Relapsing polychondritis: a possible cause of difficult extubation

We report the case of a 54-year-old woman suspected of relapsing polychondritis who underwent a nasal septum biopsy under general anaesthesia. Tracheal intubation was unremarkable, but extubation attempts failed because of upper airway inspiratory collapse induced ventilatory distress. Definitive tracheostomy placement was mandatory. Cartilage biopsy confirmed severely developed relapsing polychondritis. Even though relapsing polychondritis is rare, anaesthesiologists should be aware of this pathology and preanaesthetic evaluation may focus on particular risks associated with upper airway cartilaginous structure anatomical and histological modifications.