2025 Volume 118 Issue 6 Pages 435-441
Forestier’s disease is characterized by continuous ossification of the anterior longitudinal ligament of the vertebral bodies, leading to pharyngeal discomfort and dysphagia, although bilateral vocal cord motion impairment has rarely been reported. We report a case of Forestier’s disease who presented with concurrent bilateral vocal cord motion impairment. A 77-year-old man presented to our department with a 2-month history of persistent hoarseness. Laryngoscopy revealed swelling of the posterior wall of the hypopharynx and impaired motion of the left vocal cord. Over the next 2 days, the patient developed progressive dyspnea, reduced oral intake, and audible stridor and returned to our department, where examination revealed bilateral vocal cord motion impairment. We urgently admitted the patient to the hospital and performed a tracheotomy on the same day. Endoscopic examination of the pharynx under general anesthesia revealed an ulcerative lesion in the postcricoid area. Computed tomography (CT) showed anterior osteophytes at the fourth to fifth cervical vertebrae, and videofluoroscopy (VF) revealed contact between the osteophytes and the postcricoid area during swallowing, which led us to attribute the vocal cord motion impairment to Forestier’s disease. The clinical presentation strongly indicated the involvement of Forestier’s disease in the vocal cord motion impairment. As radical treatment, we performed cervical osteophytectomy in collaboration with our orthopedic surgery department, and the patient showed postoperative improvement of vocal cord motion and swallowing function.
Forestier’s disease should be considered as a cause of vocal cord motion impairment, and endoscopic examination may be useful for evaluating ulcer formation. It is necessary to consider indications for surgery, as in some cases, vocal cord motion impairment due to this disease can be corrected by osteophytectomy.
