Cherfane Patrick, Smaily Hussein, Khalaf Michel G, Ghaoui Nohra, Melkane Antoine E
Department of Otolaryngology - Head and Neck Surgery, Hôtel Dieu de France Hospital, Saint-Joseph University, 166830 Beirut, Lebanon.
Department of Otolaryngology - Head and Neck Surgery, Hôtel Dieu de France Hospital, Saint-Joseph University, 166830 Beirut, Lebanon.
Joint Bone Spine. 2021 Dec;88(6):105218. doi: 10.1016/j.jbspin.2021.105218. Epub 2021 May 19.
Forestier's disease or diffuse idiopathic skeletal hyperostosis (DISH) is a common, yet underreported, disease affecting the elderly population. From an otolaryngologic perspective, DISH may manifest with dysphagia, dysphonia, or even dyspnea. The purpose of this study was to identify all published cases of dysphagia and other associated upper airway symptoms resulting from DISH in the last decade and to establish subsequently a management algorithm.
A comprehensive review of the literature was conducted in May 2020 on Medline and Embase databases following the PRISMA statement for systematic reviews and meta-analysis.
Sixty-three articles, consisting of 50 case-reports and 13 case-series, met the inclusion criteria. A total of 236 cases of DISH were reported from 2010 to date. Otolaryngology instrumental evaluation, by fiberoptic laryngoscopy and fiberoptic endoscopic evaluation of swallowing, was frequently reported. Surgery was the most common treatment strategy for the management of dysphagia in 58.9% of patients, while conservative treatment was used in 41.1%. Tracheotomy for acute airway obstruction relief was performed in 6% of patients. No correlation was found between the type of treatment and dysphagia improvement.
Forestier's disease is currently a growing source of complications in elderly, mostly dysphagia and less commonly upper airway obstruction. The management of these complications requires a multidisciplinary team and a thorough approach, where the otolaryngologist plays a pivotal role.
福里斯特尔病或弥漫性特发性骨肥厚（DISH）是一种常见但报告不足的影响老年人群的疾病。从耳鼻喉科的角度来看，DISH可能表现为吞咽困难、声音嘶哑，甚至呼吸困难。本研究的目的是识别过去十年中所有已发表的由DISH导致吞咽困难及其他相关上呼吸道症状的病例，并随后建立一种管理算法。
2020年5月，根据系统评价和荟萃分析的PRISMA声明，对Medline和Embase数据库进行了全面的文献综述。
63篇文章符合纳入标准，其中包括50篇病例报告和13篇病例系列。从2010年至今共报告了236例DISH病例。经常报告采用纤维喉镜检查和纤维内镜吞咽功能评估等耳鼻喉科器械评估方法。手术是58.9%患者吞咽困难管理中最常见的治疗策略，而41.1%的患者采用保守治疗。6%的患者因急性气道梗阻缓解而行气管切开术。未发现治疗类型与吞咽困难改善之间存在相关性。
福里斯特尔病目前是老年人并发症的一个日益增多的来源，主要是吞咽困难，较少见上呼吸道梗阻。这些并发症的管理需要多学科团队和全面的方法，其中耳鼻喉科医生起着关键作用。
