Abdel-Aziz Mosaad, Azab Noha, Lasheen Hisham, Naguib Nader, Reda Ramez
a Department of Otolaryngology , Cairo University , Egypt.
b Department of Rheumatology and Rehabilitation , Cairo University , Egypt.
Acta Otolaryngol. 2017 Jun;137(6):623-626. doi: 10.1080/00016489.2016.1272136. Epub 2017 Jan 13.
Diffuse idiopathic skeletal hyperostosis (DISH) is a cause of swallowing disorders in elderly, and otolaryngologists should be aware of the disease on dealing with old patients complaining of dysphagia. The condition may be treated conservatively in most patients; however, surgical reduction of cervical osteophytes may be needed in severe cases.
Large cervical osteophytes may cause dysphagia; they compress the pharynx leading to mechanical impairment of swallowing. DISH is characterized by ossification of the anterior longitudinal spinal ligament with formation of osteophytes. The aim was to investigate swallowing disorders among patients with DISH.
The study included 139 patients with DISH. Their swallowing was evaluated using the eating assessment tool (EAT-10), and patients with swallowing disorders were subjected to fiber-optic endoscopic evaluation of swallowing (FEES), they received conservative treatment for 6 months. Patients were assessed again after treatment using the same measures that were employed before treatment.
Twenty-three patients (16.5%) demonstrated swallowing disorder, and FEES showed residues of food in the pharynx after swallow in all of them. Significant overall improvement after conservative treatment was achieved, with two patients resuming their normal regular diet. However, one patient demonstrated no improvement, and he needed surgical reduction of his large cervical osteophytes.
弥漫性特发性骨肥厚（DISH）是老年人吞咽障碍的一个病因，耳鼻喉科医生在诊治主诉吞咽困难的老年患者时应了解这种疾病。大多数患者可采用保守治疗；然而，严重病例可能需要手术切除颈椎骨赘。
巨大颈椎骨赘可导致吞咽困难；它们压迫咽部导致吞咽机械性受损。DISH的特征是前纵韧带骨化并形成骨赘。本研究旨在调查DISH患者的吞咽障碍情况。
该研究纳入了139例DISH患者。使用进食评估工具（EAT-10）对他们的吞咽情况进行评估，对有吞咽障碍的患者进行纤维喉镜吞咽功能评估（FEES），并给予6个月的保守治疗。治疗后使用与治疗前相同的方法对患者再次进行评估。
23例患者（16.5%）存在吞咽障碍，FEES显示所有患者吞咽后咽部均有食物残留。保守治疗后总体有显著改善, 2例患者恢复了正常饮食。然而，1例患者无改善，需要手术切除其巨大的颈椎骨赘。
