title: Dysphagia due to forestier disease: three cases and systematic literature review.
abstract: Forestier disease or diffuse idiopathic skeletal hyperostosis (DISH) is an uncommon cause of dysphagia. Due to rarity of this condition there is neither any demographic data nor any consensus about the investigation and treatment modalities. Here an effort is made in the present article to compile the information regarding the demographic and clinical features, investigation modalities and different methods of treatment from all the available case reports of dysphagia due to Forestier disease in the English literature till date. Three cases of the same condition are also reported in the present paper. Three cases of dysphagia due to Forestier disease treated in the ENT department of R.G. Kar Medical College and Hospital are reported herewith. A systematic review of literature is also done. All the case reports of dysphagia due to Forestier disease are obtained by World Wide Web search (WWWS) using 'Forestier Disease', 'DISH' and 'dysphagia' as the key words. Data regarding age, sex, duration of the symptom, associated symptoms, investigations done, level of vertebrae involved and different modalities of treatment with result are collected and analyzed systematically. We found total 73 cases of dysphagia due to Forestier disease. The condition commonly affects males (M:F 5.64:1) in older age group (94.52% cases are 60 years or above), often presented to the treatment facility after a long time of initiation of the symptom. Barium swallow X-rays and lateral neck X-ray were the most common investigations done to arrive at a diagnosis as per result of systematic review. Surgical removal of the causative osteophytes were the definitive treatment, but if surgery is contraindicated, conservative measures like switchover to liquid and semisolid food and proper swallow training also improve the condition to some extent. Dysphagia due to Forestier disease mostly affects older male, often has a chronic course. It can be diagnosed with simple investigations like neck X-ray or barium swallow X-rays. The definitive treatment is surgical, but if contraindicated the problem can be palliated with simple measures like swallow training and change of food.
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 3/1, Bose Para Lane, Hooghly, Baidyabati, 712222 India.
authors.forename: Sirshak
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 369/1, Avishikta-1,Purbachal, Kalitala Road, Kolkata, 700078 India.
authors.forename: Kaustuv Das
authors.initials: KD
authors.lastname: Biswas
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, Room No. 07, K.B Hostel; 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Mukherjee
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 402, Sitalchhaya Apartment, VIP Road, Kolkata, 700159 India.
authors.forename: Asimjiban
authors.initials: A
authors.lastname: Basu
authors.affiliation: Department of Otolaryngology, N.R.S. Medical College, Kolkata, India ; CE 166, Sector 1, Salt Lake City, Kolkata, 700064 India.
authors.forename: Saumik
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 55/2, Desbandhu Road (East), Kolkata, 700035 India.
authors.forename: Indranil
authors.initials: I
authors.lastname: Sen
authors.affiliation: Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 4A, 2/1, Purbachal, Salt Lake, Kolkata, 700091 India.
authors.forename: Ramanuj
authors.initials: R
authors.lastname: Sinha
keywords: Diffuse idiopathic skeletal hyperostosis; Dysphagia; Forestier disease