{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T18:01:57Z","timestamp":1784484117044,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,14]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Airway involvement following chemical ingestion is rare but may pose life-threatening challenges to the anaesthesiologist. We report an Asian woman, in her 50s, with craniovertebral junction anomaly scheduled for posterior instrumentation comprising occiput\u2013bilateral C1-C2 laminar screw and rod fixation along with foramen magnum decompression. Intraoperatively, she developed unexpected glottic narrowing which was later attributed to prior mosquito repellent ingestion which posed significant airway challenges. Initial intubation was uneventful with a video laryngoscope; however, attempts at tracheal extubation and re-intubation failed due to unrecognised airway narrowing and severe glottic oedema. Multiple attempts with smaller endotracheal tubes were unsuccessful, necessitating an emergency tracheostomy to secure the airway. Retrospective evaluation revealed a missed history of caustic ingestion and subtle tracheal narrowing on chest radiograph. This case underscores the compounded risks of airway management in patients with cervical spine anomalies and prior corrosive ingestion. Vigilant history-taking, careful review of preoperative imaging, availability of smaller tubes and readiness for surgical airway are paramount.<\/jats:p>","DOI":"10.1136\/bcr-2025-269350","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:15:20Z","timestamp":1771478120000},"page":"e269350","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Glottic narrowing secondary to prior mosquito repellent ingestion presenting as a difficult airway during craniovertebral junction surgery"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5831-7076","authenticated-orcid":false,"given":"Kanika","family":"Gupta","sequence":"first","affiliation":[{"name":"Anaesthesiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivam","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Anaesthesiology, All India Institute of Medical Sciences Deoghar, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Gupta","sequence":"additional","affiliation":[{"name":"Anaesthesiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4392-1524","authenticated-orcid":false,"given":"Ashwin Kumar","family":"Panda","sequence":"additional","affiliation":[{"name":"Neurosurgery, AIIMS Rishikesh, Rishikesh, Uttrakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"2026071910151278000_19.2.e269350.1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.otot.2020.10.006","article-title":"Upper Airway Burn Injury","volume":"31","author":"Tracy","year":"2020","journal-title":"Operative Techniques in Otolaryngology-Head and Neck Surgery"},{"key":"2026071910151278000_19.2.e269350.2","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000023586","article-title":"Case report of tracheobronchial injuries after acid ingestion: CT findings with serial follow-up: Airway complication after acid ingestion","volume":"99","author":"Kim","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"2026071910151278000_19.2.e269350.3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s12098-019-03132-x","article-title":"Liquid Mosquito Repellents \u2013 Keep Them Away from Toddlers","volume":"87","author":"Kumar","year":"2020","journal-title":"Indian J Pediatr"},{"key":"2026071910151278000_19.2.e269350.4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.4103\/0974-8237.193256","article-title":"Anaesthesia management in craniovertebral junctional anomalies","volume":"7","author":"Mascarenhas","year":"2016","journal-title":"J Craniovert Jun Spine"},{"key":"2026071910151278000_19.2.e269350.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2012.06.008"},{"key":"2026071910151278000_19.2.e269350.6","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1002\/ccr3.2395","article-title":"Corrosive injury of the trachea in children","volume":"7","author":"Goussard","year":"2019","journal-title":"Clin Case Rep"},{"key":"2026071910151278000_19.2.e269350.7","doi-asserted-by":"crossref","first-page":"S282","DOI":"10.5005\/jp-journals-10071-23305","article-title":"Corrosive Ingestion","volume":"23","author":"Kalayarasan","year":"2019","journal-title":"Indian J Crit Care Med"},{"key":"2026071910151278000_19.2.e269350.8","unstructured":"Stark P . Radiology of the trachea. In: Connor RF , ed. UpToDate."},{"key":"2026071910151278000_19.2.e269350.9","doi-asserted-by":"crossref","first-page":"643","DOI":"10.4097\/kja.23445","article-title":"Corrosive poisoning and its implications on pediatric airways","volume":"76","author":"Payal","year":"2023","journal-title":"Korean J Anesthesiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T17:15:20Z","timestamp":1784481320000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,18]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-269350"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269350","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}