A patient undergoing therapy for a head and neck cancer may experience sudden death for a variety of reasons:
Patient selection: status post therapy for a head and neck surgery
More common causes of sudden death:
(1) cardiac arrhythmia
(2) respiratory airway obstruction
(3) adverse drug effect (respiratory depression from opioid and benzodiazepine, etc)
A higher risk period is the first 3 days after surgery.
Risk factors for cardiac arrhythmias:
(1) pre-existing coronary artery disease
(2) pre-existing cardiac arrhythmia
(3) therapy with drug causing prolongation of the QT interval
(4) alcohol abuse
(5) perioperative hypotension
(6) cardiac metastases (rare)
(7) current smoking
(8) bathing in hot water (? vasovagal stimulus)
Risk factors for respiratory airway obstruction:
(1) lesions of larynx or hypopharynx
(2) mucosal edema of the upper airway
(3) allergic reaction and/or angioedema
