Case ReportForestier’s disease presenting with dysphagia and dysphonia
Section snippets
Case report
A 55-year-old man presented with a 6-month history of progressive dysphagia and dysphonia. This was associated with neck and shoulder discomfort – more neck stiffness than pain. He had a past medical history of an uncomplicated tonsillectomy and a carpel tunnel decompression. He was not on any medication and was allergic to penicillin.
On examination, he was neurologically intact with no clinical features of cervical spondylosis. A cervical X-ray and a subsequent CT scan demonstrated exuberant
Discussion
Forestier’s disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), was first described by Jacques Forestier and Jaume Rotes-Querol in 1950.1 It is a phenomenon characterized by the thickening and calcification of soft tissues namely ligaments, tendons or the joint capsules resulting in secondary formation of osteophytes.1, 2, 3 This disease most commonly affects the paraspinal ligaments – predominantly the anterior longitudinal ligament and occasionally the posterior
Conclusion
Although most patients with Forestier’s disease can be managed conservatively, for patients with symptoms justifying intervention, surgery is a safe and effective option. Patients do, however, require long-term follow-up.
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Cited by (31)
Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review
2022, Spine JournalCitation Excerpt :After discarding duplicates, 366 articles were screened on title and abstract, of which 256 articles were assessed using full text screening. The total number of included studies was 138 (including five articles identified after cross referencing), encompassing 112 case reports and 26 case series (Fig. 1), describing a total of 419 patients with dysphagia and/or airway obstruction [12–148]. A comprehensive description of quality assessment of study domains for each article is listed in Appendix B.
Otolaryngologic manifestations of Forestier's disease: A systematic review of the literature
2022, Revue du Rhumatisme (Edition Francaise)Long-term results after surgical treatment of diffuse idiopathic skeletal hyperostosis (DISH) causing dysphagia
2019, Journal of Clinical NeuroscienceThe surgical management of dysphagia secondary to diffuse idiopathic skeletal hyperostosis
2018, Clinical Neurology and NeurosurgeryCitation Excerpt :Conservative management options for ACH associated symptoms include diet modification and speech and swallow therapy. Anti-inflammatory, anti-reflux, antibiotic, steroid, muscle relaxant and sedative medications are also indicated [7,8]. Enteral feeding and gastrostomy may be required in refractory dysphagia.8
Diffuse Idiopathic Hyperostosis Manifesting as Dysphagia and Bilateral Cord Paralysis: A Case Report and Literature Review
2018, World NeurosurgeryCitation Excerpt :Tracheostomy and feeding tube placement should be reserved for patients who are poor surgical candidates or to improve nutritional and respiratory status before surgery.5 Improvement of symptoms could be in the immediate postoperative period7,23 or in the following 3 to 6 months.2,5,20 The treatement of patient with DISHphagia involves a team approach, including a spine surgeon, an otolaryngologist, and a speech therapist to rule out other causes of dysphagia (neuromuscular dysfunction, stroke, tumors, diverticula, and strictures).