Whilst the nomenclature of this pathology is confusing, distinctions of terminology do not alter the management. Hence, we support the use of the term 'air cyst', to incorporate all these lesions.

SummaryBackground:Chest wall trauma is a frequent cause for emergency department presentations, with traumatic pneumathoraces a relatively common occurance. Vocal cord paralysis however, is uncommon.Case Report:A 44 year old man presented with a traumatic pneumothorax following a fall. A weak and hoarse voice was noted and vocal cord palsy demonstrated on indirect laryngoscopy. CT chest was unremarkable for mediastinal lesions.Conclusions:Clinicians need be mindful of traction injuries to mediastinal structures when examining those with chest wall injuries.