[Vertebrogenic dysphagia in diffuse idiopathic skeletal hyperostosis (Forestier's disease)]

Abstract

Swallowing disorders can be caused by morphologic changes of the cervical spine such as diffuse idiopathic skeletal hyperostosis. The paper describes current concepts of this clinical entity also known as Forestier's disease. The symptomatology, radiographic features and treatment are discussed. Particular interest is focused on dysphagia. The diagnosis is exclusively radiographic. Cervical osteophytes can be detected in 20-30% of the population in asymptomatic patients. Therefore, the attribution of the presence of osteophytic deformities of the barium column to dysphagia should not be made unless objective evidence of impairment of pharyngeal function such as abnormal posterior pharyngeal wall motion is proven by dynamic imaging means. The therapeutic approach depends on the extent of dysphagic complaints. Indications for surgery are failure to respond to conservative management (anti-inflammatory drugs, concomitant antibiotics, dietary nutrition). The anterolateral extrapharyngeal approach is commonly preferred.