Dutta Sirshak, Biswas Kaustuv Das, Mukherjee Ankur, Basu Asimjiban, Das Saumik, Sen Indranil, Sinha Ramanuj
Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 3/1, Bose Para Lane, Hooghly, Baidyabati, 712222 India.
Department of Otolaryngology, R.G. Kar Medical College & Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004 West-Bengal India ; 369/1, Avishikta-1,Purbachal, Kalitala Road, Kolkata, 700078 India.
Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):379-84. doi: 10.1007/s12070-011-0334-3. Epub 2011 Nov 30.
Forestier disease or diffuse idiopathic skeletal hyperostosis (DISH) is an uncommon cause of dysphagia. Due to rarity of this condition there is neither any demographic data nor any consensus about the investigation and treatment modalities. Here an effort is made in the present article to compile the information regarding the demographic and clinical features, investigation modalities and different methods of treatment from all the available case reports of dysphagia due to Forestier disease in the English literature till date. Three cases of the same condition are also reported in the present paper. Three cases of dysphagia due to Forestier disease treated in the ENT department of R.G. Kar Medical College and Hospital are reported herewith. A systematic review of literature is also done. All the case reports of dysphagia due to Forestier disease are obtained by World Wide Web search (WWWS) using 'Forestier Disease', 'DISH' and 'dysphagia' as the key words. Data regarding age, sex, duration of the symptom, associated symptoms, investigations done, level of vertebrae involved and different modalities of treatment with result are collected and analyzed systematically. We found total 73 cases of dysphagia due to Forestier disease. The condition commonly affects males (M:F 5.64:1) in older age group (94.52% cases are 60 years or above), often presented to the treatment facility after a long time of initiation of the symptom. Barium swallow X-rays and lateral neck X-ray were the most common investigations done to arrive at a diagnosis as per result of systematic review. Surgical removal of the causative osteophytes were the definitive treatment, but if surgery is contraindicated, conservative measures like switchover to liquid and semisolid food and proper swallow training also improve the condition to some extent. Dysphagia due to Forestier disease mostly affects older male, often has a chronic course. It can be diagnosed with simple investigations like neck X-ray or barium swallow X-rays. The definitive treatment is surgical, but if contraindicated the problem can be palliated with simple measures like swallow training and change of food.
福里斯特尔病或弥漫性特发性骨肥厚（DISH）是吞咽困难的一种罕见病因。由于这种疾病罕见，既没有相关人口统计学数据，对于其检查和治疗方式也没有达成共识。本文旨在汇总英文文献中截至目前所有关于福里斯特尔病所致吞咽困难的病例报告中有关人口统计学和临床特征、检查方式以及不同治疗方法的信息。本文还报告了3例相同病症的病例。在此报告了在R.G.卡尔医学院及医院耳鼻喉科治疗的3例福里斯特尔病所致吞咽困难病例。同时也对文献进行了系统回顾。通过使用“福里斯特尔病”“弥漫性特发性骨肥厚”和“吞咽困难”作为关键词，在万维网搜索（WWWS）中获取了所有福里斯特尔病所致吞咽困难的病例报告。系统收集并分析了有关年龄、性别、症状持续时间、相关症状进行的检查、受累椎体水平以及不同治疗方式及结果的数据。我们共发现73例福里斯特尔病所致吞咽困难病例。该病症常见于老年男性（男性与女性比例为5.64:1）（94.52%的病例年龄在60岁及以上），常在症状出现很长时间后才前往治疗机构就诊。根据系统回顾结果，钡餐X线检查和颈部侧位X线检查是最常用于确诊的检查。手术切除致病骨赘是确定性治疗方法，但如果手术禁忌，像改用流质和半流质食物以及适当的吞咽训练等保守措施也能在一定程度上改善病情。福里斯特尔病所致吞咽困难主要影响老年男性，病程通常较长。通过颈部X线或钡餐X线等简单检查即可诊断。确定性治疗是手术，但如果禁忌，可通过吞咽训练和改变食物等简单措施缓解问题。
