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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forestier disease (ankylosing hyperostosis) is a well-recognized and common disease entity. Although these patients rarely have complaints related to their spine, they are seen by the otorhinolaryngologist because of dysphagia, since the osteophytic spurs may impinge on the posterior pharyngeal wall. Since the plain roentgenogram and barium swallow is so specific, biopsy examination of the pharyngeal mass is not necessary.
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PMID:Dysphagia and Forestier disease. 85 37

Forestier disease, or ankylosing hyperostosis, is a common disorder of middle-aged and elderly persons. Characteristic clinical and radiographic features enable the physician to distinguish between this disease and ankylosing spondylitis. The principal clinical features include aching spinal stiffness with relative preservation of function and minimal evidence of spinal immobility. Many patients have elbow and heel pain and dysphagia. Typical radiographic findings are ligament ossification, para-articular osteophytosis, and bone production at sites of tendon and ligment attachment in spinal and extraspinal locations. The extraspinal roentgenographic manifestations are so characteristic that when present, they allow the diagnosis of spinal ankylosing hyperostosis to be suggested, even in the absence of axial radiographs.
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PMID:Diffuse skeletal abnormalities in Forestier disease. 93 66

Degenerative changes in the cervical spine can produce osteophytes and other hypertrophic abnormalities. Asymptomatic osteophytes of the anterior margins of the cervical vertebrae may occur in 20-30% of the population. Occasionally, dysphagia or dysphonia may be caused by such cervical osteophytes pressing against the esophagus or trachea. Recently, the authors treated a patient with posttraumatic dysphagia and dysphonia secondary to osteophytic spurring of the anterior cervical spine. This 43-year-old man presented 2 years after sustaining a flexion/extension soft tissue injury to his cervical spine. Radiographic studies depict the progression of his osteophyte growth, which resulted in surgical intervention to relieve his inability to swallow solid foods. One year follow-up studies demonstrate normal alignment and no instability. A search of the literature revealed approximately 75 previously reported cases of anterior osteophyte-induced dysphagia, with the majority secondary to diffuse idiopathic skeletal hyperostosis. The literature briefly mentions trauma as a possible etiology of anterior osteophytosis; however, our case is unique, as it documents the time course and progression of the pathologic process.
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PMID:Posttraumatic anterior cervical osteophyte and dysphagia: surgical report and literature review. 157 7

The anterolateral and posterolateral transcervical approaches were used to expose the prevertebral space in patients with diffuse idiopathic skeletal hyperostosis. In a series of six patients, both techniques produced equally effective palliation of dysphagia without associated morbidity. Theoretically, the anterolateral approach better preserves the carotid sheath neurovascular bundle, although the risk of injuring the recurrent laryngeal nerve is greater. The posterolateral technique offers a wider exposure of the prevertebral space but requires more retraction of the carotid sheath and increases the risk of injury to the sympathetic chain. Either exposure may be used depending on the preference of the attending surgeon.
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PMID:Transcervical approaches to the prevertebral space. 169 87

In eleven patients with diffuse idiopathic skeletal hyperostosis who presented with extensive ossification in the cervical spine, progression or regression of ossification during the follow-up period were measured in extent and thickness radiographically. Intervertebral range of motion was also measured and the relation between changes of ossification and intervertebral mobility was analyzed. The range of motion at the segments at which ossification progressed was statistically quite different from those at which no progression was observed. It was found that ossification grew in thickness at mobile segments and no growth of ossification was present at immobile segments. Dysphagia caused by massive ossification was cured by surgical removal in two cases. Recurrent ossifications were detected in them some years after surgery, and one of them complained of dysphagia again. To prevent recurrent ossification and dysphagia, it was considered that immobilization of the concerned segment was necessary by bone grafting or preservation of the continuity of ossification.
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PMID:Long term follow-up of diffuse idiopathic skeletal hyperostosis in the cervical spine. Analysis of progression of ossification. 174 74

Swallowing disorders can be caused by morphologic changes of the cervical spine such as diffuse idiopathic skeletal hyperostosis. The paper describes current concepts of this clinical entity also known as Forestier's disease. The symptomatology, radiographic features and treatment are discussed. Particular interest is focused on dysphagia. The diagnosis is exclusively radiographic. Cervical osteophytes can be detected in 20-30% of the population in asymptomatic patients. Therefore, the attribution of the presence of osteophytic deformities of the barium column to dysphagia should not be made unless objective evidence of impairment of pharyngeal function such as abnormal posterior pharyngeal wall motion is proven by dynamic imaging means. The therapeutic approach depends on the extent of dysphagic complaints. Indications for surgery are failure to respond to conservative management (anti-inflammatory drugs, concomitant antibiotics, dietary nutrition). The anterolateral extrapharyngeal approach is commonly preferred.
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PMID:[Vertebrogenic dysphagia in diffuse idiopathic skeletal hyperostosis (Forestier's disease)]. 175 99

Presenting the case of a 56-year-old man diagnosed of an idiopathic ankylotic hyperostosis, with pronounced osteophytosis of the neck and bulged rear wall of the oropharynx, producing dysphagia as associated ENT symptom. Some clinical, diagnostic and therapeutic aspects of the case are contemplated by the AA.
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PMID:[Cervical ankylosing hyperostosis as a cause of dysphagia. A case report and review of the literature]. 177 66

A review of the literature and four additional cases of surgical excision of anterior cervical osteophytes causing dysphagia is presented. Surgical excision of the osteophytes is recommended only after a complete evaluation to rule out other causes of dysphagia and after an adequate period of conservative therapy. The patients must be advised that frequently symptoms will recur to some extent as time progresses. In patients who have findings consistent with diffuse idiopathic skeletal hyperostosis (DISH Syndrome) recurrence of the osteophyte appears to be more common.
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PMID:Anterior cervical osteophytes causing dysphagia. 204 28

This is the first controlled study of the frequency of back pain in a European caucasian population with diffuse idiopathic skeletal hyperostosis (DISH). Elderly patients admitted to hospital for reasons other than back pain were assessed for the presence of spinal DISH using the routine lateral chest radiograph films. A total of 106 probands (82 males, 24 females) with a mean age of 70 years fulfilled the criteria for DISH as defined previously. One hundred and seventy-eight patients (117 males, 61 females) not meeting these criteria were used as controls. The prevalence of back pain was assessed by a blinded interviewer using a structured questionnaire. Our primary hypothesis was that spinal DISH positive probands had not had back pain more often than controls. This controlled study showed no statistically significant difference in pain frequency between spinal DISH positive probands and controls at any spinal level. We conclude that back pain does not occur more often in radiographically defined DISH positive probands than in controls. The radiological finding of spinal DISH, as far as it does not lead to stenosis of the spinal canal or dysphagia, thus seems to be a finding without clinical relevance.
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PMID:Diffuse idiopathic skeletal hyperostosis (DISH) of the spine: a cause of back pain? A controlled study. 252 42

Although diffuse idiopathic skeletal hyperostosis generally affects the lumbar spine, any segment of the spine may be involved. When the cervical spine is affected, dysphagia may occur. Diabetes mellitus is commonly present. A history of previous cervical trauma is an indication to obtain cervical spine radiographs. Barium swallow and endoscopy provide confirmation of etiology. Surgery is curative.
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PMID:Dysphagia due to diffuse idiopathic skeletal hyperostosis. 265 Apr 99


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