Diffuse idiopathic skeletal hyperostosis: a rare cause of Dysphagia, airway obstruction, and dysphonia.
BACKGROUND
We retrospectively query the clinical records of patients with cervical osteophytes to distinguish the clinical features of those presenting with symptomatic dysphagia and airway obstruction.


METHODS
Retrospective review of all patients presenting over a 20-year period (1985 to 2005) with the diagnosis of cervical osteophytes and dysphagia with or without airway compromise. Two hundred thirty-four patients were identified at Marshfield Clinic between 1985 and 2005; 9 (3.8%) met criteria for inclusion.


RESULTS
Eight of nine patients presented with dysphagia. Three of nine patients presented with acute airway obstruction requiring intubation and tracheotomy. Osteophytes occurred at multiple levels, with C4, C5, and C6 being most commonly involved. Surgical decompression resulted in complete resolution of symptoms in four of five patients.


CONCLUSIONS
Although commonly found and usually asymptomatic in the older population, anterior cervical osteophytes can be a source of considerable morbidity and potential life-threatening airway obstruction. Recognizing this clinical entity is imperative in establishing a diagnosis and initiating appropriate treatment. Surgical decompression appears to be beneficial in relieving symptoms.
Nelson
R Scott
RS
Department of General Surgery, Marshfield Clinic, Marshfield, WI, USA.
Urquhart
Andrew C
AC
Faciszewski
Thomas
T
D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014832:Voice Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery