Dysphonia and Dysphagia Following the Anterior Approach to the Cervical Spine

Winslow, Catherine P.; Winslow, Timothy J.; Wax, Mark K.

doi:10.1001/archotol.127.1.51

Cited by 163 publications

(110 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…59 Rates of dysphagia after anterior cervical surgery may be as high as 60% immediately after surgery and persist in up to 21% of patients at 6 months. 10,56,62,67,68 In addition, rates of dysphagia may be underreported in up to 80% of patients. 23 The consequences of dysphagia are greater than a need for a nasogastric or gastrotomy tube because aspiration pneumonia may develop in patients with an aberrant swallowing mechanism.…”

Section: Discussionmentioning

confidence: 99%

Anterior fixation of odontoid fractures in an elderly population

Dailey

Hart

Finn

et al. 2010

SPI

114

View full text Add to dashboard Cite

Object Fractures of the odontoid process are the most common fractures of the cervical spine in patients over the age of 70 years. The incidence of fracture nonunion in this population has been estimated to be 20-fold greater than that in patients under the age of 50 years if surgical stabilization is not used. Anterior and posterior approaches have both been advocated, with excellent results reported, but surgeons should understand the drawbacks of the various techniques before employing them in clinical practice. Methods A retrospective review was undertaken to identify patients who had direct fixation of an odontoid fracture at a single institution from 1991 to 2006. Patients were followed up using flexion-extension radiographs, and stability was evaluated as bone union, fibrous union, or nonunion. Patients with bone or fibrous union were classified as stable. In addition, the incidence of procedure- and nonprocedure-related complications was extracted from the medical record. Results Of the 57 patients over age 70 who underwent placement of an odontoid screw, 42 underwent follow-up from 3 to 62 months (mean 15 months). Stability was confirmed in 81% of these patients. In patients with fixation using 2 screws, 96% demonstrated stability on radiographs at final follow-up. Only 56% of patients with fixation using a single screw demonstrated stability on radiographs. In the immediate postoperative period, 25% of patients required a feeding tube and 19% had aspiration pneumonia that required antibiotic treatment. Conclusions Direct fixation of Type II odontoid fractures showed stability rates > 80% in this challenging population. Significantly higher stabilization rates were achieved when 2 screws were placed. The anterior approach was associated with a relatively high dysphagia rate, and patients must be counseled about this risk before surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Anterior fixation of odontoid fractures in an elderly population

Dailey

Hart

Finn

et al. 2010

SPI

114

View full text Add to dashboard Cite

show abstract

“…Two studies estimate voice and swallowing impairment at 45-60% of a population having undergone anterior cervical fusion or discectomy. 18,19 After multilevel anterior cervical corpectomy two out of 36 patients, 20 after anterior stabilization with combined plate and bone fusion two out of 13 patients suffered from dysphagia. 21 In the above-mentioned studies, the majority of patients underwent surgery for spondylotic cervical myelopathy.…”

Section: Dysphagia In Cscimentioning

confidence: 99%

Dysphagia in patients with acute cervical spinal cord injury

Wolf

Meiners

2003

Spinal Cord

View full text Add to dashboard Cite

Study design: Longitudinal observational. Objectives: (a) To establish a reliable and feasible method to indicate the presence and severity of dysphagia and (b) to establish a course of treatment in individuals presenting with cervical spinal cord injury (CSCI). Setting: Spinal Cord Injury Center, Werner Wicker Klinik, Bad Wildungen, Germany. Patients and methods: This is a cross-sectional study of 51 patients consecutively admitted to the Intensive Care Unit of the SCI in-patient service. They were subjected to neurological and fiberoptic endoscopic examination of swallowing (FEES). Data concerning artificial respiration, presence of tracheostomy, oral or non-oral feeding were obtained from the medical charts. Statistics were carried out by a calculation of a nonparametric correlation (Spearman). Results: Five levels of dysphagia could be distinguished. At levels 1 and 2, patients presented with a severe impairment of swallowing, in level 3 aspiration was met by a powerful coughing reflex, level 4 comprised a laryngeal edema and/or a mild aspiration of fluids only and at level 5 laryngeal function was not compromised. On admission, 20 patients with CSCI presented with mild (level 4), eight with moderate (level 3) and 13 with severe dysphagia (levels 1 and 2). In 10 no signs of dysphagia could be detected. After treatment, level 1 was no longer detected, one patient showed level 2, two patients showed level 3, all other patients showed only mild or no signs of dysphagia any longer. Conclusions: Dysphagia of various severities was present in the majority of these patients with CSCI together with respiratory insufficiency. FEES allows for the detection and classification of dysphagia as well as for an evaluation of the therapeutic management. Under interdisciplinary treatment the prognosis of dysphagia is good.

show abstract

“…6 Retro-cricoid inflammation can induce laryngeal edema, 7 dysphonia, vocal cord immobility 8,9 or stridor. 10 Surgical treatment of DISH indicates that surgery is performed mainly via anterior approach (Smith-Robinson), 11,12 however, we must be aware of the potentially severe complication of surgical treatment such as hematoma, Horner's syndrome, recurrent nerve palsy, superior laryngeal nerve palsy, and esophageal injury. 13 Therefore, surgical treatment should be selected with care.…”

Section: Discussionmentioning

confidence: 99%

Fatal complication of diffuse idiopathic skeletal hyperostosis (DISH): report of a case

2017

J. contemp. med. sci.

View full text Add to dashboard Cite

Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory ossification involving at least four contagious vertebral bodies. It is mostly asymptomatic but the osteophytes can be rarely associated with severe complications. We report 65-year-old man who was admitted to the emergency department with severe shortness of breath and stridor not responding to medical treatment, which ended with tracheostomy lifesaving. Patient condition began 1 year ago as cervical spine pain with radiculopathy to the upper limbs, which increased to recurrent attacks of shortness of breath that responds to bronchodilators. During last months, this attack begins poorly and responds to medications and O 2 . Several radiological examination including x-ray, CT scan, and MRI reveal bony mass in front of the cervical spine with hypertrophy of soft tissues bulging and compressed larynx. Invasive techniques such as laryngoscope done by otolaryngologist to take biopsy from soft tissue, which reveals normal examination. In one-day, severe attack was not responding to O 2 and medications ended with tracheostomy to save life. It is advisable to take in consideration that patients with DISH mostly in cervical spines may be at risk of fatal complications including airway obstruction.

show abstract

Dysphonia and Dysphagia Following the Anterior Approach to the Cervical Spine

Cited by 163 publications

References 12 publications

Anterior fixation of odontoid fractures in an elderly population

Anterior fixation of odontoid fractures in an elderly population

Dysphagia in patients with acute cervical spinal cord injury

Fatal complication of diffuse idiopathic skeletal hyperostosis (DISH): report of a case

Contact Info

Product

Resources

About