An 88 year old woman fell onto her Zimmer frame striking her chin. Six hours later she developed difficulty in breathing with a hoarse voice and neck swelling, at which time she presented to the accident and emergency department. On arrival she had stridor, a hoarse voice and a large diffuse neck swelling mainly on the left side. She underwent an urgent radiograph of the neck and computed tomography. The lateral radiograph of the neck revealed a large retropharyngeal soft tissue swelling (fig 1). …