Diffuse idiopathic skeletal hyperostosis: a rare cause of Dysphagia, airway obstruction, and dysphonia

J Am Coll Surg. 2006 Jun;202(6):938-42. doi: 10.1016/j.jamcollsurg.2006.02.030.

Abstract

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.

Study design: 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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / etiology*
  • Airway Obstruction / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Decompression, Surgical / methods
  • Deglutition Disorders / diagnostic imaging
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperostosis, Diffuse Idiopathic Skeletal / complications*
  • Hyperostosis, Diffuse Idiopathic Skeletal / diagnostic imaging
  • Hyperostosis, Diffuse Idiopathic Skeletal / surgery
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Voice Disorders / diagnostic imaging
  • Voice Disorders / etiology*
  • Voice Disorders / surgery