Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited.
Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscopy. Surgical removal of all osteophytes led to the resolution of symptoms. Dyspnea with or without dysphagia caused by hypertrophic anterior cervical osteophytes is an uncommon entity. The exhaustive diagnostic workup proposed in the literature could be simplified by using fiberoptic laryngoscopy and dynamic videofluoroscopy. The causes, treatment, and outcome are discussed.
Giger
Roland
R
Department of Otorhinolaryngology and Head & Neck Surgery, University Hospital of Geneva, Geneva, Switzerland. gigerro@hotmail.com
Dulguerov
Pavel
P
Payer
Michael
M
D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology*; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013128:Spinal Osteophytosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D014741:Video Recording