2019 Volume 112 Issue 1 Pages 33-36
Forestier’s disease is characterized by sustained bone formation at the anterior margin of the spine, and with progression, it may cause symptoms like dysphagia and dyspnea. We report a case of Forestier’s disease, in which tracheotomy was required prior to orthopedic surgery due to marked narrowing of the airway. The patient was a 68-year-old man. He was examined in our department for pharyngeal discomfort, wheezing and dyspnea that had begun 3 weeks ago. Laryngeal endoscopy revealed swelling of the mucosa on the posterior pharyngeal wall and restricted movement of the arytenoid due to compression. On a plain radiograph and CT of the cervical spine, bone growth and protrusion were observed on the anterior surface of the vertebral body from the 2nd to the 5th cervical vertebra, and Forestier’s disease was diagnosed. As the airway was markedly narrowed due to restricted vocal cord movement, tracheotomy was performed under local anesthesia. Thereafter, the bone growth on the anterior surface of the spine was resected at the department of orthopedic surgery. Postoperatively, the pharyngeal edema persisted and it took a month for closure of the tracheostoma. In cases of Forestier’s disease like the present one, where impaired movement of the vocal cords and pharyngeal edema are observed prior to surgery performed to resect hyperostosis in the anterior region of the spine, our experience suggests the necessity of actively considering tracheotomy, because extubation may be difficult.
