Dysphagia and dyspnea due to an anterior cervical osteophyte.
Hypertrophic anterior cervical osteophytes have been reported as a cause of dysphagia, with about 100 cases described in the literature; on the other hand, chronic or acute dyspnea due to edema of the laryngeal inlet or bilateral vocal cord adduction-fixation is rare. We report a 57-year-old patient with a 2-year history of dysphagia and episodic dyspnea, who suffered sudden, severe respiratory distress necessitating emergency tracheotomy. A voluminous anterior cervical osteophyte at the C5 level was diagnosed by computed tomography (CT) and barium swallow test and removed by an anterior approach to the cervical spine, with clinical remission. The incidence, pathogenetic mechanisms, radiological diagnosis, and surgical indications of anterior cervical osteophytes associated with dysphagia and dyspnea are discussed. We advise examining cervical spine patients with dysphagia and/or dyspnea by radiography and CT when other investigations are not conclusive for a digestive or respiratory pathology.
Maiuri
Francesco
F
Department of Neurosurgery, School of Medicine, University "Federico II", via Pansini 5, 80131 Naples, Italy.
Stella
Lucio
L
Sardo
Luigi
L
Buonamassa
Simona
S
D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D002908:Chronic Disease; D003680:Deglutition Disorders / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D004947:Esophagus / Q000473:pathology; D006801:Humans; D006984:Hypertrophy; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013128:Spinal Osteophytosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed