Abstract
Dysphagia, is a significant sign of many different lesions in upper digestive system especially in proximal esophagus. Tumors, gastroesophageal reflux, achalasia and extrinsic compressions are the most common causes that may lead to dysphagia in geriatric population. Cervical osteophyte induced dysphagia, is one of the uncommon reasons of dysphagia, therefore other causes of dysphagia must be excluded to establish the exact diagnosis. Eagle syndrome is one of the considerable reason which may lead to misdiagnosis in patients with cervical osteophytes. In this case report, we represent four patients who had dysphagia due to anteriorly located cervical osteophytes and evaluate the patients with special reference to Eagle syndrome. After a detailed anamnesis and ENT examination, cervical plain radiographs in four projections and Towne radiographs were obtained for every patient. After that, magnetic resonance imaging (MRI) of cervical spine and barium swallowing studies were performed to evaluate the presence of esophageal compression. Eagle syndrome was excluded due to absence of other symptoms and physical signs, eventhough unilateral or bilateral elongation of styloid processes was found in all of the patients. Cervical osteophytes induced dysphagia is a rare clinical entity, diagnosis should be done by a careful examination, intensive radiologic evaluation. Moreover, all the other causes like Eagle syndrome should be excluded during the diagnosis of cervical osteophyte induced dysphagia.
Highlights
Cervical osteophytes have been reported to be one of the rare causes, despite of its high prevalance (20%–30%) in elderly population (1)
Cervical osteophytes induced dysphagia is a rare clinical entity, diagnosis should be done by a careful examination, intensive radiologic evaluation
All the other causes like Eagle syndrome should be excluded during the diagnosis of cervical osteophyte induced dysphagia
Summary
Cervical osteophytes have been reported to be one of the rare causes, despite of its high prevalance (20%–30%) in elderly population (1). Barium swallow showing indentations on the esophagial lumen caused by anterior osteophyte formations and ossificated anterior longitudinal ligament more prominent at C3-4 and C4-5 levels. Sagittal T2-w MRI demonstrating excessive anterior osteophyte formations and ossificated anterior longitudinal ligament compressing on the esophagus at multiple levels. Barium swallow showing indentations on the esophagial lumen caused by anterior osteophyte formations more prominent at C5-6 and C6-7 levels. A 56-year-old man suffered from progressive difficulty in swallowing of solid meals predominantly and a feeling of suffocation for two years, which especially increased in the last six months He has some complaints related to gastroesophageal reflux which occasionally became symptomatic, lansoprasol 30 mg/day was started for symptoms of gastroesophageal reflux. Cervical MRI showed excessive anterior osteophyte formations in multiple levels and compression of esophagus due to ossificated anterior longitudinal ligament (Fig. 3c). Cervical MRI showed anterior osteophyte formations at the same levels which compressed the esophagus (Fıg. 4c)
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