Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Diffuse idiopathic skeletal hyperostosis (DISH) is a rare and potentially life-threatening syndrome. We present the case of a patient complaining about severe dyspnoea and diagnosed with vocal cord paresis. An emergency tracheotomy was performed to restore his breathing. Diagnostic imaging revealed large mass-occupying cervical osteophytes compressing the larynx. The osteophytes were removed via an anterior cervical approach, and vital signs were normalized. However, postoperatively, a fistula was discovered between the upper part of the oesophagus and the trachea. As a result, a gastrostomy tube had to be placed indefinitely. Literature review confirms the rare frequency of emergency tracheostomy due to DISH syndrome. The aim of the present study is to expand on our knowledge of a rare pathological entity that can frequently be misdiagnosed.

[1]  Ł. Kubaszewski,et al.  Diffuse Idiopathic Skeletal Hyperostosis of Cervical Spine with Dysphagia—Molecular and Clinical Aspects , 2021, International journal of molecular sciences.

[2]  P. D. de Jong,et al.  Diffuse idiopathic skeletal hyperostosis: Etiology and clinical relevance. , 2020, Best practice & research. Clinical rheumatology.

[3]  S. Acharya,et al.  Progressive dysphagia and dysphonia secondary to DISH-related anterior cervical osteophytes: A case report , 2020, Surgical neurology international.

[4]  Laryngeal cancer , 2018, Concise Notes in Oncology for MRCP and MRCS.

[5]  N. Karaarslan,et al.  Forestier syndrome presenting with dysphagia: case report of a rare presentation. , 2017, Journal of spine surgery.

[6]  M. Knaub,et al.  Acute and chronic low back pain. , 2014, The Medical clinics of North America.

[7]  F. Nascimento,et al.  Diffuse idiopathic skeletal hyperostosis: A review , 2014, Surgical neurology international.

[8]  D. Buskila,et al.  Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms , 2013, Nature Reviews Rheumatology.

[9]  R. Austin.  Thoracotomy for tracheal disruption after traumatic intubation: a case report. , 2010, AANA journal.

[10]  C. Bono,et al.  Long-term results of surgical treatment of dysphagia secondary to cervical diffuse idiopathic skeletal hyperostosis. , 2009, The spine journal : official journal of the North American Spine Society.

[11]  F. Oner,et al.  Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications , 2009, European Spine Journal.

[12]  J. Esdaile,et al.  Exercise therapy for patients with diffuse idiopathic skeletal hyperostosis , 2008, Clinical Rheumatology.

[13]  P. Dulguerov,et al.  Anterior Cervical Osteophytes Causing Dysphagia and Dyspnea: An Uncommon Entity Revisited , 2007, Dysphagia.

[14]  R. Mader.  Clinical manifestations of diffuse idiopathic skeletal hyperostosis of the cervical spine. , 2002, Seminars in arthritis and rheumatism.

[15]  D. Rowe,et al.  Diffuse Idiopathic Skeletal Hyperostosis: Musculoskeletal Manifestations , 2001, The Journal of the American Academy of Orthopaedic Surgeons.

[16]  C. Wrobel,et al.  Diffuse idiopathic skeletal hyperostosis. , 2000, Journal of neurosurgery.

[17]  J. Fagan,et al.  TRACHEOSTOMY , 1965, The Lancet.

[18]  O. Ibekwe,et al.  Cervical spondylosis and dysphagia , 1981, The Journal of Laryngology & Otology.

[19]  D. Resnick,et al.  Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). , 1976, Radiology.

[20]  Thomas S Lee,et al.  Journal of Otolaryngology - Head and Neck Diseases Case Management of Concurrent Tracheo-esophageal Perforation , 2020 .