A Case of Dysphagia due to Cricopharyngeal Dysfunction and Diffuse Idiopathic Skeletal Hyperostosis / 대한연하장애학회지

ABSTRACT

Cricopharyngeal dysfunction is a disorder in which excessive tension in the upper esophageal sphincter occurs leads to dysphagia. Diffuse idiopathic skeletal hyperostosis is a disease in which excessive bone formation is widely observed in various parts of the body including the cervical spine. This case report shows a dysphagia patient who had cricopharyngeal dysfunction combined with diffuse idiopathic skeletal hyperostosis. A male patient suffering from dysphagia for 4 months visited the hospital. He was examined by using a videofluoroscopic swallow study, which confirmed simultaneous cricopharyngeal dysfunction and diffuse idiopathic skeletal hyperostosis. Considering the advanced age of the patient, a botulinum toxin injection was first administered to treat his cricopharyngeal dysfunction. The patient showed partial improvement with this treatment. However, dysphagia persisted due to incomplete occlusion of the epiglottis by the anterior osteophyte. The patient was in good general condition; therefore a partial cervical corpectomy was performed for cervical diffuse idiopathic skeletal hyperostosis. The patient showed complete recovery from dysphagia post-surgery. In conclusion, two separate treatments were individually given; a botulinum toxin injection for cricopharyngeal dysfunction and surgery for diffuse idiopathic skeletal hyperostosis, and each treatment was confirmed as effective.