Post-extubation stridor resulting from chronic laryngeal edema following radiotherapy
Reliably predicting which patients may have a difficult airway is a cornerstone of airway management by physicians. Radiotherapy to the airway can lead to short- and long-term side effects such as future difficult intubation, chronic laryngeal edema and post-extubation respiratory complications. We present the case of a 76-year-old man with chronic laryngeal edema secondary to a remote history of neck radiation for laryngeal carcinoma, who presents to the emergency department with aspiration pneumonia requiring mechanical ventilation. Although the patient’s respiratory status improved after several days of mechanical ventilation, he failed several extubation attempts due to upper airway obstruction secondary to edema and required a tracheostomy. This case highlights the crucial, but often overlooked long-term complications of neck radiotherapy.