Ann Rehabil Med.  2014 Dec;38(6):865-870. 10.5535/arm.2014.38.6.865.

Kinematic Changes in Swallowing After Surgical Removal of Anterior Cervical Osteophyte Causing Dysphagia: A Case Series

• Jeong H
• Seo HG
• Han TR
• Chung CK
• Oh BM

• KMID: 2267101
• DOI: http://doi.org/10.5535/arm.2014.38.6.865

Abstract

This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in the maximal hyoid vertical movement length (13.16+/-5.87 to 19.09+/-4.77 mm, p=0.080), hyoid movement velocities (170.24+/-84.71 to 285.53+/-104.55 mm/s, p=0.043), and upper esophageal sphincter opening width (3.97+/-0.42 to 6.39+/-1.32 mm, p=0.043) after surgery. In conclusion, improved upper esophageal sphincter opening via enhancement of hyoid movement after cervical anterior osteophyte resection may be the kinetic mechanism of improved swallowing function.

Keyword

Deglutition disorders; Osteophyte; Hyoid bone

MeSH Terms

Barium
Deglutition Disorders*
Deglutition*
Diet
Esophageal Sphincter, Upper
Humans
Hyoid Bone
Osteophyte*
Retrospective Studies
Barium

Figure

• 

  Fig. 1 Lateral view X-ray (left), preoperative CT (middle), and postoperative CT (right) images of cases. White lines indicate the section level of the CT image, which represents the thickest osteophyte. The level of the thickest osteophyte was C4-5 in 1 case (A) and C5-6 in 4 cases (B-E). CT, computed tomography; VB, vertebral body; OP, osteophyte.

• 

  Fig. 2 Exemplary trajectories of the epiglottis. (A) The changes of UES opening width. (B) Cervical lateral view x-ray with digital coordination (•, epiglottis margin; *, anterior margin of hyoid bone; ▪, vocal fold margin; y-axis, a straight line connecting the anterior-inferior border of the 4th cervical vertebra (the '0' point)). (C) Preoperative trajectory. (D) Postoperative trajectory. UES, upper esophageal sphincter; Fl, fluid; Ep, epiglottis; Hy, hyoid; Vc, vocal fold.

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