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Anterior cervical osteophytes resulting in severe dysphagia and aspiration: two case reports and literature review

Published online by Cambridge University Press:  27 April 2009

M P Kos ,
B J van Royen ,
E F David  and
H F Mahieu
M P Kos*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Free University Medical Center, Amsterdam, The Netherlands Department of Otolaryngology, Waterland Hospital, Purmerend, The Netherlands
B J van Royen
Affiliation:
Department of Orthopedic Surgery, Free University Medical Center, Amsterdam, The Netherlands
E F David
Affiliation:
Department of Radiology, Free University Medical Center, Amsterdam, The Netherlands
H F Mahieu
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Free University Medical Center, Amsterdam, The Netherlands Department of Otolaryngology/Head and Neck Surgery, Meander Medical Center, Amersfoort, The Netherlands
*
Address for correspondence: Dr Martijn P Kos, Department of Otolaryngology, Waterland Hospital, PO Box 250, 1440 AG Purmerend, The Netherlands. Fax: +31 299 457555 E-mail: martijn.kos@gmail.com
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Abstract

Objective:

We report two cases in which dysphagia and aspiration, caused by anterior cervical osteophytes, were so severe that surgical resection was performed.

Method:

Case reports and a review of the world literature concerning dysphagia caused by anterior cervical osteophytes, in regard to pathogenesis, diagnosis and treatment.

Results:

Two patients, aged 71 and 70 years, had long-standing, slowly progressive dysphagia and aspiration; one patient had recurrent episodes of aspiration pneumonia as a result. Both patients were diagnosed on videofluoroscopy with large bony anterior cervical osteophytes. Immediate relief of symptoms was obtained after resection of the osteophytes via an anterolateral, extrapharyngeal approach. Anterior cervical osteophytes are relatively common in the elderly, although not frequently diagnosed, and are mostly seen in cases of diffuse idiopathic skeletal hyperostosis. If therapy is indicated it is mainly conservative; resection is rarely needed.

Conclusion:

In patients with anterior cervical osteophytes, surgical treatment is indicated only for selected cases with large, bony osteophytes and severe symptoms.

