Walther E K
Universitäts-Hals-Nasen-Ohren-Klinik Bonn.
Laryngorhinootologie. 1991 Nov;70(11):604-8. doi: 10.1055/s-2007-997066.
Swallowing disorders can be caused by morphologic changes of the cervical spine such as diffuse idiopathic skeletal hyperostosis. The paper describes current concepts of this clinical entity also known as Forestier's disease. The symptomatology, radiographic features and treatment are discussed. Particular interest is focused on dysphagia. The diagnosis is exclusively radiographic. Cervical osteophytes can be detected in 20-30% of the population in asymptomatic patients. Therefore, the attribution of the presence of osteophytic deformities of the barium column to dysphagia should not be made unless objective evidence of impairment of pharyngeal function such as abnormal posterior pharyngeal wall motion is proven by dynamic imaging means. The therapeutic approach depends on the extent of dysphagic complaints. Indications for surgery are failure to respond to conservative management (anti-inflammatory drugs, concomitant antibiotics, dietary nutrition). The anterolateral extrapharyngeal approach is commonly preferred.
吞咽障碍可能由颈椎的形态学改变引起,如弥漫性特发性骨肥厚。本文描述了这种也被称为Forestier病的临床实体的当前概念。讨论了其症状、影像学特征和治疗方法。特别关注吞咽困难。诊断完全依靠影像学检查。在无症状患者中,20% - 30%的人群可检测到颈椎骨赘。因此,除非通过动态成像手段证实存在诸如咽后壁运动异常等咽功能受损的客观证据,否则不应将钡剂柱上骨赘畸形的存在归因于吞咽困难。治疗方法取决于吞咽困难症状的严重程度。手术指征为对保守治疗(抗炎药物、联合使用抗生素、饮食营养)无反应。通常首选咽外侧前入路。