Myxedema of the Larynx: An Underrecognized Cause of Airway Compromise in Patients With Severe Hypothyroidism

Myxedema coma and severe hypothyroidism are rare diagnoses with a high rate of mortality. Associated respiratory failure is well recognized; however, airway compromise as the result of myxedema infrequently is discussed. We report a case of severe hypothyroidism resulting in respiratory compromise attributable to myxedematous infiltration of the larynx. A 62-year-old woman presented with confusion and severe hypothyroidism. Imaging demonstrated profound upper airway edema, and the results of a laryngoscopy suggested laryngeal myxedematous infiltration. She was emergently intubated and responded to thyroid hormone replacement. A review of the literature revealed 13 similar cases of laryngeal myxedema in patients with severe hypothyroidism, suggesting this complication may be more prevalent than initially appreciated.