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We report a case of an 84-year-old man who developed delayed bilateral vocal cord paralysis requiring tracheostomy following right middle cerebral artery infarction involving the opercular-insular region, raising the possibility that unilateral opercular-insular injury may disrupt bilateral laryngeal motor control in certain individuals, and highlighting the need for awareness of this rare but life-threatening complication after middle cerebral artery infarction.
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Park et al. (2026) studied this question.
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