Recurrent noncardiogenic pulmonary edema secondary to obstruction by hemiepiglottic remnant

Recurrent episodes of pulmonary edema developed in a 39-year-old man following removal of a squamous cell carcinoma of the lateral pharyngeal wall and adjacent base of the tongue. The sequence of events suggests that the supine position precipitated acute upper airway obstruction by the hemiepiglottis left at the time of surgery. Removal of the remnant resulted in disappearance of the paroxysmal pulmonary edema and renewed ability to lie flat. Although pulmonary edema secondary to upper airway obstruction is a recognized entity, to our knowledge this is the first time this complication is reported as a result of intermittent inspiratory obstruction following partial laryngeal resection.