{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:50:21Z","timestamp":1784242221650,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Prone positioning is frequently used in patients intubated for COVID\u201019\u2010related lung injury to improve oxygenation. At our institution, we observed severe tongue edema develop in some of these patients. Hence, we sought to determine the incidence of tongue edema in this cohort and whether prone positioning was a risk factor associated with this complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010system retrospective cohort study of patients intubated for respiratory failure secondary to COVID\u201019 who subsequently developed clinically notable tongue edema from March 13 to July 5, 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>260 patients were intubated for COVID\u201019\u2010related respiratory failure during the study period. 158 patients (60.8%) underwent at least one episode of proning. Twelve patients in total (4.6%) developed clinically significant tongue edema. Eleven of the twelve patients (91.7%) who developed tongue edema underwent proning prior to the development of edema. Prone positioning was associated with an increased incidence of tongue edema (odds ratio [OR] 7.56, 95% confidence interval [CI] 0.96\u201359.46, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.027). In all proned patients who developed edema, this complication was noted during proning or shortly after supination (range, 0\u20134\u2009days). Tongue edema was primarily managed with conservative measures; one patient required tracheostomy for definitive management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tongue edema appears to develop in a subset of patients with COVID\u201019 who are intubated. It appears to be associated with prone positioning but is likely multifactorial in nature. Further investigation into its incidence and pathophysiology is warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 132:287\u2013289, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29773","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T07:11:49Z","timestamp":1626765109000},"page":"287-289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of Severe Tongue Edema With Prone Positioning in Patients Intubated for <scp>COVID<\/scp>\u201019"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7703-2404","authenticated-orcid":false,"given":"Amanda","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Georgetown University Hospital  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7441-1572","authenticated-orcid":false,"given":"Tejasvi","family":"Peesay","sequence":"additional","affiliation":[{"name":"School of Medicine Georgetown University  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5010-1326","authenticated-orcid":false,"given":"Annemarie","family":"Newark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Georgetown University Hospital  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2851-2126","authenticated-orcid":false,"given":"Sarah","family":"Shearer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Georgetown University Hospital  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9198-5121","authenticated-orcid":false,"given":"Keon","family":"Parsa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Georgetown University Hospital  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Washington Hospital Center  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5382-9440","authenticated-orcid":false,"given":"William Z.","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Georgetown University Hospital  Washington District of Columbia U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery MedStar Washington Hospital Center  Washington District of Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,31]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"WHO Coronavirus (COVID\u201019) DashboardWorld Health Organization website. Updated July 29 2021. Available at:https:\/\/covid19.who.int. Accessed July 29 2021."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6775"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-237108"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29374"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06059-6"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-236981"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2020.100454"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41368-020-0074-x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1567-5769(02)00162-5"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989411100411"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2F000348946807700307"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29773","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29773","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T06:42:22Z","timestamp":1692600142000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29773"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,31]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/lary.29773"],"URL":"https:\/\/doi.org\/10.1002\/lary.29773","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,31]]},"assertion":[{"value":"2021-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}