Forestier's syndrome : a rare cause of dysphagia. A case report and review of the literature (original) (raw)
Related papers
Forestier syndrome presenting with dysphagia: case report of a rare presentation
Journal of spine surgery (Hong Kong), 2017
Diffuse idiopathic skeletal hyperostosis (DISH) (Forestier syndrome) is a rheumatologic disease, the etiology of which is not exactly known. It is characterized by spinal osteophyte formations resulting from the ossification of the paravertebral ligaments and muscles. Anterior longitudinal ligament is the usual site of involvement and the frequency of the disease increases after the 5th decade. Lower cervical segments are the most frequently involved regions whereas the upper cervical involvement leading to dysphagia is very rare. In this report, a 77-year-old patient with Forestier syndrome in upper cervical region presenting with dysphagia was presented. Anterior cervical osteophyte resection was performed with no need for discectomy, fusion or stabilization. The patient showed a significant improvement in his all preoperative symptoms, and no recurrence was detected at 1-year follow-up.
Forestier's Disease and Dysphagia
A 60-year-old man was seen in the King Faisal Specialist Hospital and Research Centre, Saudi Arabia, with 6 months' history of progressive dysphagia with the sensation of the presence of a foreign body, hoarseness of voice, limitation of neck flexion, and breathing difficulty on attempting neck flexion. A plain cervical radiograph, barium swallow, and computed tomography confirmed the presence of large cervical osteophytes, which were the cause of his symptoms.
Forestierʼs Disease and Dysphagia
Neurosurgery Quarterly, 1994
months' history of progressive dysphagia with the sensation of the presence of a foreign body, hoarseness of voice, limitation of neck flexion, and breathing difficulty on attempting neck flexion. A plain cervical radiograph, barium swallow, and computed tomography confirmed the presence of large cervical osteophytes, which were the cause of his symptoms.
Dysphagia Due to Forestier Disease: Three Cases and Systematic Literature Review
Indian Journal of Otolaryngology and Head & Neck Surgery, 2011
Forestier disease or diffuse idiopathic skeletal hyperostosis (DISH) is an uncommon cause of dysphagia. Due to rarity of this condition there is neither any demographic data nor any consensus about the investigation and treatment modalities. Here an effort is made in the present article to compile the information regarding the demographic and clinical features, investigation modalities and Keywords Forestier disease Á Diffuse idiopathic skeletal hyperostosis Á Dysphagia
International Journal of Spine Research, 2020
Background Diffuse Idiopathic Skeletal Hyperostosis (DISH) or Forestier disease is defi ned as a non-infl ammatory ossifi cation of ligaments of the spinal colon [1]. It is mostly seen in the upper thoracic vertebra but can also occur anywhere on the vertebral colon [2]. Estimated prevalence is suggested between 2.9%-28% in general [3]. Mostly identifi ed as an incidental fi nding on plain radiographs or computerized tomography most cases are asymptomatic. But based on location and size symptoms may vary from neck and back pain, to dysphagia and eating disabilities. The incidence rises with age and several metabolic disorders like diabetes mellitus and hypercholesterolemia are risk factors for DISH [2,4]. We present a rare case of Forestier disease with multi-level vertebra involvement from the upper cervical to the thoracic area which has not been reported in the literature before.
Brazilian Journal of Otorhinolaryngology, 2014
Introduction: Forestier's disease affects the spinal column of primarily elderly men. It is not rare, but it is often undiagnosed and can lead to significant morbidity and mortality. When it affects the cervical spine, it can result in important otorhinolaryngological manifestations. Objective: To analyze the pharyngeal and laryngeal symptoms of the Forestier's disease. Methods: Literature review of the Web of Knowledge, PubMed, and SciELO databases and of the ten most frequently cited journals in the field of otorhinolaryngology. Additionally, a manual search was performed for publications in the reference lists of selected articles, mostly those of a historical nature. Results: The etiology of the disease is still unclear. Symptoms of complications are more significant than the disease itself. Dysphagia is the most common cervical symptom and has several involved mechanisms. Other symptoms are sleep apnea, pharyngeal globus, coughing, dysphonia, dyspnea, otalgia, and medullary compression. The diagnosis is verified by appropriate radiological study. Treatment is based on a conservative strategy. Patients with refractory dysphagia and respiratory impairment can be surgically treated. Conclusion: Forestier's disease should be suspected in elderly patients with the major symptoms of complications, which are common in otorhinolaryngology practice and when identified, a multidisciplinary approach should be instituted as soon as possible.
