Pruijn Ineke M J, Marres Henri A M, van den Broek Guido B
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Int J Surg Case Rep. 2024 Sep;122:110111. doi: 10.1016/j.ijscr.2024.110111. Epub 2024 Aug 2.
The manifestation of acute upper airway obstruction, coupled with dysphagia and potential vocal cord paresis, typically raises suspicion of advanced laryngeal or pharyngeal malignancy. However, this case report illuminates an unusual systemic condition- diffuse idiopathic skeletal hyperostosis (DISH) with cervical osteophytes-that can resemble the clinical presentation of these malignancies.
Two cases involving 78-year and 82-year-old males exhibiting progressive dysphagia, dysphonia, and acute upper airway obstruction due to substantial osteophytes at the C2-C4 levels are presented.
Clinicians should consider DISH in the differential diagnosis of dysphagia and upper airway obstruction after ruling out laryngeal and pharyngeal malignancies. Timely recognition and appropriate management of DISH has proven effective in relieving symptoms and restoring normal swallowing and breathing, preventing acute life-saving interventions, contributing to improved patient outcomes.
急性上气道梗阻的表现，再加上吞咽困难和潜在的声带麻痹，通常会引发对晚期喉或咽恶性肿瘤的怀疑。然而，本病例报告揭示了一种不寻常的全身性疾病——伴有颈椎骨赘的弥漫性特发性骨肥厚（DISH）——它可能类似于这些恶性肿瘤的临床表现。
介绍了两例分别为78岁和82岁男性的病例，他们因C2 - C4水平的大量骨赘而出现进行性吞咽困难、声音嘶哑和急性上气道梗阻。
临床医生在排除喉和咽恶性肿瘤后，应在吞咽困难和上气道梗阻的鉴别诊断中考虑DISH。事实证明，及时识别和适当处理DISH可有效缓解症状，恢复正常吞咽和呼吸，避免进行急性救命干预，从而改善患者预后。
