We describe a patient with a history of psychiatric disorder who was brought to our hospital after attempted suicide by hanging. Severe subcutaneous facial, palpebral and cervical emphysema was present, with dysphonia, dysphagia and slight respiratory difficulty. Fiberoptic bronchoscopy revealed upper airway obstruction due to edema in an intact airway. Successive CAT scans gave evidence of hyoid fracture and laryngocele, in addition to the corresponding emphysema of the subcutaneous area and pneumomediastinum. Given the persistence of dysphagia, we ordered esophageal tests, which showed functional alteration of the upper esophageal sphincter. Suprasternal cervicotomy to drain the pneumomediastinum and laryngeal microsurgery to treat the laryngocele resolved the problem.