윤상인두근 기능부전과 광범위특발골격뼈형성과다증으로 인한 연하곤란 환자의 치료: 증례 보고

Abstract

Cricopharyngeal dysfunction is a disorder in which excessive tension in the upper esophageal sphincter occurs leads to dysphagia. Diffuse idiopathic skeletal hyperostosis is a disease in which excessive bone formation is widely observed in various parts of the body including the cervical spine. This case report shows a dysphagia patient who had cricopharyngeal dysfunction combined with diffuse idiopathic skeletal hyperostosis. A male patient suffering from dysphagia for 4 months visited the hospital. He was examined by using a videofluoroscopic swallow study, which confirmed simultaneous cricopharyngeal dysfunction and diffuse idiopathic skeletal hyperostosis. Considering the advanced age of the patient, a botulinum toxin injection was first administered to treat his cricopharyngeal dysfunction. The patient showed partial improvement with this treatment. However, dysphagia persisted due to in-complete occlusion of the epiglottis by the anterior osteophyte. The patient was in good general condition; there-fore a partial cervical corpectomy was performed for cervical diffuse idiopathic skeletal hyperostosis. The patient showed complete recovery from dysphagia post-surgery. In conclusion, two separate treatments were individually given; a botulinum toxin injection for cricopharyngeal dysfunction and surgery for diffuse idiopathic skeletal hyper-ostosis, and each treatment was confirmed as effective.