Surgical procedures in diffuse idiopathic skeletal hyperostosis (Forestier disease)

• Published in: Stomato-pharyngology Vol. 25; no. 2; pp. 157 - 163
• Main Authors: Baba, Susumu, Kanyama, Risaki, Tomoda, Koichi, Fukumori, Takayuki, Shimano, Takashi, Utsunomiya, Toshio, Iwai, Hiroshi, Kaneda, Naoko, Okazaki, Haruka, Konishi, Masaya
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Stomato-pharyngology 2012; 日本口腔・咽頭科学会
• Subjects: diffuse idiopathic skeletal hyperostosis; dysphagia; dyspnea; Forestier disease; Forestier病; laryngeal nerve; 呼吸障害; 喉頭神経; 嚥下障害; 強直性脊椎骨増殖症
• ISSN: 0917-5105; 1884-4316
• DOI: 10.14821/stomatopharyngology.25.157

Subjects with Forestier disease, a form of diffuse idiopathic skeletal hyperostosis, suffer from dysphagia and/or dyspnea due to bone formation in front of cervical vertebrae. Surgery in severe cases is not always successful, however, because clinical symptoms are due both to physical bony lesion compression against the pharynx, esophageal, larynx, and nerves and to local inflammation, including swelling and fibrosis. We report the results of surgery in 5 subjects. Bony lesions were removed and principal organs such as upper and lower laryngeal nerves were conserved in all cases. Cases 1 and 2, however, complained of their symptoms several months after surgery. We then, added a procedure to decrease space between vertebrae and the periosteum after bony lesion removal, suturing the periosteum closely. We found excellent results in cases 3-5. Minimizing space after eliminating bony lesions conceivably helps minimize local inflammation in Forestier disease.