In this case report, we present a patient with a potentially life-threatening airway obstruction after the recreational use of nitrous oxide. The patient initially presented with a globus sensation and hoarse voice. Flexible nasal endoscopy showed severely swollen arytenoids not responding to treatment with progression over time. After two days of mechanical ventilation the patient was extubated and discharged home without permanent disability. When confronted with patients with complaints of the throat after nitrous oxide abuse, we recommend flexible nasal endoscopy to identify potential airway compromise.
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