J Korean Soc Spine Surg.  2006 Dec;13(4):327-331.

Diffuse Idiopathic Skeletal Hyperostosis Associated with Dysphonia and Dysphagia: A Case Report

• Ahn YJ
• Hahn SH
• Yang BK
• Yi SR
• Yoo JH
• Yoon DJ
• Chung BJ
• Zoo MH
• Kim SW

Abstract

We encountered a rare case of diffuse idiopathic skeletal hyperostosis (DISH) associated with dysphonia and dysphagia. An 80 year-old man developed progressive dysphonia and dysphagia. The radiology study, esophagogram and nasopharyngoscopic exam revealed the esophagus and the posterior wall of the nasopharynx to be severely compressed by the unfused osteophyte of the 3rd and 4th cervical intervertebral space. It was thought that the osteophyte formation was caused by not merely DISH but degenerative changes due to a concentration of stress around the unfused hyperostosis. A resection of the osteophyte was performed, which resolved the clinical symptoms. The follow-up radiology study, esophagogram and nasopharyngoscopic exam showed that the osteophyte had disappeared.

Keyword

DISH; Cervical spine; Anterior degenerative osteophyte; Dysphonia; Dysphagia

MeSH Terms

Aged, 80 and over
Deglutition Disorders*
Dysphonia*
Esophagus
Follow-Up Studies
Humans
Hyperostosis
Hyperostosis, Diffuse Idiopathic Skeletal*
Nasopharynx
Osteophyte

Figure

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  Fig. 1. (A) and (B) Preoperative cervical spine lateral radiograph and sagittal CT scan show contiguous ossification along the anterior aspect of the first (C1) to seventh cervical vertebrae (C7), with a localized osteophyte between C3 and C4.

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  Fig. 2. (A) In barium esophagogram, the posterior wall of the hypopharynx is indented by osteophytes and the esophagus is significantly narrowed from C3 to C4. (B) Nasopharyngoscopic view shows mass projecting from posterior wall of hypopharynx.

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  Fig. 3. (A) and (B) Postoperative cervical spine lateral radiograph and sagittal CT scan show no osteophytes between C3 and C4.

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  Fig. 4. (A) In barium esophagogram, no osteophytes are seen impinging on the posterior wall of the pharynx and contrast media pass-es well through the esophagus. (B) Nasopharyngoscopic view shows widened pharynx without mass.

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