Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, Gyeonggi-do, Republic of Korea.
J Int Med Res. 2022 Aug;50(8):3000605221116757. doi: 10.1177/03000605221116757.
Dysphagia is common in patients with cervical osteophytes. We aimed to determine whether head rotation as a compensatory technique is effective for dysphagia caused by unilateral cervical osteophytes.
We retrospectively analyzed videofluoroscopic swallowing study (VFSS) data obtained in one university hospital. Patients whose VFSS showed pharyngeal stasis by mechanical obstruction due to cervical osteophytes were selected. They were divided into a unilateral skewed osteophyte group and a diffuse central osteophyte group as confirmed by laryngoscopy or computed tomography. The effect of head rotation on swallowing was investigated. Fisher's exact test was used for statistical analysis.
Among 2876 patients who underwent VFSSs, we identified 48 patients with osteophyte-induced dysphagia. The osteophytes were centrally located in 36 patients and unilateral in the remaining 12. Ten of the patients with unilateral osteophytes showed improvement when they swallowed with head rotation toward the osteophyte side, but none of the patients with central osteophytes showed effective swallowing. A statistically significant relationship was found between swallowing with head rotation and skewed cervical osteophytes.
Swallowing with head rotation was safe, easy, and effective for patients with dysphagia caused by unilateral cervical osteophytes. We advise attempting this method prior to considering surgical approaches.
颈椎骨赘患者常发生吞咽困难。本研究旨在确定头旋转作为一种代偿技术是否对单侧颈椎骨赘引起的吞咽困难有效。
我们回顾性分析了在一家大学医院进行的视频透视吞咽研究（VFSS）的数据。选择 VFSS 显示因颈椎骨赘导致机械性梗阻而出现咽部滞留的患者。通过喉镜或计算机断层扫描确认患者为单侧斜行骨赘组和弥漫性中央骨赘组。研究头旋转对吞咽的影响。采用 Fisher 确切检验进行统计学分析。
在 2876 例行 VFSS 的患者中，我们确定了 48 例因骨赘引起的吞咽困难患者。36 例患者的骨赘位于中央，其余 12 例为单侧。10 例单侧骨赘患者在向骨赘侧旋转头部吞咽时吞咽改善，但无中央骨赘患者的吞咽有效。头旋转吞咽与斜行颈椎骨赘之间存在统计学显著关系。
对于单侧颈椎骨赘引起的吞咽困难患者，头旋转吞咽是安全、简便且有效的。我们建议在考虑手术方法之前尝试这种方法。
