Acute airway obstruction in a patient with forestier disease. Case report

Ossification of the anterior longitudinal ligament of the spine, known as Forestier disease or diffuse idiopathic skeletal hyperostosis, is usually an asymptomatic disorder. The area most frequently affected is the thoracic spine, followed by lumbar and cervical regions. In the case of cervical involvement with clinical manifestations, the most common symptoms include dysphagia, dyspnoea, dysphonia, and can exceptionally cause an acute airway obstruction. The airway management of these patients represents a great anaesthetic challenge. The case is reported of an eighty-five-year-old patient who had an acute airway obstruction associated with Forestier disease. A fibre-optic-assisted intubation was accomplished under sevoflurane inhaled anaesthesia, maintaining spontaneous ventilation, with subsequent tracheostomy performed by ENT surgeons.