Post-extubation stridor in Down's syndrome.

Laryngeal oedema, giving rise to stridor, is a recognized although rare complication following extubation of the trachea in children. It was our clinical impression that children with Down's syndrome, in particular, had a tendency to develop obstruction of the airway following operation. In Down's syndrome there are many abnormalities which affect the face and skull: those affect' ing the airway include a flattened nasal bridge, short nose, small mouth and a short neck. Since some patients have cardiac or gastrointestinal abnormalities as well, major surgery may be required in childhood. Other abnormalities of relevance are hypotonia (Smith, 1976) and a predisposition to thyroid dysfunction (Lobo, Khan and Tew, 1980).