Delayed Intractable Postextubation Laryngeal Edema after General Anesthesia

We report a case of delayed intractable postextubation laryngeal edema after extubation in 78-year-old female patient who underwent uneventful operation. The patient had underwent tracheostomy 30 years ago. After 14 hours extubation, she developed postextubation laryngeal edema. Reintubation was done, and she was transferred to the intensive care unit. After this, tracheal intubation is repeated, postextubation laryngeal edema occurs again 48 hours after extubation the last, after all, the patient underwent a tracheostomy. postextubation laryngeal edema can happen any time after the extubation despite of intensive treatment, particularly in patients with history of previous tracheostomy. It seems ideal to avoid tracheal manipulation if other anesthetic plan is available and careful history taking and evaluation of airway will be helpful for these patients.