We describe a case of retropharyngeal hematoma after a cervical hyperextension injury in an elderly man. Progressive hoarseness, dysphagia, and dyspnea were the early signs that necessitated oral endotracheal intubation and, ultimately, tracheostomy. The hematoma was explored and drained through a lateral cervical approach, and a bleeding vessel in a small tear in the anterior spinous ligament was noted and cauterized. The patient recovered uneventfully.
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