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Dysphagia due to diffuse idiopathic skeletal hyperostosis: An analysis of five cases
Rheumatology International, 06/02/09

Masiero S et al. – Study concludes that swallowing dynamics alterations may be due to Forestier’s disease.

• Aim was to evaluate the possible physiopathogenetic mechanisms affecting swallowing dynamics in diffuse idiopathic skeletal hyperostosis (DISH) patients with cervical involvement
• 5 cases of dysphagia caused by diffuse idiopathic skeletal hyperostosis or Forestier’s disease of the cervical spine are presented
• This was observed by clinical evaluations, X-ray and videofluoroscopy

• Dysphagia in particular was present for solid foods in all pts
• 3 pts showed bolus aspiration into the airways, mainly in the post-swallowing phase
• 1 patient with preserved epiglottic tilt showed post-swallowing penetration
• The physiopathogenetic mechanisms affecting swallowing dynamics were:
  • mechanical compression of the pharyngeal lumen associated with abnormal epiglottic tilt
  • incomplete upper esophageal sphincter openings and
  • epiglottic/vallecula stasis

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