[Giant cervical hyperostosis of the prevertebral space: presentation of two cases and review of the literature].
Swellings of the retropharyngeal area are quite rare and all cases have common symptoms deriving from the site of origin, size, interaction with the surrounding anatomical structures and the presence, or lack thereof, of any associated inflammation. The main symptoms are dysphagia, the feeling of a foreign body in the pharynx and dyspnea. The present work describes two clinical cases of hyperostosis of the cervical column both of which presented discrete dysphagia, intermittent dyspnea and swelling in the area located between the pharynx and the spinal column thus leading to the feeling of having a foreign body in the area. The first case was a hyperostosis of the prevertebral space located on the right side and running medially toward the homolateral palatine tonsil. The pharyngoepiglottic fold area was medialized while the glottic region appeared normal. The second case had an ovoid median swelling in the hypopharynx stemming from the prevertebral space. During normal respiration the upper part of the laryngeal face of the epiglottis came into contact with this swelling while during phonation the glottic plane was normal. CT, MRI and endoscopy all proved able to provide information regarding the anatomy of the neoformation and the relationship with the neighboring structures. Many surgical techniques have been described to gain access to the spinal column osteophytes. The transcervical techniques give better exposure than transoral approaches although they increase the risk of damaging the recurrent laryngeal nerve and the sympathetic nervous system; moreover they require marked retraction of the carotid artery. In the authors' experience surgery was opted for in only one of the cases as the patient was relatively young and in good general health. The transcervical posterolateral approach was chosen as it provided better exposure of the cervical region between C3 and C6 than did the anterolateral approach.
Bruno
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E
Clinica Otorinolaringoiatrica, II Università Tor Vergata di Roma.
Alessandrini
M
M
De Angelis
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E
D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006801:Humans; D015576:Hyperostosis / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed