Dysphagia due to anterior cervical osteophytes complicated with hypopharynx abscess

Abstract

This report concerns a case of an 80-year-old man with progressive dysphagia and stridor. Patient's clinical and radiological evaluation revealed a mass of the hypopharynx and a large cervical osteophyte. Microlaryngoscopy under general anaesthesia demonstrated the presence of a hypopharynx abscess that was drained. A tracheotomy was performed in order to secure the airway, and 6 weeks later, the patient was decannulated and returned to full consistency diet.

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

“…Progressive swallowing difficulty is the most common cervical anterior osteophyte symptom [ 2 ]. Many possible mechanisms explain the dysphagia caused by osteophytes, including direct impingement by large osteophytes, obstruction by local edema and inflammation, spasm of the adjacent cricopharyngeal structure, fibrosis and adhesion from the tissue reaction near the protruding mass, and interference with epiglottis movement [ 7 ].…”

“…Dysphagia with anterior cervical osteophytes can be managed conservatively or surgically. In previous studies, the first-line treatment for symptomatic patients was diet modification and postural changes during swallowing [ 3 , 7 , 8 ]. Surgical removal is reserved for patients with persistent symptoms, despite optimal medical management, and radiographic evidence suggesting functional swallowing impairment by the osteophytes [ 3 , 7 , 8 ].…”

“…In previous studies, the first-line treatment for symptomatic patients was diet modification and postural changes during swallowing [ 3 , 7 , 8 ]. Surgical removal is reserved for patients with persistent symptoms, despite optimal medical management, and radiographic evidence suggesting functional swallowing impairment by the osteophytes [ 3 , 7 , 8 ]. Carlson et al [ 1 ] reported that 9/9 patients showed significant subjective swallowing improvement within three months after surgery, and Oppenlander et al [ 9 ] reported that 9/9 patients experienced significant improvement of swallowing function in VFSS after osteophytectomies.…”

Anterior Cervical Osteophyte Resection for Treatment of Dysphagia

“…3,5,9 Osteophytes may cause dysphagia via multiple mechanisms, including mechanical compression of the esophagus, interference with normal epiglottis movement, compression of the Auerbach's myenteric plexus, and the induction of inflammation and edema about the esophagus, which can lead to fibrosis and adhesions, preventing normal motility and causing cricopharyngeal spasm. 10,11 Most cases can be treated nonsurgically with diet modification, muscle relaxants, anti-inflammatories, postural changes during eating, phonophoresis, and swallowing rehabilitation programs. 12,13 When conservative treatment fails, surgical osteophyte resection can improve hyoid movement, leading to enhanced upper esophageal sphincter opening 11 and symptoms of dysphagia.…”

The Relationship between Anterior Tubercle of the Atlas to the Adjacent Oropharyngeal Airway Volume: Implication of Normalized Variables and Gender Differences

“…From these findings, they suggested that the cervical spinal osteophytes are one potential cause of airway obstruction. In addition, there are several case reports which regard OSA patients with cervical spinal osteophytes, as one of the causes of airway obstruction [8,9]. [2] In a previous study to investigate the potential link between OSA and the calcification of ligaments, the prevalence of the calcification of ligaments in OSA patients and the relationship between these findings, and OSA severity were examined [10].…”