Swallowing disorders among patients with diffuse idiopathic skeletal hyperostosis

Area of Science:

• Geriatric Medicine
• Otolaryngology
• Gastroenterology

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by ossification of the anterior longitudinal spinal ligament.
• Large cervical osteophytes associated with DISH can lead to mechanical dysphagia by compressing the pharynx.

Purpose of the Study:

• To investigate the prevalence and characteristics of swallowing disorders in patients diagnosed with DISH.
• To evaluate the effectiveness of conservative management for dysphagia in DISH patients.

Main Methods:

• A study involving 139 patients with DISH.
• Swallowing function was assessed using the Eating Assessment Tool (EAT-10) and Fiber-optic Endoscopic Evaluation of Swallowing (FEES).
• Patients with swallowing disorders received 6 months of conservative treatment, followed by reassessment.

Main Results:

• 16.5% of DISH patients (23 out of 139) exhibited swallowing disorders, with pharyngeal food residues noted on FEES.
• Conservative treatment led to significant overall improvement, enabling two patients to return to a regular diet.
• One patient required surgical intervention due to persistent symptoms and large cervical osteophytes.

Conclusions:

• DISH is a recognized cause of dysphagia in the elderly population.
• Otolaryngologists should consider DISH in elderly patients presenting with swallowing difficulties.
• While conservative management is often effective, surgical reduction of cervical osteophytes may be necessary for severe cases.