When Postextubation Stridor Is Not Edema: Bilateral Lateral Subglottic Mucosal Tears.

Iatrogenic tracheal injury following endotracheal intubation is a rare but potentially life-threatening complication. Most reported injuries involve the posterior membranous tracheal wall. We describe a case in which a patient required rapid sequence emergency intubation in the ED and, three days later, following extubation, developed acute stridor and increasing oxygen requirements, found to be secondary to bilateral, inferiorly based lateral mucosal tears of the subglottic larynx and superior trachea with an associated grade 1 subglottic stenosis. This case highlights the importance of maintaining a high suspicion for airway trauma when a patient presents with difficulty breathing, stridor, or decreasing oxygenation after intubation and supports downsized endotracheal tube splinting as an effective nonsurgical management strategy.