Post-traumatic Lingual Hematoma-An Emergency to Manage: A Systematic Review of Literature

A varied list of reasons for lingual hematoma is listed in literature. These are allergic reaction, post-traumatic, spontaneous in patients on anticoagulants or antiplatelets, viral or bacterial infections, self-inflicted injuries, tongue bite during seizures, child abuse and iatrogenic. In the present review, the authors have concentrated on post-traumatic lingual hematoma and its management.

The authors have systematically searched the literature reporting post-traumatic lingual hematoma following the PRISMA guidelines. The search was performed in PubMed, Google Scholar, Semantic Scholar and the Cochrane library database from 1985 to 2023.

38 studies {41 patients (27 males and 14 females)} were included and analyzed in the present systematic review. All patients, except 2 (succumbs due to their medical condition), reported complete resolution of hematoma. The age range was 70 days-79 years. In all the reported studies, the airway was managed with either intubation and/or tracheostomy. Treatment varied from only observation, airway maintenance (intubation/tracheostomy), steroids administration, antibiotic coverage, reversal of antiplatelet or anticoagulant drugs, embolization or surgical intervention.

Prompt recognition and management of the airway are the crucial step in these patients. Acute lingual hematoma is a clinical diagnosis, and to prevent related complications, a detailed history of preexisting comorbidities and medication is crucial. Most importantly, repeated examination of oral cavity in case of lingual hematoma is mandatory.