Dysphagia caused by ventral osteophytes of the cervical spine: clinical and radiographic findings
European Archives of Oto-Rhino-Laryngology, 2009
The purpose of our study was to demonstrate the clinical and radiographic Wndings in patients with dysphagia and ventral osteophytes of the cervical spine due to degeneration or as a typical feature of diVuse idiopathic skeletal hyperostosis (DISH, Forestier Disease). Since 2003 we encountered 20 patients with such changes in the cervical spine causing an impairment of deglutition. A total of 12 patients had one solitary pair of osteophytes of neighboring vertebrae, 4 patients revealed two pairs and 4 patients had triple pairs of osteophytes. Thirty-two osteophytes were observed totally. A total of 14 of these arose from the right, 15 from the left side and 3 from the middle of the anterior face of the vertebra. Ten patients suVered from DISH, while ten patients revealed osteophytes as a part of a degenerative disorder of the cervical spine. The osteophytes had an average length of 19 mm maximum anterior posterior range. Most of the osteophytes (16) were found in the segments C5/6 and C6/7. Osteophytes of vertebrae C3/4/5 occurred in six cases. Only in one case C2/3 was aVected. Functional endoscopic evaluation of swallowing (FEES) revealed an aspiration of thin liquids in seven patients with osteophytes arising from the anterior face of the vertebra C3/4/5 restricting the motility of the epiglottis, which seemed not to close the aditus laryngis. Retention of solids in the piriform sinus on the side obstructed by an osteophyte (C4/5) could also be repeatedly evidenced through FEES. In one case, a strong impairment of the voice because of an immobility of the right vocal cord due to mechanical obstruction by an osteophyte was the indication for surgical removal of the structure. Thus, the dysphagia of this patient was reduced and his voice turned to normal. The development of symptoms in patients with ventral osteophytes was very much related to the location of the structures. Moreover, the clinical symptoms were to some extent dependent on the size of the osteophytes, although there was no direct correlation between size of the structure and severity of the patient's complaint.
Forestier disease: single-center surgical experience and brief literature review
The Annals of otology, rhinology, and laryngology, 2010
We describe the experience of our otolaryngology department in the treatment of Forestier disease, particularly regarding the diagnostic process, surgical treatment, and postoperative outcomes. The charts of 12 patients who underwent surgical treatment of Forestier disease between January 1, 2003, and January 1, 2009, were analyzed. All patients were subjected to clinical, radiologic, and endoscopic evaluation that confirmed the presence of cervical osteophytes. All patients were treated by a right-sided prevascular transcervical approach to remove cervical osteophytes. A literature review on Forestier disease was also carried out. One case of immediate postoperative hemorrhage was reported. During the postoperative follow-up, ranging from 1 to 5 years, all patients underwent cervical radiography and fiberoptic laryngoscopy that confirmed no evidence of recurrence, and all patients remained asymptomatic. A prevascular transcervical right-sided approach seems to be an effective treat...
How to diagnose and treat symptomatic anterior cervical osteophytes?
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2010
Introduction: Forestier disease, a cervical anterior form of diffuse idiopathic skeletal hyperostosis (DISH) is electively diagnosed in the elderly population. ENT symptoms are likely prevalent (dysphagia, and less frequently dysphonia, dyspnea, etc.), but diagnosis and the relation between symptoms and anterior longitudinal ligament ossification can be difficult to demonstrate. Starting from two clinical cases and a review of the literature, the authors propose a diagnostic and therapeutic course of action. Materials and methods: A typical description of Forestier disease is related based on the cases of two 80-and 79-year-old men referred with gradually worsening swallowing problems leading to dysphagia. Both underwent surgical resection of cervical osteophytes via a lateral cervical approach after failure of the medical treatments. Discussion: Based on the clinical presentations and the analysis of the literature, the authors describe the clinical features of the cervical anterior form of DISH presenting with ENT symptoms. The diagnosis and conservative therapeutic, and surgical management of anterior cervical hyperostosis based on ongoing gradual solutions are described.