Progressive upper airway stenosis secondary to cervical diffuse idiopathic skeletal hyperostosis manifested by aspiration

Abstract

A 63-year-old man with a 1-year history of difficulty swallowing was transferred to our hospital for treatment of aspiration pneumonia and rhabdomyolysis. Fiberoptic endoscopic evaluation of swallowing performed on the 8th day of hospitalization revealed a retropharyngeal prominence. Cervical computed tomography revealed osteophytes, particularly prominent at the C2-C4 level; therefore, he was diagnosed with diffuse idiopathic skeletal hyperostosis (DISH). Although snoring was observed from the day of admission, he developed stridor on the 13th day of hospitalization, necessitating endotracheal intubation, followed by tracheostomy. Elective transcervical resection of the osteophytes resolved airway stenosis and dysphagia in this patient. DISH is not rare, and cervical DISH should be considered in the differential diagnosis in patients with dysphagia, aspiration, or airway stenosis.