Hines Kevin, Elmer Nicholas, Detweiler Maxwell, Fatema Umma, Gonzalez Glenn A, Montenegro Thiago S, Franco Daniel, Prasad Srinivas, Jallo Jack, Sharan Ashwini, Heller Joshua, Boon Maurits, Spiegel Joseph, Harrop James
Thomas Jefferson University, Philadelphia, PA, USA.
Jefferson Hospital for Neuroscience, Philadelphia, PA, USA.
Global Spine J. 2022 Jun;12(5):877-882. doi: 10.1177/2192568220967358. Epub 2020 Nov 18.
Retrospective observational case series.
To assess the outcome of patients with diffuse idiopathic skeletal hyperostosis (DISH) with dysphagia who underwent cricopharyngeal myotomy (CPM) in conjunction with anterior osteophytectomy (OP).
This is a retrospective observational study of 9 patients that received combined intervention by neurosurgeons and otolaryngologists. Inclusion criteria for surgery consisted of patients who failed to respond to conservative treatments for dysphagia and had evidence of both upper esophageal dysfunction and osteophyte compression. We present the largest series in literature to date including patients undergoing combined OP and CPM.
A total of 88.9% (8/9) of the patients who underwent OP and CPM showed improvement in their symptoms. Of the aforementioned group, 22.2% of these patients had complete resolution of their symptoms, 11.1% did not improve, and only 2 patients showed recurrence of their symptoms. None of the patients in whom surgery was performed required reoperation or suffered serious complication related to the surgical procedures.
Based on the literature results, high rate of improvements in dysphagia, and low rate of complications, combined OP and CPM procedures may be beneficial to a carefully selected group of patients.
回顾性观察病例系列。
评估患有吞咽困难的弥漫性特发性骨肥厚（DISH）患者接受环咽肌切开术（CPM）联合前路骨赘切除术（OP）的治疗效果。
这是一项对9例接受神经外科医生和耳鼻喉科医生联合干预的患者进行的回顾性观察研究。手术的纳入标准包括吞咽困难保守治疗无效且有食管上段功能障碍和骨赘压迫证据的患者。我们呈现了迄今为止文献中最大的一组接受OP和CPM联合手术的患者系列。
总共88.9%（8/9）接受OP和CPM的患者症状有所改善。在上述组中，22.2%的患者症状完全缓解，11.1%没有改善，只有2例患者症状复发。接受手术的患者中没有一人需要再次手术或出现与手术相关的严重并发症。
基于文献结果、吞咽困难改善率高以及并发症发生率低，OP和CPM联合手术可能对精心挑选的一组患者有益。
