Original scientific articleDiffuse Idiopathic Skeletal Hyperostosis: A Rare Cause of Dysphagia, Airway Obstruction, and Dysphonia
Section snippets
Methods
Institutional review board approval was obtained and a retrospective chart review was done using our electronic medical record. The records of patients seen at Marshfield Clinic over a 20-year period (1985 to 2005) were reviewed for a diagnosis of cervical osteophytes. Those with associated dysphagia with or without airway obstruction were included. All patients had undergone evaluation to rule out other causes of their symptomatology. Data were collected with respect to age, duration of
Results
Two hundred thirty-four patients were identified with a diagnosis of cervical osteophytes. Nine (3.8%) met criteria for inclusion (Table 1). Mean age of the 9 patients was 77 years; there were 7 men and 2 women.
Eight patients presented with dysphagia (eight of nine), with solid food being the most problematic. Three patients developed acute airway obstruction and required tracheotomy, with subsequent percutaneously placed endoscopic gastrostomy tube for nutrition. Two patients developed marked
Discussion
Our patient population reveals that this is a disease of the elderly. The most common complaint was solid-food dysphagia (n = 8), followed by stridor (n = 3), regurgitation (n = 2), globus (n = 1), and dysphonia (n = 1). Patients typically had a long history of dysphagia or other complaints before diagnosis was confirmed, in some cases it was years. Barium esophagram and computed tomography scans were helpful in confirming the diagnosis. C4 to C5 was the cervical level most commonly involved,
Acknowledgment
We thank Marshfield Clinic Research Foundation for its support through the assistance of Graig Eldred and Alice Stargardt in the preparation of this article.
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Acute airway obstruction in a patient with forestier disease. Case report
2019, Revista Espanola de Anestesiologia y ReanimacionDiffuse idiopathic skeletal hyperostosis (DISH) – A common but less known cause of back pain
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2014, Journal for Nurse PractitionersCitation Excerpt :Swallowing may be accompanied by muscle spasms and pain as a bolus of food passes through the esophagus and lower esophageal sphincter.11 Other consequences of DISH in the cervical spine include stridor, globus pharyngeus, respiratory compromise, sleep apnea, and difficulty with intubation.19,20,21 Unfortunately, nonoperative measures are rarely effective in addressing dysphagia symptoms caused by DISH, as exemplified in the case report presented here.
Dysphagia due to anterior cervical hyperosteophytosis
2009, Surgical NeurologyCitation Excerpt :Dysphagia due to ACH is considered an uncommon entity and has been described mainly in case reports. The osteophytic overgrowth causing dysphagia has been attributed to multiple etiologies including DISH, trauma, postlaminectomy syndromes, and cervical spondylosis [6,23,31,37-39,48]. Although various mechanisms have been suggested, the predominant cause of dysphagia is thought to be mechanical compression of the esophagus by overgrown osteophytes.
Stiffness and axial pain are associated with the progression of calcification in a mouse model of diffuse idiopathic skeletal hyperostosis
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Competing Interests Declared: None.