[Dysphagia due to giant cervical osteophytes].
We reported a patient with isolated dysphagia due to an esophageal canal stenosis compressed by focal cervical spondylotic osteophytes. The patient was a 63-year-old male who developed swallowing disturbance of predominantly solid materials. The neurological examination showed subjectively isolated dysphagia unassociated with any significant cranial nerve signs. Cervical magnetic resonance imaging and X-ray demonstrated giant cervical spurs focally at the ventral portion of the C 5/6 vertebral bodies, protruding ventrally and compressing mildly to the esophageal canal. The intervertebral disc formation was relatively preserved between the osteophytes. At the neck flexion portion, the esophagus was severely compressed between the osteophytes and the epiglottis. Videofluoroscopic examination of swallowing function showed a congestion of the contrast medium at the portion of the epiglottic vallecula, unassociated with aspiration into the trachea. The endoscopic examination showed erosion of the posterior wall of the esophagus at the portion compressed by the osteophytes. The anti-inflammatory medication improved the symptom of dysphagia, and the patient has been carefully followed-up without a surgical procedure. The presence of giant osteophyte should be considered in the differential diagnosis of subjectively isolated dysphagia unassociated with any significant cranial nerve signs.
Tanaka
Yuji
Y
Neurology Service, Hyogo Brain and Heart Center at Himeji, Japan.
Yoneda
Yukihiro
Y
Kita
Yasushi
Y
Tabuchi
Masayasu
M
D002574:Cervical Vertebrae; D003680:Deglutition Disorders / Q000209:etiology*; D004940:Esophageal Stenosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013128:Spinal Osteophytosis / Q000150:complications*