title: Partial Epiglottoplasty for Pharyngeal Dysphagia due to Cervical Spine Pathology.
abstract: OBJECTIVE
  To examine the role of epiglottoplasty in patients with pharyngeal dysphagia due to pharyngeal crowding from cervical spine pathology and to assess swallowing outcomes following epiglottoplasty.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Academic tertiary care medical center.
  
  
  METHODS
  Dysphagia can occur in patients with cervical spine pathology because of hypopharyngeal crowding. Swallowing studies, such as modified barium swallow study and fiberoptic endoscopic evaluation of swallowing, may demonstrate a nonretroflexing epiglottis owing to cervical spine osteophytes or hardware, thus impeding pharyngeal bolus transit. We performed partial epiglottoplasties in a series of these patients. A retrospective review of swallowing outcomes was performed to assess the efficacy of this surgery in this patient population.
  
  
  RESULTS
  Epiglottic dysfunction causing dysphagia due to cervical spine pathology was diagnosed by modified barium swallow study and/or fiberoptic endoscopic evaluation of swallowing in 12 patients. Findings included hypopharyngeal crowding because of cervical osteophytes (n = 8) or cervical hardware (n = 4) associated with absent epiglottic retroflexion and retained vallecular residue. Partial epiglottoplasty resulted in significant reduction of vallecular residue and a significant increase in functional swallow outcomes without an increase in swallow morbidity.
  
  
  CONCLUSIONS
  There is a role for partial epiglottoplasty in patients with dysphagia attributed to hypopharyngeal crowding from cervical spine pathology. Surgery enables reduced vallecular residue and improved functional swallowing outcomes.
authors: Department of Otolaryngology-Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA nausheen.jamal@tuhs.temple.edu.
authors: Nausheen
authors: N
authors: Jamal
authors: Departments of Audiology and Speech, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA.
authors: Andrew
authors: A
authors: Erman
authors: Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA.
authors: Dinesh K
authors: DK
authors: Chhetri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000150:complications*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications*
keywords: Forestier’s disease; cervical osteophyte; diffuse idiopathic skeletal hyperostosis; dysphagia; epiglottic dysfunction; epiglottidectomy; epiglottoplasty