Abstract
A 75-year-old man was diagnosed at a related hospital with mild ankylosing spondylitis in 1991, but did not seek further care for his spinal condition. In January of 2001, the patient presented with severe dysphagia. According to the speculation of an otolaryngologist at the authors’ hospital, his dysphagia was caused by osteophytes based on radiographs of the cervical spine. The images showed osteophytes at the C3/4 level and a large ossified lesion of the anterior longitudinal ligament below C4.
A fiber optic esophagoscopy revealed a distention of the posterior esophageal wall just posterior of the epiglotis. A dynamic esophogram showed abnormal movement of the epiglotis and contrast medium flowed into the trachea. The ossified lesion below C4 clearly was not involved and could be left untreated. Symptoms of dysphagia disappeared immediately after excision of the osteophytes at the C3/4 level. The patient was able to eat and drink comfortably. The dynamic esophogram provided the surgeons with a precise distinction of the causal structures and allowed them to limit the extent of the operation.
