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After standard hip arthroplasty, an 82-year-old patient with previously undiagnosed diffuse idiopathic skeletal hyperostosis of the cervical spine experienced life-threatening side effects after use of a supraglottic airway device (i-gel). Extensive mucosal erosion and denudation of the cricoid cartilage caused postoperative supraglottic swelling and prolonged respiratory failure requiring tracheostomy. In this case report, we highlight the importance of evaluating risk factors for failure of supraglottic airway devices.

A 74-year-old woman presented with persistent dysphagia, dysphonia, and throat gurgling. Prior intraoperative biopsies were negative, and outside imaging revealed supraglottic swelling. Magnetic resonance imaging (MRI) demonstrated a well-defined T1 and T2 hypointense, avidly enhancing hypopharyngeal mass. Deep intraoperative rebiopsies revealed a tumor with CD34+ tissue, diagnostic of a solitary fibrous tumor. A broad range of nonsquamous cell tumors should be considered when a submucosal laryngeal mass is encountered. MRI may be particularly helpful in guiding appropriate biopsy.

We present two patients with airway obstruction due to supraglottic swelling; one was caused by a brown spider bite on an ear (loxoscelism) and the other from eating buffalo fish. In the latter patient it was likely due to scrombroid poisoning, a histamine-like reaction, but may have been an anaphylaxic reaction.