Protrusion of the tongue is a common, though often neglected finding in fire fatalities. According to a study recently published by Bernitz et al., it is an indicator of vital burning.
This statement has been doubted repeatedly. Retrospective analysis of 61 fire fatalities from our own autopsy material did not show any statistically significant increased incidence of tongue protrusion in deaths with vital exposure to heat.
Similarly, there was no correlation with the degree of destruction by the fire in general or the extent of cervical burning. Further prospective studies seem to be necessary also with regard to the pathophysiological processes.