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Diffuse idiopathic skeletal hyperostosis syndrome DISH is a rare cause of dysphagia. The actual pathology of DISH is the calcification of perivertebral anterolateral ligament. It was first described by Forestier and Rotes-Querol in The primary diagnosis is radiological and its etiology has not been exactly identified. The most common symptoms are neck pain, limitation of movement, and dysphagia, yet, aspiration, dyspnea, and laryngeal stridor may also be seen rarely. Hyperostosis Case Study
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CASE 387 SKULL Hyperostosis frontalis internaDiffuse idiopathic skeletal hyperostosis DISH is a progressive, systematic, non-inflammatory disease of unknown origin that causes ossification of ligaments and tendons attached to bone. It is most commonly observed in the spine, particularly at the lower thoracic and cervical levels 1.
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While DISH is usually asymptomatic, it may occasionally cause compression myelopathy, dysphagia, and dyspnea. To our knowledge, however, there are only a see more previous reports of DISH-associated acute airway obstruction requiring surgical treatment 2 - 4. Here we describe an extremely unusual case of DISH wherein the patient developed acute airway obstruction after upper respiratory tract infection. A year-old man who was unable Hyperostosis Case Study breathe was admitted to our hospital emergency department after complaining of cold-like symptoms such as fever and cough along with dyspnea for several days. His past medical history included posterior cervical laminectomy and laminoplasty performed for compression myelopathy following ossification of the posterior longitudinal ligament OPLLwith a prolonged history of mild dysphagia.
Significant anterior protrusion of the ossified anterior longitudinal ligament at the C level was also observed Fig. The surrounding soft tissues at the level of the hyoid bone were markedly swollen, and the airway was obstructed Fig. Laryngofiberscopy performed by an otolaryngologist showed a normal epiglottis and surrounding mucosal surface, with Hyperostosis Case Study posterior pharyngeal wall largely protruding.
There was no vocal cord paralysis in the glottis. Emergency orotracheal intubation was performed to secure the airway.
We concluded that the airway obstruction was triggered by soft-tissue swelling following an upper respiratory tract infection in the presence of the huge osteophytes. The next day, the patient underwent anterior Caxe of the extensive osteophytes on the anterior longitudinal ligament Hyperostosis Case Study. The patient was extubated the day after the surgery, and bronchial fiberscopy was performed to confirm that the airway was not obstructed.
Despite presenting with transient dysphagia, the patient was discharged without symptoms 21 days after admission.
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Figure 1. AB Sagittal computed tomography CT Hyperostosis Case Study of the neck shows Sthdy ankylosed cervical spine secondary to ossification of the anterior and posterior longitudinal ligaments. Laminectomy at the C2, C5, and C6 levels and laminoplasty at the C3 and C4 levels had been performed in the past.]
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