A Silent Complication: Review of Lingual Edema Following Intubation

Abstract

Objective

To synthesize published clinical evidence on post-intubation lingual edema, focusing on pathophysiology, clinical presentation, diagnosis, management, and prevention strategies.

Methods

A narrative review was performed using PubMed, Scopus, and EMBASE from inception through April 2025. Search terms included “tongue edema,” “macroglossia,” “lingual edema,” “endotracheal intubation,” “airway management,” and “critical care.” Eligible English-language reports describing lingual edema in adults following endotracheal intubation were included and synthesized qualitatively.

Results

A total of 48 studies were included, consisting predominantly of case reports, case series, and observational studies.

Conclusions

Post-intubation lingual edema is an uncommon but potentially life-threatening complication. Early recognition, mechanism-directed management, and preventive strategies, including atraumatic airway techniques, optimal positioning, frequent reassessment and device repositioning, and selective consideration of bradykinin-targeted therapy when angioedema is suspected, are critical to reducing morbidity.