Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis (DISH)

Area of Science:

• Otolaryngology
• Orthopedics
• Pulmonology

Background:

• Diffuse idiopathic skeletal hyperostosis (Forestier's disease) is a condition characterized by non-inflammatory osteophyte formation.
• Advanced stages can lead to dysphagia and respiratory symptoms like hoarseness and stridor.
• Severe respiratory distress is an uncommon but serious complication.

Observation:

• Two identical cases of chronic respiratory distress were identified.
• The distress was attributed to bilateral vocal cord adduction-fixation.
• Cervical skeletal pathology was a concurrent finding in both patients.

Findings:

• The presented cases highlight a rare manifestation of Forestier's disease.
• Bilateral vocal cord adduction-fixation, associated with cervical skeletal changes, can cause severe respiratory compromise.
• Detailed clinical, diagnostic, and therapeutic evaluations were performed.

Implications:

• This study underscores the importance of considering Forestier's disease in patients with unexplained chronic respiratory distress.
• Early diagnosis and management of laryngeal pathology secondary to skeletal changes are crucial.
• Further research into the mechanisms and optimal treatment strategies for such rare presentations is warranted.