Razura Diego E, Shuman Elizabeth A, Johns Michael M, O'Dell Karla
Quillen College of Medicine East Tennessee State University Johnson City Tennesse USA.
Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine University of Southern California Los Angeles California USA.
OTO Open. 2024 Aug 30;8(3):e70003. doi: 10.1002/oto2.70003. eCollection 2024 Jul-Sep.
To describe the clinical courses and interventions of symptomatic patients with bilateral vocal fold motion impairment (BVFMI) attributed to diffuse idiopathic skeletal hyperostosis (DISH).
Retrospective cohort study.
Single Institution Academic Health Center.
Retrospective chart review of patients ≥18 years old evaluated and treated for symptomatic BVFMI secondary to DISH between February 2021 and March 2023. A literature review was conducted.
A total of 4 cases were identified. All patients were male and had symptomatic BVFMI attributed to cervical spine DISH, as seen on imaging. Symptoms ranged from life-threatening dyspnea to breathy dysphonia in addition to dysphagia. Each patient was offered surgery for DISH. Two patients underwent osteophyte removal at the C5-C6 level with improved vocal fold (VF) mobility, breathing, and voice quality. Two patients elected serial observation as voice, swallow, and airway symptoms were manageable. The literature review showed a male-dominant (100%) presentation with an average of 70 years of age. Hypertension (45%) and diabetes mellitus (36%) were the most common comorbidities. Most patients were treated surgically (55%).
Both surgical and conservative interventions may be considered for symptomatic relief and improvement in VF mobility on a patient-to-patient basis. Further study is warranted to investigate the etiology and treatment outcomes in these cases.
描述因弥漫性特发性骨肥厚（DISH）导致双侧声带运动障碍（BVFMI）的有症状患者的临床病程及干预措施。
回顾性队列研究。
单一机构学术健康中心。
对2021年2月至2023年3月期间因DISH继发有症状BVFMI而接受评估和治疗的18岁及以上患者进行回顾性病历审查。进行了文献综述。
共确定4例患者。所有患者均为男性，影像学检查显示有因颈椎DISH导致的有症状BVFMI。症状范围从危及生命的呼吸困难到呼吸性发声困难，此外还有吞咽困难。每位患者均接受了针对DISH的手术治疗。2例患者在C5 - C6水平进行了骨赘切除术，声带（VF）活动度、呼吸及嗓音质量均得到改善。2例患者因嗓音、吞咽及气道症状可控制而选择了连续观察。文献综述显示，患者以男性为主（100%），平均年龄70岁。高血压（45%）和糖尿病（36%）是最常见的合并症。大多数患者接受了手术治疗（55%）。
对于有症状的患者，可根据个体情况考虑手术和保守干预措施以缓解症状并改善VF活动度。有必要进一步研究这些病例的病因及治疗结果。
