Presented at the 2009 Triological Society Annual Meeting at COSM, Phoenix, Arizona, U.S.A., May 28–31, 2009.
Head and Neck
Ischemic necrosis of the tongue in patients with cardiogenic shock†
Article first published online: 5 MAY 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 7, pages 1345–1349, July 2010
How to Cite
Roman, B. R., Immerman, S. B. and Morris, L. G. T. (2010), Ischemic necrosis of the tongue in patients with cardiogenic shock. The Laryngoscope, 120: 1345–1349. doi: 10.1002/lary.20974
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 JUN 2010
- Article first published online: 5 MAY 2010
- Manuscript Accepted: 23 MAR 2010
- Level of Evidence: 4
Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue.
Retrospective analysis of hospital charts.
Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock.
Five critically ill patients in our institution's cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intra-aortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue.
Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis. Laryngoscope, 2010