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Summary
Forestier disease, or ankylosing hyperostosis of the cervical spine, can cause severe airway obstruction. This condition involves osteophyte formation leading to vocal cord paralysis and requires surgical intervention.
Area of Science:
- Otolaryngology
- Spinal Surgery
Background:
- Forestier disease, characterized by ankylosing hyperostosis of the cervical spine, is known to cause dysphagia and aspiration.
- The posterior plate of the cricoid cartilage is a critical anatomical region for airway patency.
Observation:
- Two patients presented with Forestier disease causing ulceration of the cricoid cartilage posterior plate.
- This led to inflammatory edema and secondary bilateral vocal cord paralysis, resulting in significant airway obstruction.
Findings:
- The disease progression involves initial mild dysphagia, followed by increasing airway obstruction due to osteophyte formation.
- Pathogenesis includes superimposed infection on cricoid ulceration caused by laryngeal movement over sharp osteophytes.
Implications:
- Prompt diagnosis and management are crucial for preventing life-threatening airway compromise.
- Treatment strategies involve securing the airway (tracheostomy), ruling out malignancy (endoscopy), antibiotic therapy, and surgical osteophyte excision.