title: Cervical osteophytes impinging on the pharynx: importance of size and concurrent disorders for development of aspiration.
abstract: OBJECTIVE
  This study evaluated the clinical significance of cervical osteophytes impinging on the pharynx in patients with dysphagia and the importance of concurrent disorders that may affect swallowing function.
  
  
  METHODS
  On videofluoroscopy, anterior cervical osteophytes were found in 55 (32 men, 23 women; mean age, 69 years) of 3318 patients with dysphagia (1.7%). Coexisting diseases that affected swallowing function were found in 28 patients (stroke, n = 7; thyroidectomy, n = 7; tongue base or laryngeal cancer surgery, n = 5; other diseases, n = 9). Swallowing function was assessed with videofluoroscopy evaluating epiglottic tilting, laryngeal closure, impression of the hypopharynx, pharyngeal residue, and aspiration.
  
  
  RESULTS
  With advancing age, the probability of aspiration (odds ratio, 1.07; p < 0.05) and of enlarging osteophytes (odds ratio, 1.26; p < 0.01) increased; the probability was higher for osteophytes at more than one vertebrae (odds ratio, 8.00; p < 0.01) and for concurrent diseases (odds ratio, 8.02; p < 0.01). Aspiration was found in 75% of patients with osteophytes larger than 10 mm and in 34% with osteophytes smaller than or equal to 10 mm. In 88% of patients with small osteophytes who aspirated, other diseases affected swallowing function.
  
  
  CONCLUSIONS
  Aspiration is common in patients with dysphagia and cervical osteophytes larger than 10 mm. Aspiration is rare in patients with osteophytes smaller than or equal to 10 mm unless these patients suffer from other disorders that may affect swallowing.
authors.affiliation: Department of Radiology and Ludwig Boltzmann-Institute for Radiologic Tumor Research, University of Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Strasser
authors.forename: W
authors.initials: W
authors.lastname: Schima
authors.forename: E
authors.initials: E
authors.lastname: Schober
authors.forename: P
authors.initials: P
authors.lastname: Pokieser
authors.forename: A
authors.initials: A
authors.lastname: Kaider
authors.forename: D M
authors.initials: DM
authors.lastname: Denk
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013128:Spinal Osteophytosis / Q000150:complications* / Q000000981:diagnostic imaging