductor palsy [Ref: Essentials otolaryngology 2nd/e p. 740\o Respiratory distress (dysnea & stridor) is seen in bilateral abductor palsy.Clinical features of RUN ParalysisUnilateral RLN paralysis (unilateral abductor paralysis)o Unilateral RLN paralysis is usually mild and may be asymptomatic,o The cord is fixed in paramedian positiono There may be some change in voice (slight hoarsness) and some dysfunction in swallowing, but no problems of aspiration or airway obstruction."Vocal weakness, hoarseness and dysphonia are signs of unilateral paralysis " -- Essential otolaryngologyo The voice gradually improves due to compensation by the healthy cord which crosses the midline to meet the paralysed one.o Usually no treatment is requiredBilateral RLN paralysis (Bilateral abductor paralysis)o This is the most dangerous paralysis as both the cords are in median or paramedian position, obstructing the airway.o There is dyspnea and stridor o Voice is goodo Treatment includes : -Tracheostomy : - It is required as an emergency procedure when there is severe respiratory1 distress or upper respiratory tract infection.Lateralization of cord: - Aim is to move and fix the cord in a lateral position to improve the airway.