Dual Airway Compromise From Infantile Hemangioma and Laryngomalacia: Fatal Airway Obstruction Following Self-Extubation.

Abstract

An 18-month-old toddler was found unresponsive in a face-down position by her adoptive mother's boyfriend. The patient had a history of dual airway obstruction: laryngomalacia involving the supraglottic region and a GLUT1-positive infantile hemangioma causing subglottic narrowing. She initially underwent supraglottoplasty, but due to limited improvement and persistent subglottic stenosis, a tracheostomy was performed. She was also prescribed oral propranolol for the hemangioma. At the time of death, the tracheostomy tube was found outside her airway. Whether the tube was removed or dislodged remains unclear, but the loss of airway access caused death. This case highlights the danger of pediatric airway obstruction and the importance of tracheostomy management, airway monitoring, and interdisciplinary care in complex pediatric cases.