Abstract
PurposeTo investigate the surgical outcome of patients with osteophyte-associated dysphagia (OAD) using the functional outcome swallowing scale (FOSS).MethodsA retrospective chart review of 10 surgical cases of OAD (9 male and 1 female patient; mean age of 65 years) from 1982 to 2017 was performed, and radiographic evaluations were conducted by video fluoroscopic swallow study (VFSS) and conventional radiography. All OAD cases were treated at a single institution, and osteophytes were surgically resected by the anterior approach under gentle retraction of the affected esophagus. FOSS (0 for normal, 5 for worst) was used for clinical evaluations, and surgical complications were recorded.ResultsVFSS evaluation of OAD showed that the affected osteophyte was located at C4/5 in four patients, followed by C3/4 in three patients. The mean FOSS showed significant improvement from 2.5 preoperatively to 0.3 postoperatively, and no major surgical complications were recorded. Comorbidities were diabetes mellitus in four patients, ossification of the posterior longitudinal ligament in three patients, and lumbar spinal stenosis (LSS) in three patients.ConclusionSurgical treatment of OAD was promising, and all patients showed clinical recovery. Evaluation of dysphagia using FOSS was easy and reliable for OAD management, and FOSS 2 might be a good indication for surgical intervention.
Highlights
Anterior cervical osteophytes are a common finding in degenerative spinal conditions, especially among the elderly population, with a reported 30% incidence of osteophytosis and with diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease [1,2,3,4,5].Clinical studies have showed that up to 6% of patients with DISH manifested symptoms of osteophyte-associated dysphagia (OAD) [5,6]
video fluoroscopic swallow study (VFSS) evaluation of OAD showed that the affected osteophyte was located at C4/5 in four patients, followed by C3/4 in three patients
Evaluation of dysphagia using Functional Outcome Swallowing Scale (FOSS) was easy and reliable for OAD management, and FOSS 2 might be a good indication for surgical intervention
Summary
Clinical studies have showed that up to 6% of patients with DISH manifested symptoms of osteophyte-associated dysphagia (OAD) [5,6]. Recent studies used the Functional Outcome Swallowing Scale (FOSS) (0 for normal, 1 for episodic dysphagia, 2 for dysphagia with no body weight (BW) change, 3 for BW loss 10%, and 5 for non-oral feeding) and reported reliable evaluation of dysphagia among patients with OAD (Table 1) [7]. The purpose of this study was to investigate the clinical features and surgical outcomes of patients with OAD. This study was a retrospective chart review of 10 consecutive surgical cases of OAD (male, 9; female, 1; mean age, 65.0 (55–78) years) treated at our institution between 1982 and 2017.
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