Surgical procedures in diffuse idiopathic skeletal hyperostosis (Forestier disease)
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 co...
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| Published in | Stomato-pharyngology Vol. 25; no. 2; pp. 157 - 163 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Society of Stomato-pharyngology
2012
日本口腔・咽頭科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-5105 1884-4316 |
| DOI | 10.14821/stomatopharyngology.25.157 |
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| Abstract | 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. |
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| AbstractList | 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.
Forestier病は全身の靱帯・腱付着部の硬直・骨化を示す強直性脊椎骨増殖症 (diffuse idiopathic skeletal hyperosteosis) の1つである. 頸椎で生じたものでは喉頭や咽頭・食道を圧迫して咽喉頭違和感や呼吸障害・嚥下障害をきたす. 進行例には切除術が選択されるが, 十分な病変切除がされたにもかかわらず, 手術効果が即座に出ない例も認められ, 症状発生には, 病変の物理的な喉頭・食道圧迫だけでなく, 局所での浮腫や繊維化を含めた炎症の機序が考えられている.我々は今回, 本疾患の5例に対し手術的治療を行った. 病変部の正確な切除と上・下喉頭神経などの温存を図ったが, 症例1・2では不十分な手術成績であった. そこで, 手術に際し骨病変切除で生じる椎骨と骨膜間の死腔を減少させるため骨膜を寄せて縫合する処置を追加し良好な成績を得た. こうしたことから, Forestier病の手術に際し, 椎前部の死腔縮小処置が局所の炎症を低下させ, 術後の症状回復を早めるのではないかと考える. 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. |
| Author | Shimano, Takashi Iwai, Hiroshi Kaneda, Naoko Okazaki, Haruka Tomoda, Koichi Utsunomiya, Toshio Fukumori, Takayuki Baba, Susumu Kanyama, Risaki Konishi, Masaya |
| Author_FL | 岡崎 はるか 完山 理咲 岩井 大 馬場 奨 宇都宮 敏生 島野 卓史 金田 直子 福森 崇之 小西 将矢 友田 幸一 |
| Author_FL_xml | – sequence: 1 fullname: 岩井 大 – sequence: 2 fullname: 島野 卓史 – sequence: 3 fullname: 馬場 奨 – sequence: 4 fullname: 金田 直子 – sequence: 5 fullname: 岡崎 はるか – sequence: 6 fullname: 完山 理咲 – sequence: 7 fullname: 小西 将矢 – sequence: 8 fullname: 宇都宮 敏生 – sequence: 9 fullname: 友田 幸一 – sequence: 10 fullname: 福森 崇之 |
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| References | 13) Patterson HA, Byerly G. Esophageal obstruction due to lesions of the cervical apine. Ann Surg 1958; 147: 863-867. 3) 斎藤真希子, 前原潤一, 河野浩之, 他: 意識障害と急性呼吸不全により救急搬送されたForestier病の1例. 日気食会報 2010; 61: 510-514. 8) Gamache FW Jr, Voorhies RM. Hypertrophic cervical osteophytes causing dysphagia. a view. J Neurosurg 1980; 53: 338-344. 17) 薮田良三, 竹林脩文: Forestier病の1症例について. 耳喉 1980; 52: 493-497. 4) 立花新太郎, 長野昭, 林浩一郎, 他: Dysphagiaを主訴とせるForestier病の3例. 関東整災誌 1974; 5: 195-198. 16) 兵藤政光, 西窪加緒里, 宋硯柱, 他: Forestier病 (強直性脊椎骨増殖症) による嚥下障害に対する外科治療. 耳鼻臨床 2010; 103: 155-161. 9) 杉山誠一, 清水克時, 宮本敬, 他: 嚥下障害を来したdiffuse idiopathic skeletal hyperostosisに対する手術治療. 臨整外 2001; 36: 1149-1154. 10) 長谷川和寿, 藤田隆一, 岡島行一, 他: 嚥下障害を伴ったForestier病の2例. 整・災外 1987; 30: 887-891. 5) McCafferty RR, Harrison MJ, Tamas LB, et al. Ossification of the anterior longitudinal ligament and Forestier's disease: an analysis of seven cases. J Neurosurg 1995; 83: 13-17. 11) Crowther JA, Andran GM. Dysphagia due to cervical spondylosis. J Laryngol Otol 1985; 99: 1167-1169. 12) Uppal S, Wheatley AH. Transpharyngeal approach for the treatment of dysphagia due to Forestier's disease. J Laryngol Otol 1999; 113: 366-368. 