THE ASSOCIATION of unilateral laryngeal paralysis with other paralyses, and sometimes with anesthesias, has been common knowledge since Avellis1 described 10 cases of unilateral paralysis of the soft palate and the larynx. In the years since 1891 others have observed similar association of signs, and several names have been attached to the complex. Vernet2 in 1918, partly on the basis of his work reported earlier (1916),3 provided a comprehensive view of the various associated paralyses and anesthesias. It referred to the complex as a syndrome of the last four pairs of cranial nerves. Lederer4 proposed a nomenclature based on the nerves involved and the location of the lesion responsible. According to his classification, the lesion could be bulbar, in the jugular foramen, in the parapharyngeal space, or near the arch of the aorta. A more recent review, with the report of one case, by Fox and