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      Kinematic Changes in Swallowing After Surgical Removal of Anterior Cervical Osteophyte Causing Dysphagia: A Case Series

      case-report

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          Abstract

          This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in the maximal hyoid vertical movement length (13.16±5.87 to 19.09±4.77 mm, p=0.080), hyoid movement velocities (170.24±84.71 to 285.53±104.55 mm/s, p=0.043), and upper esophageal sphincter opening width (3.97±0.42 to 6.39±1.32 mm, p=0.043) after surgery. In conclusion, improved upper esophageal sphincter opening via enhancement of hyoid movement after cervical anterior osteophyte resection may be the kinetic mechanism of improved swallowing function.

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          Physiology and radiology of the normal oral and pharyngeal phases of swallowing.

          J A Logemann, Jane Stewart, Alister W Dodds (1990)
          Article 0 comments Cited 69 times – based on 0 reviews     Review now
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            Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies.

            Nam-Jong Paik, Hye Jeon, Norman Lee … (2008)
            (1) To compare the kinematic motion of the hyoid bone and the epiglottis in healthy controls and a sample of patients with dysphagia of different etiologies, and (2) to evaluate the potential value of kinematic swallowing analysis to differentiate the mechanism of dysphagia. We performed two-dimensional video motion analysis of the hyoid bone using videofluoroscopic images in nine controls without any swallowing difficulty, and seven patients with supratentorial stroke, three patients with inflammatory myopathy who showed dysphagia. Main outcome measures were: (1) horizontal and vertical excursion of the hyoid bone, and rotation of the epiglottis, and (2) trajectory of the hyoid bone and epiglottis during swallowing. Horizontal excursion of the hyoid bone and rotation of the epiglottis were reduced in patients with myopathy as compared to control and patients with stroke (P<0.05). Patients with dysphagia showed different patterns as compared to control in trajectory analysis according to their etiology. We conclude that extent and pattern of movement of the hyoid bone and the epiglottis during swallowing were different according to etiology of dysphagia, and swallowing motion analysis could be applied to differentiate the mechanism of dysphagia.
            Article 0 comments Cited 50 times – based on 0 reviews     Review now
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              Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis.

              Hideo Hosoe, Katsuji Shimizu, Yasushi Suzuki … (2009)
              Although cervical anterior osteophytes accompanying diffuse idiopathic skeletal hyperostosis (DISH) are generally asymptomatic, large osteophytes sometimes cause swallowing disorders. Surgical resection of the osteophyte has been reported to be an effective treatment; however, little study has been given to the recurrences of osteophytes. A prospective study was performed for seven patients who underwent surgical resection of cervical anterior osteophytes for the treatment of recalcitrant dysphagia caused by osteophytes that accompanied DISH. The seven patients were six men and one woman ranging in age from 55 to 78 years (mean age = 65 years). After a mean postoperative follow-up period of 9 years (range: 6-13 years), surgical outcomes were evaluated by symptom severity and plain radiographs of the cervical spine. On all operated intervertebral segments, the effect of postoperative intervertebral mobility (range of movement > 1 degree) on the incidence of recurrent osteophytic formation (width > 2 mm) was analyzed by Fisher's exact test. Complete relief of the dysphagia was obtained within one month postoperatively in five patients, while it was delayed for 3 months in two patients. All of the patients developed recurrent cervical osteophytic formation, with an average increase rate of approximately 1 mm/year following surgical resection. Of the 20 operated intervertebral segments, the incidence of recurrent osteophytes was significantly higher (P = 0.0013) in the 16 segments with mobility than in the four segments without mobility. Five of the seven patients remained asymptomatic, although radiological recurrence of osteophytes was seen at the final follow-up. The two remaining patients complained of moderate dysphagia 10 and 11 years after surgery, respectively; one of these two required re-operation due to progressive dysphagia 11 years postoperatively. In patients with cervical DISH and dysphagia, surgical resection of osteophytes resulted in a high likelihood of the recurrence of osteophytes. Therefore, attending surgeons should continue to follow these patients postoperatively for more than 10 years in order to assess the regrowth of osteophytes that may contribute to recurrent symptoms.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Rehabil Med
                Journal ID (iso-abbrev): Ann Rehabil Med
                Journal ID (publisher-id): ARM
                Title: Annals of Rehabilitation Medicine
                Publisher: Korean Academy of Rehabilitation Medicine
                ISSN (Print): 2234-0645
                ISSN (Electronic): 2234-0653
                Publication date (Print): December 2014
                Publication date (Electronic): 24 December 2014
                Volume: 38
                Issue: 6
                Pages: 865-870
                Affiliations
                [1 ]Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
                [2 ]Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
                Author notes
                Corresponding author: Byung-Mo Oh. Department of Rehabilitation Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-2619, Fax: +82-2-743-7473, keepwiz@ 123456gmail.com
                Article
                DOI: 10.5535/arm.2014.38.6.865
                PMC ID: 4280387
                PubMed ID: 25566490
                SO-VID: 86582762-7d27-493c-9771-547d72111530
                Copyright © Copyright © 2014 by Korean Academy of Rehabilitation Medicine
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 10 April 2014
                Date accepted : 16 June 2014
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: deglutition disorders,osteophyte,hyoid bone
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: deglutition disorders, osteophyte, hyoid bone

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