Upper aerodigestive tract frostbite complicating volatile substance abuse

Volatile substance abuse has become increasingly popular among today's youth. It has reportedly been used by up to 13% of teenage populations. Physicians need to be aware of the potential complications which may arise from this form of substance abuse. We describe the case of a young male who presented with massive edema affecting his lips, oral cavity, oropharynx and trachea. It was later discovered that his injury was secondary to thermal trauma related to the abuse of a fluorinated hydrocarbon propellant. This presentation may easily be confused with allergic or angioneurotic edema. Denial by the patient can lead to a further delay in diagnosis. This case is especially notable since frostbite injury involving the upper aerodigestive tract is extremely rare. We discuss the differential diagnosis and the management principals required in the care of this patient. We also present a pertinent review of the literature related to both volatile substance abuse and its complications involving the airway.