Delayed fatal upper-airway obstruction due to laryngopharyngeal burns and thermal epiglottis

Abstract

A 48-year-old man complained of throat swelling and difficulty swallowing after eating hot food. Several hours later, he collapsed and was observed to be gasping for breath. Bystander and ambulance-initiated cardiopulmonary resuscitation was unsuccessful, and he was pronounced deceased at the scene. At autopsy, the aryepiglottic folds were markedly oedematous, with adjacent areas of mucosal inflammation and necrosis from a recent burn. Death was attributed to upper-airway obstruction due to glottic inlet oedema associated with epiglottic and laryngopharyngeal thermal injury. Although thermal epiglottitis not involving fire is an unusual injury and is rarely fatal, the reported case demonstrates a lethal episode arising from the ingestion of excessively hot food. Thermal epiglottitis therefore represents an uncommon cause of delayed upper-airway obstruction in adults that should be considered in individuals presenting with a sore throat and shortness of breath, particularly if there is a history of hot-food ingestion.

Laryngeal oncocytic cystadenoma and sudden death

“…Critical swelling may also be caused by anaphylaxis or may be due to edema from burns [ 7 ]. One of the more common scenarios in medicolegal settings is the so-called café coronary syndrome when the upper airway is blocked by poorly-masticated food, often in demented or intoxicated individuals [ 8 ].…”