Dysphagia due to diffuse idiopathic skeletal hyperostosis: an analysis of five cases

We report five cases of dysphagia caused by diffuse idiopathic skeletal hyperostosis or Forestier’s disease of the cervical spine observed by clinical evaluations, X-ray and videofluoroscopy. Dysphagia in particular was present for solid foods in all patients. Three patients showed bolus aspiration into the airways, mainly in the post-swallowing phase and one patient with preserved epiglottic tilt showed post-swallowing penetration. The physiopathogenetic mechanisms affecting swallowing dynamics were mechanical compression of the pharyngeal lumen associated with abnormal epiglottic tilt, incomplete upper esophageal sphincter openings and epiglottic/vallecula stasis. According to our results we can hypothesize that these kinetic alterations may due to Forestier’s disease.