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01-10-2006 | Case Report

Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

Authors: Roland Giger, MD, Pavel Dulguerov, MD, Michael Payer, MD

Published in: Dysphagia | Issue 4/2006

Abstract

Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscopy. Surgical removal of all osteophytes led to the resolution of symptoms. Dyspnea with or without dysphagia caused by hypertrophic anterior cervical osteophytes is an uncommon entity. The exhaustive diagnostic workup proposed in the literature could be simplified by using fiberoptic laryngoscopy and dynamic videofluoroscopy. The causes, treatment, and outcome are discussed.

Resnick D, Shaul SR, Robins JM: Diffuse idiopathic skeletal hyperostosis (DISH): Forestier’s disease with extraspinal manifestations. Radiology 115:513–524, 1975PubMed

Matan AJ, Hsu J, Fredrickson A: Management of respiratory compromise caused by cervical osteophytes: a case report and review of the literature. Spine J 2:456–459, 2002PubMedCrossRef

Nemours-Auguste S, Barag N: Dysphagia caused by cervical arthrosis. Presse Med 25:2295–2297, 1960

Saffouri HH, Ward PH: Surgical correction of dysphagia due to cervical osteophytes. Ann Otol Rhinol Laryngol 83:65–70, 1974PubMed

El-Sallab RA, Laws JW: Oesophageal and tracheal pseudo-tumours due to anterior cervical osteophytes. Br J Radiol 38:682–684, 1965PubMedCrossRef

Benhabyles M, Brattström H, Sundén G: Dysphagia and dyspnoea as complications in spondylarthritis ankylopoetica with cervical osteophytes. Acta Orthop Scand 41:396–401, 1970PubMedCrossRef

Saunders WH: Cervical osteophytes and dysphagia. Ann Otol Rhinol Laryngol 79:1091–1097, 1970PubMed

Girgis IH, Guirguis NN, Mourice M: Laryngeal and pharyngeal disorders in vertebral ankylosing hyperostosis. J Laryngol Otol 96:659–664, 1982PubMed

Hassard AD: Cervical ankylosing hyperostosis and airway obstruction. Laryngoscope 94:966–968, 1984PubMedCrossRef

10.

Sidi J, Hadar T, Shvero J, Har-El G, Shoshana M, Abraham A: Respiratory distress due to diffuse cervical hyperostosis. Ann Otol Rhinol Laryngol 96:178–181, 1987PubMed

11.

Solomons NB, Linton DM, Potgieter PD: Cervical osteophytes and respiratory failure. S Afr Med J 71:259–260, 1987PubMed

12.

Davies RP, Sage MR, Brophy BP: Cervical osteophyte induced dysphagia. Australas Radiol 33:323–325, 1989

13.

Karlins NL, Yagan R: Dypnea and hoarseness. A complication of diffuse idiopathic skeletal hyperostosis. Spine 16:235–237, 1991PubMed

14.

Rath T, Aita JF, Strauss DF, Hellbusch LC: A case report of Forestier’s disease. Nebraska Med J 74:306–308, 1989

15.

Jonathan D, Baer S: Cervical osteophytes: their significance in ENT practice (Ankylosing vertebral hyperostosis-Forestier’s disease). J Laryngol Otol 104:23–238, 1990

16.

Alonso-Vielba J, Morais D, Matesanz A, Santos J: Distress of the airway due to vertebral ankylosing hyperostosis or Forestier-Rotes’ disease. An Otorinolaringol Ibero Am 21:159–167, 1994

17.

Demuynck K, Van Calenbergh F, Goffin J, Verschakelen J, Demedts M, Van de Woestijne K: Upper airway obstruction caused by a cervical osteophyte. Chest 108:283–284, 1995PubMed

18.

Laus M, Malaguti MC, Alfonso C, Ferrari D, Zappoli FA, Giunti A: Dysphagia due to cervical osteophytosis. Chir Organi Mov 80:263–271, 1995PubMed

19.

Bruno E, Alessandrini M, De Angelis E: Giant cervical hyperostosis of the prevertebral space: presentation of two cases and a review of the literature. Acta Otorhinolaryngol Ital 16:532–536, 1996PubMed

20.

Tollefsen I, Hognestad S, Svihus R: Forestier syndrome. A rare cause of dysphagia and dyspnea. Tidsskr Nor Laegeforen 117:4076–4078, 1997PubMed

21.

Marks B, Schober E, Swoboda H: Diffuse idiopathic skeletal hyperostosis causing obstructing laryngeal edema. Eur Arch Otorhinolaryngol 255:256–258, 1998PubMedCrossRef

22.

Verstraete WL, De Cauwer HG, Verhulst D, Jacobs F: Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis (DISH). Acta Otorhinolaryngol Belg 52:79–84, 1998PubMed

23.

Papakostas K, Thakar A, Nandapalan V, O’Sullivan G: An unusual case of stridor due to osteophytes of the cervical spine: Forestier’s disease. J Laryngol Otol 113:65–67, 1999PubMed

24.

Kasper D, Hermichen H, Köster R, Schultz-Coulon HJ: Clinical manifestations of diffuse idiopathic skeletal hyperostosis (DISH). HNO 50:978–983, 2002PubMedCrossRef

25.

Maiuri F, Stella L, Sardo L, Buonamassa S: Dysphagia and dyspnea due to an anterior cervical osteophyte. Arch Orthop Trauma Surg 122:245–247, 2002PubMedCrossRef

26.

Manceau A, Beutter P, Lescanne E: Cervical osteophytes and ENT disease: three surgery cases. Ann Otolaryngol Chir Cervicofac 119:44–51, 2002PubMed

27.

Stancampiano FF, Zavaleta E, Astor F: Anterior cervical osteophytes: a rare cause of dysphagia and upper airway obstruction in older patients. J Am Geriatr Soc 50:1910–1911, 2002PubMedCrossRef

28.

Aronowitz P, Cobarrubias F: Anterior cervical osteophytes causing airway compromise. N Engl J Med 349:2540, 2003PubMedCrossRef

29.

Fuerderer S, Eysel-Gosepath K, Schröder U, Delank KS, Eysel P: Retro-pharyngeal obstruction in association with osteophytes of the cervical spine. J Bone Joint Surg (Br) 86-B:837–840, 2004CrossRef

30.

Kodama M, Sawada H, Udaka F, Kameyama M, Koyama T: Dysphagia caused by an anterior cervical osteophyte: case report. Neuroradiology 37:58–59, 1995PubMedCrossRef

31.

Mader R: Clinical manifestations of diffuse idiopathic skeletal hyperostosis of the cervical spine. Semin Arthritis Rheum 32:130–135, 2002PubMedCrossRef

32.

Deutsch EC, Schild JA, Mafee MF: Dysphagia and Forestier’s disease. Arch Otolaryngol 111:400–402, 1985PubMed

Title: Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited
Authors: Roland Giger, MD
Pavel Dulguerov, MD
Michael Payer, MD
Publication date: 01-10-2006
Publisher: Springer-Verlag
Published in: Dysphagia / Issue 4/2006
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-006-9049-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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