FORESTIER'S SYNDROME. Specialistic otolaryngologic findings

Dysphagia is a com­mon com­plaint in otol­a­ryn­gol­o­gist prac­tice; ­often ­there are asso­ciat­ed com­plaints of a for­eign ­body sen­sa­tion, ody­no­pha­gia, hoarse­ness, ­cough, ­neck ­pain and ­decreased ­range of ­neck ­motion. All ­these symp­toms can be ­caused by cer­vi­cal ­DISH (Diffuse Idiopathic Skeletal Hyperostosis) ­also ­known as Forestier’s dis­ease. Usually ­patients ­with dys­pha­gia under­go ­tests ­such as con­trast esoph­a­go­gram and eso­phag­o­gas­tros­co­py ­before con­sult­ing the otol­a­ryn­gol­o­gyst. The aim of ­this ­study is to dem­on­strate how the rou­ti­nary per­for­mance of fib­e­ren­dos­co­py of the ­upper air-diges­tive ­ways can ­direct the diag­nos­tic and ther­a­peu­tic pro­ce­dure, there­fore remark­ably reduc­ing unnec­es­sary incon­ven­ienc­es for the ­patient, hos­pi­tal­iza­tion ­times and con­se­quent­ly ­waste of mon­ey. The ­authors ­present ­three cas­es of dys­pha­gia ­caused by oste­oph­y­tes ­spread ­from cer­vi­cal ­spine (­DISH syn­drome) and com­press­ing the low­er ­part of the phar­ynx and the ­upper ­part of the lar­ynx caus­ing par­tial obstruc­tion of the laryn­geal adit­us. Fiberendoscopic and cer­vi­cal ­spine X-ray ­test ­were ­used to ­make the diag­no­sis and ­their find­ings, at the ­first vis­it and at the six ­months fol­low-up vis­it, are ­described.