“…Etiology remains unclear but a number of mechanisms have been implicated including obstruction of salivary ducts due to head position (prone, sitting, neck rotation, or head extension), leading to retention of secretions by glandular ischemia by squeezing arterial or venous vessels and retrograde passage of air into glands. Another hypothesis is that inadequate plane of anesthesia during intubation leads to straining and coughing and hence causing increased intraoral pressures and overactive pharyngeal reflexes which stimulate copious secretions [2]. Other factors implicated include trauma, infection, dehydration, hypersensitivity reactions (drug allergies), and use of anticholinergics, vasopressors, and muscle relaxants.…”