Diffuse idiopathic skeletal hyperostosis causing obstructing laryngeal edema

Marks, Bernard; Schober, Ewald; Swoboda, Herwig

doi:10.1007/s004050050053

Cited by 46 publications

(38 citation statements)

References 17 publications

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“…Thus, it may give rise to cervical myelopathy (Goto et al, 1995) or thoracic cord compression as a result of spinal stenosis (Wilson & Jaspan, 1990), sometimes causing sudden paraplegia requiring urgent treatment by laminectomy (Johnsson et al, 1983). DISH may also cause dysphagia (Eviatar & Harell, 1987) and laryngeal oedema with severe dyspnoea necessitating emergency tracheotomy (Marks et al, 1998).…”

Section: Symptomatologymentioning

confidence: 99%

DISH and the monastic way of life

Rogers

Waldron

2001

Intl J of Osteoarchaeology

126

122

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Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition and its prevalence increases markedly with age. This paper describes the pathology and aetiology of the condition; DISH seems to be related to obesity and type II diabetes and is probably a multisystem hormonal disorder. DISH occurs frequently in human skeletal remains, particularly in those recovered from monastic sites. Evidence is presented to confirm this association and the causes are discussed. We also present criteria for the diagnosis of DISH in human remains, which we suggest would permit valid inter-study comparisons.

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Section: Symptomatologymentioning

confidence: 99%

DISH and the monastic way of life

Rogers

Waldron

2001

Intl J of Osteoarchaeology

126

122

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“…Dyspnea caused by a large extraluminal osteophytic mass directly compressing, distorting, and finally obstructing the airway with no evidence of associated vocal fold immobility or soft tissue swelling has been reported in 18 cases [5, 6, 8, 12, 14, 16, 18-20, 23, 24, 28-30]. Mechanical irritation of the retrocricoid area caused by rolling over prominent and spiky osteophytes at each swallow resulting in a chronic inflammatory edema obstructing the larynx has been postulated as the cause of dyspnea in five reported cases [2,11,17,21,27]. Similarly, iatrogenic manipulations such as tracheal intubation and respiratory infections may increase tissue inflammation and may complicate moderate symptoms [8,12,19].…”

Section: Pathogenesis Of Dyspneamentioning

confidence: 99%

Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

2007

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Abstract. Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH). We present the case of an 83-year-old patient with progressive dysphagia and acute dyspnea, necessitating emergency tracheotomy. Voluminous anterior cervical osteophytes extending from C3 to C7 and narrowing the pharyngoesophageal segment by external compression and bilateral vocal fold immobility were diagnosed radiologically and by fiberoptic laryngoscopy. Surgical removal of all osteophytes led to the resolution of symptoms. Dyspnea with or without dysphagia caused by hypertrophic anterior cervical osteophytes is an uncommon entity. The exhaustive diagnostic workup proposed in the literature could be simplified by using fiberoptic laryngoscopy and dynamic videofluoroscopy. The causes, treatment, and outcome are discussed.

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“…Respiratory compromise is rare in patients with DISH, but airway obstruction, airway edema, and aspiration pneumonia can be seen in DISH patients [3][4][5]. Usually, the sitting or lateral position alleviates dyspneic symptoms.…”

Section: Discussionmentioning

confidence: 96%

Airway management of a patient with Forestier's disease

Özkalkanlı¹,

Katırcıoğlu²,

Ozkalkanli³

et al. 2006

J Anesth

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Forestier's disease, also called diffuse idiopathic skeletal hyperostosis (DISH), is a noninflammatory enthesopathy, ossifying the anterolateral spine and sparing the disc and joint space in elderly men, mostly at thoracic levels. Intubation difficulty and spinal cord injury are potential problems when managing the airway in DISH patients. We report a patient with Forestier's disease who was admitted for osteophyte resection. After taking a detailed history, we evaluated the airway carefully. Also, preparation for difficult intubation was done. After a rapid sequence induction, we performed mask ventilation and laryngoscopy without hyperextension of the neck, to prevent spinal cord injury. Although the worldwide standard for management of the airway in DISH patients is awake fiberoptic intubation, we chose conventional laryngoscopy because a fiberoptic bronchoscope was not available.

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Diffuse idiopathic skeletal hyperostosis causing obstructing laryngeal edema

Cited by 46 publications

References 17 publications

DISH and the monastic way of life

DISH and the monastic way of life

Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited

Airway management of a patient with Forestier's disease

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