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[Dysphagia due to giant cervical osteophytes]
Yuji Tanaka1, Yukihiro Yoneda, Yasushi Kita
1Neurology Service, Hyogo Brain and Heart Center at Himeji, Japan.
No to Shinkei = Brain and Nerve
|December 13, 2002
Summary
Giant cervical osteophytes can cause isolated dysphagia by compressing the esophagus. This case highlights the importance of considering cervical spondylosis in swallowing difficulties without neurological signs.
Area of Science:
- Neurology
- Gastroenterology
- Orthopedics
Background:
- Dysphagia, or difficulty swallowing, can arise from various causes, including neurological, structural, and inflammatory conditions.
- Cervical spondylosis, a degenerative condition of the cervical spine, commonly causes neck pain and neurological deficits.
- Esophageal compression by cervical osteophytes is a rare but recognized cause of dysphagia.
Observation:
- A 63-year-old male presented with isolated dysphagia, primarily affecting solid food intake.
- Neurological examination revealed no significant cranial nerve deficits, suggesting a non-neurological etiology.
- Cervical imaging identified large osteophytes at C5/6 impinging on the esophagus, particularly during neck flexion.
Findings:
- Videofluoroscopic swallowing studies showed contrast material pooling in the epiglottic vallecula without aspiration.
- Endoscopy revealed esophageal wall erosion at the site of osteophyte compression.
- The patient's dysphagia improved with anti-inflammatory medication, and surgical intervention was avoided.
Implications:
- Giant cervical osteophytes should be included in the differential diagnosis for isolated dysphagia, even in the absence of neurological symptoms.
- Conservative management with anti-inflammatory drugs can be effective for osteophyte-induced dysphagia.
- This case underscores the importance of comprehensive evaluation for structural causes of swallowing dysfunction.