Characteristics and Clinical Course of Dysphagia Caused by Anterior Cervical Osteophyte
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective To investigate swallowing characteristics of patients with dysphagia caused by anterior cervical osteophytes (ACOs) and compare clinical courses according to treatment options. Methods A retrospective analysis of 1,866 videofluoroscopic swallowing studies (VFSS) of patients with ACOs from electronic medical records was performed. Patients with other diseases that could explain the dysphagia were excluded. Dysphagia characteristics and severity and clinical and radiological characteristics of subjects with ACOs were evaluated. Dysphagia characteristics and clinical course were compared among three treatment groups: surgical treatment, swallowing rehabilitation, and conservative treatment. Results Subjects were 22 men and 1 woman with a mean age of 78.69±8.01 years. The mean osteophyte thickness was 9.07±3.84 mm. It was significantly thicker in the surgical group than that in other groups (p=0.01). ACOs were most frequently found at C5 level. This level also had the thickest osteophytes. However, videofluoroscopic dysphagia scales (VDS) were not significantly different among the three treatment groups. The pharyngeal phase score of the VDS was significantly higher in the surgical group (p=0.041). Dysphagia severity was decreased significantly in the surgical group at 3 months after the initial VFSS (p=0.004). Conclusion The main swallowing characteristics in patients with ACOs were dysphagia features of the pharyngeal phase, including inappropriate airway protection, decreased laryngeal elevation, and reduced epiglottis inversion. When determining treatment options, it may be helpful to consider dysphagia severity at pharyngeal phase and osteophyte thickness.
Abstract
Objective To investigate swallowing characteristics of patients with dysphagia caused by anterior cervical osteophytes (ACOs) and compare clinical courses according to treatment options. Methods A retrospective analysis of 1,866 videofluoroscopic swallowing studies (VFSS) of patients with ACOs from electronic medical records was performed. Patients with other diseases that could explain the dysphagia were excluded. Dysphagia characteristics and severity and clinical and radiological characteristics of subjects with ACOs were evaluated. Dysphagia characteristics and clinical course were compared among three treatment groups: surgical treatment, swallowing rehabilitation, and conservative treatment. Results Subjects were 22 men and 1 woman with a mean age of 78.69±8.01 years. The mean osteophyte thickness was 9.07±3.84 mm. It was significantly thicker in the surgical group than that in other groups (p=0.01). ACOs were most frequently found at C5 level. This level also had the thickest osteophytes. However, videofluoroscopic dysphagia scales (VDS) were not significantly different among the three treatment groups. The pharyngeal phase score of the VDS was significantly higher in the surgical group (p=0.041). Dysphagia severity was decreased significantly in the surgical group at 3 months after the initial VFSS (p=0.004). Conclusion The main swallowing characteristics in patients with ACOs were dysphagia features of the pharyngeal phase, including inappropriate airway protection, decreased laryngeal elevation, and reduced epiglottis inversion. When determining treatment options, it may be helpful to consider dysphagia severity at pharyngeal phase and osteophyte thickness.
참고문헌 (25)
- Lecerf P, "How to diagnose and treat symptomatic anterior cervical osteophytes", Eur Ann Otorhinolaryngol Head Neck Dis, 127, pp.111~116 (2010)
- von der Hoeh NH, "Results after the surgical treatment of anterior cervical hyperostosis causing dysphagia", Eur Spine J, 24(Suppl 4), pp.S489~S493 (2015)
- Hyeonghui Jeong, "Kinematic Changes in Swallowing After Surgical Removal of Anterior Cervical Osteophyte Causing Dysphagia: A Case Series", Annals of Rehabilitation Medicine, 38(6), pp.865~870 (2014), 대한재활의학회
- Egerter AC, "Dysphagia secondary to anterior osteophytes of the cervical spine", Global Spine J, 5, pp.e78~e83 (2015)
- Granville LJ, "Anterior cervical osteophytes as a cause of pharyngeal stage dysphagia", J Am Geriatr Soc, 46, pp.1003~1007 (1998)
- Utsinger PD, "Diffuse skeletal abnormalities in Forestier disease", Arch Intern Med, 136, pp.763~768 (1976)
- Zhang C, "Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine : a case report and literature review", Clin Interv Aging, 9, pp.553~557 (2014)
- Terk AR, "Hyoid bone and laryngeal movement dependent upon presence of a tracheotomy tube", Dysphagia, 22, pp.89~93 (2007)
- Song J, "Clinical and radiological analysis of ossification of the anterior longitudinal ligament causing dysphagia and hoarseness", Neurosurgery, 58, pp.913~919 (2006)
- Kim J, "Validation of the videofluoroscopic dysphagia scale in various etiologies", Dysphagia, 29, pp.438~443 (2014)
- Han TR, "The prediction of persistent dysphagia beyond six months after stroke", Dysphagia, 23, pp.59~64 (2008)
- Won Kyung Lee, "Characteristics of Dysphagia in Severe Traumatic Brain Injury Patients: A Comparison With Stroke Patients", Annals of Rehabilitation Medicine, 40(3), pp.432~439 (2016), 대한재활의학회
- Verlaan JJ, "Diffuse idiopathic skeletal hyperostosis of the cervical spine : an underestimated cause of dysphagia and airway obstruction", Spine J, 11, pp.1058~1067 (2011)
- Kim SK, "The prevalence of diffuse idiopathic skeletal hyperostosis in Korea", J Rheumatol, 31, pp.2032~2035 (2004)
- Seidler TO, "Dysphagia caused by ventral osteophytes of the cervical spine : clinical and radiographic findings", Eur Arch Otorhinolaryngol, 266, pp.285~291 (2009)
- Oppenlander ME, "Dysphagia due to anterior cervical hyperosteophytosis", Surg Neurol, 72, pp.266~270 (2009)
- Di Vito J Jr, "Cervical osteophytic dysphagia : single and combined mechanisms", Dysphagia, 13, pp.58~61 (1998)
- Strasser G, "Cervical osteophytes impinging on the pharynx : importance of size and concurrent disorders for development of aspiration", Am J Roentgenol, 174, pp.449~453 (2000)
- Flynn JM, "Anterior cervical osteophytes causing dysphagia", Bol Asoc Med P R, 83, pp.47~53 (1991)
- Erdur O, "Surgical management of dysphagia due to anterior cervical osteophytes", J Craniofac Surg, 28, pp.e80~e84 (2017)
- Lui Jonathan YC, "The surgical management of dysphagia secondary to diffuse idiopathic skeletal hyperostosis", Clin Neurol Neurosurg, 167, pp.36~42 (2018)
- Mata S, "A controlled study of diffuse idiopathic skeletal hyperostosis: clinical features and functional status", Medicine(Baltimore), 76, pp.104~117 (1997)
- Bartalena T, "DISH of the cervical spine causing epiglottis impingement", Indian J Radiol Imaging, 19, pp.132~134 (2009)
- Bilbao G, "Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies", Acta Neurochir(Wien), 152, pp.1155~1163 (2010)
- Miyamoto K, "Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis", Eur Spine J, 18, pp.1652~1658 (2009)