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J Korean Dysphagia Soc 2019; 9(2): 84-88

Published online July 30, 2019

Copyright © The Korean Dysphagia Society.

Temporarily Aggravated Dysphagia Following Osteophytectomy and Fixation in a Patient with Cervical Osteophyte

Shinhoo Kim, M.D., Han Gil Seo, M.D., Ph.D.

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Abstract

An anterior cervical osteophyte is one of the causes of dysphagia. Surgical treatment is one of the treatment options available, and previous studies have suggested that it is an immediate and effective treatment. This paper reports a case of temporarily aggravated dysphagia after surgical treatment in a patient with anterior cervical osteophyte. A 75-year-old male complained of dysphagia for one year. A videofluoroscopic swallowing study (VFSS) revealed anterior cervical osteophytes at the C3 and C4 level, which resulted in decreased epiglottic folding and partial obstruction of the bolus passage. After he underwent osteophytectomy and anterior fixation, the post-operative VFSS showed an aggravation of dysphagia with prevertebral soft tissue edema. The major cause of dysphagia was attributed to the limitation of movement of the posterior pharyngeal wall and upper esophageal sphincter due to the increased prevertebral soft tissue thickness. In conclusion, surgery should be considered when a severe dysphagia is persistent after adequate conservative treatment in patients with dysphagia due to anterior cervical osteophytes, and patients at high risk of postoperative dysphagia might require swallowing rehabilitation.

Keywords: Osteophyte, Cervical vertebrae, Deglutition disorders, Fluoroscopy, Surgical procedure

Article

Review Article

J Korean Dysphagia Soc 2019; 9(2): 84-88

Published online July 30, 2019

Copyright © The Korean Dysphagia Society.

Temporarily Aggravated Dysphagia Following Osteophytectomy and Fixation in a Patient with Cervical Osteophyte

Shinhoo Kim, M.D., Han Gil Seo, M.D., Ph.D.

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Abstract

An anterior cervical osteophyte is one of the causes of dysphagia. Surgical treatment is one of the treatment options available, and previous studies have suggested that it is an immediate and effective treatment. This paper reports a case of temporarily aggravated dysphagia after surgical treatment in a patient with anterior cervical osteophyte. A 75-year-old male complained of dysphagia for one year. A videofluoroscopic swallowing study (VFSS) revealed anterior cervical osteophytes at the C3 and C4 level, which resulted in decreased epiglottic folding and partial obstruction of the bolus passage. After he underwent osteophytectomy and anterior fixation, the post-operative VFSS showed an aggravation of dysphagia with prevertebral soft tissue edema. The major cause of dysphagia was attributed to the limitation of movement of the posterior pharyngeal wall and upper esophageal sphincter due to the increased prevertebral soft tissue thickness. In conclusion, surgery should be considered when a severe dysphagia is persistent after adequate conservative treatment in patients with dysphagia due to anterior cervical osteophytes, and patients at high risk of postoperative dysphagia might require swallowing rehabilitation.

Keywords: Osteophyte, Cervical vertebrae, Deglutition disorders, Fluoroscopy, Surgical procedure

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