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Emergency physicians sometimes have to face rare causes of acute dyspnea. We report a case of laryngopharyngeal compression in a patient with Launois-Bensaude syndrome. This patient had predictive criteria of difficult intubation and failed to respond to noninvasive ventilation (NIV) treatment. The relatively well-supported situation sustained intubation decision until ventilation ceased a few minutes after in-hospital arrival. In this case, in-hospital intubation was better than prehospital's.