2) Foresier J, Rotes-Querol J. Senile ankylosing hyperostosis of spine. Ann Rheum Dis 1950; 9: 321-330. 1) Presutti L, Alicandri-Ciufelli M, Oiccinini A, et al. G. Forestier Disease: single-center surgical experience and brief literature review. Ann Otol Rhinol Laryngol 2010; 199: 602-608. 6) Saunders WH. Cervical osteophytes and dysphagia. Ann Otol Rhinol Laryngol 1970; 79: 1091-1097. 7) 時岡隆光, 安田舜一, 光田昌弘, 他: 誤嚥性肺炎を反復した強直性脊椎骨増殖症の1例. 臨整外 1991; 26: 1095-1098. 14) Utsinger PD. Diffuse idiopathic skeletal hyperosteosis. Clin Rheum Dis 1985; 11: 325-351. 15) Carrau RL, Cintron FR, Astor F. Transcervical approaches to the prevertebral space. Arch Otoralyngol Head Neck Surg 1990; 116: 1070-1073. |
| References_xml | – reference: 6) Saunders WH. Cervical osteophytes and dysphagia. Ann Otol Rhinol Laryngol 1970; 79: 1091-1097. – reference: 15) Carrau RL, Cintron FR, Astor F. Transcervical approaches to the prevertebral space. Arch Otoralyngol Head Neck Surg 1990; 116: 1070-1073. – reference: 2) Foresier J, Rotes-Querol J. Senile ankylosing hyperostosis of spine. Ann Rheum Dis 1950; 9: 321-330. – reference: 14) Utsinger PD. Diffuse idiopathic skeletal hyperosteosis. Clin Rheum Dis 1985; 11: 325-351. – reference: 11) Crowther JA, Andran GM. Dysphagia due to cervical spondylosis. J Laryngol Otol 1985; 99: 1167-1169. – reference: 3) 斎藤真希子, 前原潤一, 河野浩之, 他: 意識障害と急性呼吸不全により救急搬送されたForestier病の1例. 日気食会報 2010; 61: 510-514. – reference: 17) 薮田良三, 竹林脩文: Forestier病の1症例について. 耳喉 1980; 52: 493-497. – reference: 7) 時岡隆光, 安田舜一, 光田昌弘, 他: 誤嚥性肺炎を反復した強直性脊椎骨増殖症の1例. 臨整外 1991; 26: 1095-1098. – reference: 10) 長谷川和寿, 藤田隆一, 岡島行一, 他: 嚥下障害を伴ったForestier病の2例. 整・災外 1987; 30: 887-891. – reference: 1) Presutti L, Alicandri-Ciufelli M, Oiccinini A, et al. G. Forestier Disease: single-center surgical experience and brief literature review. Ann Otol Rhinol Laryngol 2010; 199: 602-608. – reference: 9) 杉山誠一, 清水克時, 宮本敬, 他: 嚥下障害を来したdiffuse idiopathic skeletal hyperostosisに対する手術治療. 臨整外 2001; 36: 1149-1154. – reference: 5) McCafferty RR, Harrison MJ, Tamas LB, et al. Ossification of the anterior longitudinal ligament and Forestier's disease: an analysis of seven cases. J Neurosurg 1995; 83: 13-17. – reference: 8) Gamache FW Jr, Voorhies RM. Hypertrophic cervical osteophytes causing dysphagia. a view. J Neurosurg 1980; 53: 338-344. – reference: 12) Uppal S, Wheatley AH. Transpharyngeal approach for the treatment of dysphagia due to Forestier's disease. J Laryngol Otol 1999; 113: 366-368. – reference: 4) 立花新太郎, 長野昭, 林浩一郎, 他: Dysphagiaを主訴とせるForestier病の3例. 関東整災誌 1974; 5: 195-198. – reference: 13) Patterson HA, Byerly G. Esophageal obstruction due to lesions of the cervical apine. Ann Surg 1958; 147: 863-867. – reference: 16) 兵藤政光, 西窪加緒里, 宋硯柱, 他: Forestier病 (強直性脊椎骨増殖症) による嚥下障害に対する外科治療. 耳鼻臨床 2010; 103: 155-161. |
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| SubjectTerms | 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 |
| Title | Surgical procedures in diffuse idiopathic skeletal hyperostosis (Forestier disease) |
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