As otolaryngologists, we are the first to be consulted for dysphagia. One must consider both extrinsic and intrinsic etiologies in the differential diagnosis. We report a patient with dysphagia due to large osteophyte at level of cricoid and pressing on the esophagus. Patient was diagnosed to be suffering from Diffuse Idiopathic skeletal Hyperostosis and was managed conservatively. Introduction Diffuse Idiopathic skeletal Hyperostosis (DISH) is the skeletal disease of unknown etiology, characterized by flowing ossification along the anterior and lateral aspects of spinal column. We present an interesting case presenting with dysphagia and on investigation found to be suffering from DISH. An astute otolaryngologist needs to be aware of the spine pathology in cases of dysphagia. Here we briefly describe the presenting features, radiographic findings and management options. Case Report A 60 year old male presented to our out patient department with complaint of difficulty in swallowing for one month. The difficulty was mainly limited to solids, non-progressive and got relieved with fluids. Patient was non-smoker and teetotaler. There was no history of similar complaints in the past and history of regurgitation was absent. On examination oral cavity and oropharynx were normal but the indirect laryngoscopy revealed midline bulge on the posterior wall of pharynx just above the level of arytenoids. X-ray soft tissue neck lateral view was done which revealed osteophytes at three different levels in Cervical spine namely C2-3, C3-4 and C5-6 as depicted below (Figure1).
展开▼
