7144 “the bone in my throat belongs to me” : pharnygeal dysphagia from anterior cervical osteophytes.

Abstract

69 yo male with a long-standing history of gastroesophageal reflux disease presented with a pressure sensation in his posterior pharynx. Dysphagia associated with this sensation resulted in a 20 lb weight loss and the inability to swallow his medications. Evaluation with a video endoscope revealed several large osteophytes in the midline of the posterior pharynx with an osteophyte from C-5 covering the proximal part of the upper esophageal sphincter. The obstruction of the upper esophageal sphincter was confirmed by a barium swallow and a MRI documented the location and benign nature of these phenomenally large anterior osteophytes. Anterior cervical osteophytectomy by our neurosurgeon (CFE) resulted in prompt, complete resolution of the globus sensation, the feeling of a bone in the posterior pharynx and the dysphagia. Conclusion: Anterior cervical osteophytes can cause pharyngeal dysphagia by physical obstruction of the proximal upper esophageal sphincter. Endoscopy, lateral neck films, barium swallow and MRI demonstrated the pathology which was readily reversed by surgery. 69 yo male with a long-standing history of gastroesophageal reflux disease presented with a pressure sensation in his posterior pharynx. Dysphagia associated with this sensation resulted in a 20 lb weight loss and the inability to swallow his medications. Evaluation with a video endoscope revealed several large osteophytes in the midline of the posterior pharynx with an osteophyte from C-5 covering the proximal part of the upper esophageal sphincter. The obstruction of the upper esophageal sphincter was confirmed by a barium swallow and a MRI documented the location and benign nature of these phenomenally large anterior osteophytes. Anterior cervical osteophytectomy by our neurosurgeon (CFE) resulted in prompt, complete resolution of the globus sensation, the feeling of a bone in the posterior pharynx and the dysphagia. Conclusion: Anterior cervical osteophytes can cause pharyngeal dysphagia by physical obstruction of the proximal upper esophageal sphincter. Endoscopy, lateral neck films, barium swallow and MRI demonstrated the pathology which was readily reversed by surgery.