Keywords

OsteophytesCervical SpineDysphagia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 10 , October 2009 , pp. 1169 - 1173
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Resnick, D, Shaul, SR, Robins, JM. Diffuse idiopathic skeletal hyperosteosis (DISH): Forestier's disease with extraspinal manifestations. Radiology 1975;115:513–24Google Scholar
2Matan, AJ, Hsu, J, Fredrickson, A. Management of respiratory compromise caused by cervical osteophytes: a case report and a review of the literature. Spine J 2002;2:456–9Google Scholar
3Mosher, HP. Exostosis of the cervical vertebrae as a cause of difficulty in swallowing. Laryngoscope 1926;36:181–2Google Scholar
4LeRoux, BT. Dysphagia and its causes. Geriatrics 1962;17:560–8Google Scholar
5Gamache, FW, Voorhies, RM. Hypertrophic cervical osteophytes causing dysphagia. J Neurosurg 1980;53:338–44CrossRefGoogle ScholarPubMed
6Kiss, C, Szilagyi, M, Paksy, A, Poór, G. Risk factors for diffuse idiopathic skeletal hyperostosis: a case control study. Rheumatology 2002;41:27–30CrossRefGoogle ScholarPubMed
7Verlaan, JJ, Oner, FC, Maat, GJ. Diffuse idiopathic skeletal hyperostosis in ancient clergymen. Eur Spine J 2007;16:1129–35Google Scholar
8Bone, RC, Nahum, AM, Harris, AS. Evaluation and correction of dysphagia-producing cervical osteophytosis. Laryngoscope 1974;84:2045–50CrossRefGoogle ScholarPubMed
9Crowther, JA, Ardran, GM. Dysphagia due to cervical spondylosis. J Laryngol Otol 1985;99:1167–9CrossRefGoogle ScholarPubMed
10Eviatar, E, Harell, M. Diffuse idiopathic skeletal hyperosteosis with dysphagia (a review). J Laryngol Otol 1987;101:627–32CrossRefGoogle Scholar
11Resnick, D, Shapiro, RF, Wiesner, KB, Niwayama, G, Utsinger, PD, Shaul, SR. Diffuse idiopathic skeletal hyperosteosis (DISH) [ankylosing hyperostosis of Forestier and Rotes-Querol]. Semin Arthritis Rheum 1978;7:153–78Google Scholar
12Lambert, JR, Tepperman, PS, Jimenez, J, Newman, A. Cervical spine disease and dysphagia. Four new cases and a review of the literature. Am J Gastroenterol 1981;76:35–40Google Scholar
13Kissel, P, Youmans, JR. Posttraumatic anterior cervical osteophyte and dysphagia: surgical report and literature review. J Spinal Disord 1992;5:104–7Google Scholar
14Jahnke, V. Clinical aspects of pharyngoesophageal dysphagia from the otorhinolaryngologic viewpoint. Arch Otorhinolaryngol Suppl 1990;1:33–50Google Scholar
15Oga, M, Mashima, T, Iwakuma, T, Sugioka, Y. Dysphagia complications in ankylosing spinal hyperosteosis and ossification of the posterior longitudinal ligament. Spine 1993;18:391–4Google Scholar
16Biesinger, E, Schrader, M, Weber, B. Osteochondrosis of the cervical spine as a cause of globus sensation and dysphagia [in German]. HNO 1989;37:33–5Google ScholarPubMed
17Girgis, IH, Guirguis, NN, Mourice, M. Laryngeal and pharyngeal disorders in vertebral ankylosing hyperosteosis. J Laryngol Otol 1982;96:659–64Google Scholar
18Zerhoumi, EA, Bosma, JF, Donner, MW. Relationship of cervical spine disorders to dysphagia. Dysphagia 1987;1:129–33Google Scholar
19Bauer, F. Dysphagia due to cervical spondylosis. J Laryngol Otol 1953;67:615–30CrossRefGoogle ScholarPubMed
20Brandenberg, G, Leibrock, LG. Dysphagia and dysphonia secondary to anterior cervical osteophytes. Neurosurgery 1986;18:90–3CrossRefGoogle ScholarPubMed
21Beahrs, OH, Schmidt, HW. Dysphagia caused by hypertrophic changes in the cervical spine. Ann Surg 1959;149:297–9Google Scholar
22Burkus, JK. Esophageal obstruction secondary to diffuse idiopathic skeletal hyperosteosis. Orthopedics 1988;11:717–20Google Scholar
23Meeks, LW, Renshaw, TS. Vertebral osteophytes and dysphagia. Ann Otol Rhinol Laryngol 1970;79:1091–7Google Scholar
24Perrone, JA. Dysphagia due to massive cervical exostosis. Arch Otolaryngol 1969;86:346–7Google Scholar
25Richter, D, Ostermann, PA, Schumann, C, Dávid, A, Muhr, G. Ventral hyperosteosis of the cervical spine — a rare differential diagnosis of dysphagia [in German]. Chirurg 1995;66:431–3Google Scholar
26Iglauer, S. A case of dysphagia due to an osteochondroma of cervical spine osteotomy – recovery. Ann Rhin Laryngol 1938;47:799–803CrossRefGoogle Scholar
27Akhtar, S, O'Flynn, PE, Kelly, A, Valentine, PM. The management of dysphagia in skeletal hyperostosis. J Laryngol Otol 2000;114:154–7CrossRefGoogle ScholarPubMed
28Carrau, RL, Cintron, FR, Astor, F. Transcervical approaches to the prevertebral space. Arch Otolaryngol Head Neck Surg 1990;116:1071–3Google Scholar
29Krause, P, Castro, WH. Cervical hyperostosis: a rare cause of dysphagia. Case description and bibliographical survey. Eur Spine J 1994;3:56–8CrossRefGoogle ScholarPubMed
30Giger, R, Dulguerov, P, Payer, M. Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited. Dysphagia 2006;21:259–63Google Scholar