We report a case of massive tongue engorgement associated with the placement of a laryngeal tube device (King Airway-LTS-D EMS). Our patient developed isolated, massive lingual swelling approximately 3 hours after the out-of-hospital placement of a laryngeal tube. Swelling resolved 2 days later in the ICU after fiberoptic-guided exchange of the laryngeal tube for an endotracheal tube. It is most likely that the observed swelling was due to obstruction of venous drainage from the tongue by the oropharyngeal balloon. Other etiologies for lingual swelling such as angioedema cannot be definitively ruled out but are less likely to have caused the patient's tongue engorgement.
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