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An unusual case of stridor due to osteophytes of the cervical spine: (Forestier's disease)

Published online by Cambridge University Press:  29 June 2007

K. Papakostas ,
A. Thakar ,
V. Nandapalan  and
G. O'Sullivan
K. Papakostas*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Arrowe Park Hospital, Upton, Wirral, Merseyside, UK.
A. Thakar
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Arrowe Park Hospital, Upton, Wirral, Merseyside, UK.
V. Nandapalan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Arrowe Park Hospital, Upton, Wirral, Merseyside, UK.
G. O'Sullivan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Arrowe Park Hospital, Upton, Wirral, Merseyside, UK.
*
Address for correspondence: Mr K. Papakostas, ENT Department, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL.
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Abstract

Stridor is a noisy breathing caused by compromised airway in the larynx and trachea. The causes can either be due to intrinsic or extrinsic compression. Stridor resulting from extrinsic compression due to anterior cervical osteophytes is rare.

We report an unusual case of acute stridor due to an osteophytic mass in the cervical vertebrae resulting in a mechanical upper airway obstruction. The underlying pathology was Forestier's disease or diffuse idiopathic skeletal hyperostosis (DISH). Stridor is a rare manifestation of DISH and it certainly represents the most lifethreatening one. Only a few cases have been reported in the English literature and are mainly secondary to impaired function of the vocal folds, or postcricoid ulceration and oedema. We present such a case, in that stridor was the result of direct airway obstruction by the osteophytic mass and an emergency tracheostomy had to be performed to establish an airway.

Keywords

StridorSpinal Osteophytosis, Forestier's disease
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 1 , January 1999 , pp. 65 - 67
Copyright
Copyright © JLO (1984) Limited 1999

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References

Barsamian, J. G., Cobb, L. W., Bremer, A. M., Schemer, R. B., Northup, H. M. (1985) Radiographic, clinical and histopathologic evaluation with surgical treatment of Forestier's disease. Oral Surgery Oral Medicine Oral Pathology 59: 136–141.CrossRefGoogle ScholarPubMed
Brandenberg, G., Leibrock, L. G. (1986) Dysphagia and dysphonia secondary to anterior cervical osteophytes. Neurosurgery 18: 90–93.CrossRefGoogle ScholarPubMed
Deutsch, E. C., Schild, J. A., Mafee, M. F. (1985) Dysphagia and Forestier's disease. Archives of Otolaryngology 111: 400–402.Google Scholar
Forestier, J., Rotes-Querol, J. (1950) Senile ankylosing hyperostosis of the spine. Annals of the Rheumatic Diseases 9: 321–330.CrossRefGoogle ScholarPubMed
Gamache, F. W., Voorhies, R. M. (1980) Hypertrophic cervical osteophytes causing dysphagia. A review. Journal of Neurosurgery 53: 338–344.CrossRefGoogle ScholarPubMed
Hassard, A. D. (1984) Cervical ankylosing hyperostosis and airway obstruction. Laryngoscope 94: 966–968.CrossRefGoogle ScholarPubMed
Hilding, D. A., Tachdjian, M. O. (1960) Dysphagia and hypertrophic spurring of the cervical spine. New England Journal of Medicine 263: 11–14.CrossRefGoogle ScholarPubMed
Jonathan, D., Baer, S. (1990) Cervical osteophytes: their significance in ENT practice (ankylosing vertebral hyperostosis-Forestier's disease). Journal of Laryngology and Otology 104: 236–238.CrossRefGoogle ScholarPubMed
Maran, A., Jacobson, I. (1971) Cervical osteophytes presenting with pharyngeal symptoms. Laryngoscope 81: 412–417.CrossRefGoogle ScholarPubMed
McCafferty, R. R., Harrison, M. J., Tamas, L. B., Larkins, M. V. (1995) Ossification of the anterior longitudinal ligament and Forestier's disease: an analysis of seven cases. Journal of Neurosurgery 83: 13–17.CrossRefGoogle ScholarPubMed
Meeks, L. W., Renshaw, T. S. (1973) Vertebral osteophytosis and dysphagia. Journal of Bone and Joint Surgery 55: 197–201.CrossRefGoogle ScholarPubMed
Resnick, D., Niwayama, G. (1976) Radiographic and pathologic featues of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 119: 559–568.CrossRefGoogle Scholar
Resnick, D., Shaul, S. R., Robins, J. M. (1975) Diffuse idiopathic skeletal hyperostosis (DISH): Forestier's disease with extraspinal manifestation. Radiology 115: 513–524.CrossRefGoogle Scholar
Rotes-Querol, J. (1996) Clinical manifestations of diffuse idiopathic skeletal hyperostosis (DISH). British Journal of Rheumatology 35: 1193–1196.CrossRefGoogle ScholarPubMed
Verstraete, W. L., Cauwer, H. G., Verhulst, D., Jacobs, F. (1998) Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis. Acta Otolaryngologica Belgica 52(1): 79–84.Google ScholarPubMed