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Dysphagia due to cervical osteophytosis
M Laus1, M C Malaguti, C Alfonso
1Divisione di Ortopedia e Traumatologia Polichlinico S. Orsola-Malpighi, Bologna.
La Chirurgia Degli Organi Di Movimento
|July 1, 1995
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) cervical lesions can cause breathing and swallowing difficulties. Conservative or surgical treatments effectively resolved symptoms in six patients, with no recurrence observed.
Area of Science:
- Orthopedics
- Otolaryngology
- Gastroenterology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) can manifest as cervical lesions.
- These lesions, particularly anterior osteophytes and prevertebral ossifications, may compress vital structures.
- Such compression can lead to significant respiratory and digestive pathway compromise.
Purpose of the Study:
- To report a series of six cases of cervical DISH causing dysphagia, dysphonia, and dyspnea.
- To evaluate the efficacy of conservative and surgical management strategies for these debilitating symptoms.
Main Methods:
- Retrospective case series of six patients with cervical DISH.
- Conservative management involved anti-inflammatory drugs and dietary modifications for moderate symptoms.
- Surgical intervention entailed prevascular extrapharyngeal removal of osteophytes and ossifications for severe cases.
Main Results:
- Three patients with moderate dysphagia improved with conservative treatment, showing lesion remodeling and symptom resolution.
- Three patients with severe respiratory/nutritional deficits underwent surgery, experiencing rapid symptom relief.
- Follow-up revealed asymptomatic patients with no radiographic recurrence at 1-7 years post-treatment.
Conclusions:
- Cervical DISH presents a treatable cause of upper airway and digestive tract compression.
- Both conservative and surgical approaches can effectively manage symptoms associated with cervical DISH.
- Long-term follow-up indicates sustained positive outcomes and absence of lesion recurrence.