Progressive dysphagia and dysphonia secondary to DISH-related anterior cervical osteophytes: A case report

Kumar, Manoj; Shahi, Prem Bahadur; Adsul, Nitin; Acharya, Shankar; Kalra, K; Chahal, Rupinder

doi:10.25259/sni_61_2020

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…An interesting management option described in the literature is the cervical collar. The use of a cervical collar was associated with improved outcomes in patients who underwent surgery for anterior cervical osteophytes [ 17 ]. Surgery is recommended when conservative treatment fails to improve quality of life and for patients with severe cervical symptoms such as dysphagia and airway obstruction [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Kosmidou¹,

Karamatzanis²,

Angelis³

et al. 2022

Cureus

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Diffuse idiopathic skeletal hyperostosis (DISH) is a rare and potentially life-threatening syndrome. We present the case of a patient complaining about severe dyspnoea and diagnosed with vocal cord paresis. An emergency tracheotomy was performed to restore his breathing. Diagnostic imaging revealed large massoccupying cervical osteophytes compressing the larynx. The osteophytes were removed via an anterior cervical approach, and vital signs were normalized. However, postoperatively, a fistula was discovered between the upper part of the oesophagus and the trachea. As a result, a gastrostomy tube had to be placed indefinitely. Literature review confirms the rare frequency of emergency tracheostomy due to DISH syndrome. The aim of the present study is to expand on our knowledge of a rare pathological entity that can frequently be misdiagnosed.

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Section: Discussionmentioning

confidence: 99%

Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Kosmidou¹,

Karamatzanis²,

Angelis³

et al. 2022

Cureus

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“…Esophageal diagnosis and laryngoscopy combined with a fluoroscopic barium swallowing test may be useful in the diagnosis of DISH contributing to dysphagia or dysphonia [ 56 ].…”

Section: Clinical Aspectsmentioning

confidence: 99%

“…Painkillers, sedatives, nonsteroidal anti-inflammatory drugs, muscle relaxants, and anti-reflux medications are also used [ 5 ]. The role of disodium etidronate bisphosphonate in preventing DISH in animal testing is not yet a standard in humans [ 56 ]. Corticosteroid injections are also an option [ 5 ].…”

Section: Clinical Aspectsmentioning

confidence: 99%

Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia—Molecular and Clinical Aspects

Dąbrowski

Kubaszewski

2021

IJMS

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Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of the ligaments of the cervical spine; in some cases, it may result in dysphagia. The condition is more common in men over 50 years of age with metabolic disorders, and it is often asymptomatic and not a major issue for patients. The etiology of DISH is poorly understood, and known genetic factors indicate multiple signal pathways and multigene inheritance. In this review, we discuss the epidemiological, clinical, and etiological aspects of DISH with a special focus on dysphagia.

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“…It has been reported in other diseases such as diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis, acromegaly, hypoparathyroidism, and trauma, of which DISH and ankylosing spondylitis are the most common ( 1 ). Osteophytes at the anterior edge of the cervical spine can cause a series of clinical symptoms, such as progressive dysphagia, foreign body sensation, pain during swallowing ( 2 ), cervical stiffness and pain, and dyspnea and dysphonia ( 3 – 5 ), among others. In a study by Strasser et al ( 6 ), only 1.7% of patients with osteophytes had dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Diffuse idiopathic skeletal hyperostosis with ossification of the posterior longitudinal ligament in the cervical spine: A rare case with dysphagia and neurological deficit and literature review

Luo

Zhang

et al. 2022

Front. Surg.

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Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by the calcification and ossification of ligaments and tendons. Progressive dysphagia caused by DISH-related anterior cervical osteophytes and deteriorating dysphagia caused by DISH combined with neurological dysfunction resulting from the posterior longitudinal ligament is rare. The initial diagnosis is misleading and patients often consult several specialists before spine surgeons. This study aims to provide a comprehensive review of the literature on this challenging pathological association. We also present a case illustration where a 53-year-old man presented with progressive dysphagia and foreign body sensation in the pharynx, accompanied by a neurological numbness defect in the right upper limb. Radiography and computed tomography confirmed the existence of osteophytes at the anterior edge of the C4–C7 pyramid and ossification of the posterior longitudinal ligament, in which the giant coracoid osteophyte could be seen at the anterior edge of the C4–C5 pyramid. The anterior cervical osteophyte was removed, and decompression and fusion were performed. The symptoms were relieved postoperatively. No recurrence of symptoms was found during the six-month follow-up. Spine surgeons should consider progressive dysphagia caused by DISH-related osteophytes at the anterior edge of the cervical spine as it is easily misdiagnosed and often missed on the first evaluation. When combined with ossification of the posterior longitudinal ligament, following cervical osteophyte resection it is necessary to consider stabilizing the corresponding segments via fusion.

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Progressive dysphagia and dysphonia secondary to DISH-related anterior cervical osteophytes: A case report

Cited by 8 publications

References 8 publications

Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia—Molecular and Clinical Aspects

Case Report: Diffuse idiopathic skeletal hyperostosis with ossification of the posterior longitudinal ligament in the cervical spine: A rare case with dysphagia and neurological deficit and literature review

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