scholarly journals Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine: A Risk for Acute Airway Obstruction

2020 ◽  
pp. 014556132093121
Author(s):  
Spenser Souza ◽  
Blake Raggio ◽  
Anna Bareiss ◽  
Paul Friedlander
2020 ◽  
Vol 11 ◽  
pp. 124
Author(s):  
Giovanni Miccoli ◽  
Emanuele La Corte ◽  
Ernesto Pasquini ◽  
Giorgio Palandri

Background: One of the most serious and potentially life-threatening adverse events associated with anterior cervical spine surgery is postoperative hematoma with acute airway obstruction. The causes of unpredicted delayed bleeding are, however, not fully elucidated. Here, we report a case of delayed arterial bleeding and sudden airway obstruction following a two-level ACDF. Case Description: A 52-year-old male presented with the right paracentral disc herniations at the C4–C5 and C5–C6 levels. A two-level ACDF was performed. Notably, on the 5th postoperative day, the patient developed an acute respiratory distress due to a large right lateral retrotracheal hematoma requiring emergency evacuation at the bedside. This was followed by formal ligation of a branch of the right superior thyroid artery in the operating room. In addition, an emergency tracheotomy was performed. By postoperative day 15, the tracheotomy was removed, and the patient was neurologically intact. Conclusion: A superior thyroid artery hemorrhage should be suspected if a patient develops delayed neck swelling with or without respiratory decompensation several days to weeks following an ACDF. Notably, these hematomas should be immediately recognized and treated (i.e., decompression starting at the bedside and completed in the operating room) to prevent catastrophic morbidity or mortality.


Vestnik ◽  
2021 ◽  
pp. 107-112
Author(s):  
М.А. Алиев ◽  
М.Ж. Мирзабаев ◽  
Б.М. Аглаков ◽  
Д.Б. Мустафинов ◽  
М.С. Алматов ◽  
...  

Диффузный идиопатический скелетный гиперостоз - системное состояние, характеризующееся наличием по меньшей мере трех костных мостиков в переднебоковом отделе позвоночника. Распространенность заболевания составляет 2,9% - 42,0%. Важным компонентом для диагностики гиперостоза было наличие костного нароста в передней части смежных позвонков. Дебют диффузного идиопатического скелетного гиперостоза протекает бессимптомно, в результате чего заболевание обнаруживается как случайное открытие во время рентгенологического обследования других заболеваний. Клинически значимым симптомом гиперостоза в шейном отделе является дисфагия и обструкция дыхательных путей. В результате костного нароста, расположенного кпереди от тел позвонков в шейном отделе позвоночника, трахея и пищевод смещаются, что приводит к дисфагии и обструкции дыхательных путей, что является главным диагностическим критерием и показанием к оперативному лечению. Diffuse idiopathic skeletal hyperostosis is a systemic condition characterized by the presence of at least three bone bridges in the anterolateral spine. The prevalence of the disease is 2.9% - 42.0%. An important component for the diagnosis of hyperostosis was the presence of a bone growth in the anterior part of the adjacent vertebrae. The onset of diffuse idiopathic skeletal hyperostosis is asymptomatic, as a result of which the disease is detected as an accidental discovery during X-ray examination of other diseases. A clinically significant symptom of cervical hyperostosis is dysphagia and airway obstruction. As a result of the bone growth located anteriorly from the vertebral bodies in the cervical spine, the trachea and esophagus are displaced, which leads to dysphagia and airway obstruction, which is the main diagnostic criterion and indication for surgical treatment.


2019 ◽  
Vol 58 (2) ◽  
pp. 271-276 ◽  
Author(s):  
Yuki Yoshimatsu ◽  
Kazunori Tobino ◽  
Ken Maeda ◽  
Kensuke Kubota ◽  
Yohei Haruta ◽  
...  

2011 ◽  
Vol 11 (11) ◽  
pp. 1058-1067 ◽  
Author(s):  
Jorrit-Jan Verlaan ◽  
Petronella F.E. Boswijk ◽  
Jacob A. de Ru ◽  
Wouter J.A. Dhert ◽  
F. Cumhur Oner

2021 ◽  
pp. 219256822098827
Author(s):  
Giorgio Lofrese ◽  
Alba Scerrati ◽  
Massimo Balsano ◽  
Roberto Bassani ◽  
Michele Cappuccio ◽  
...  

Study Design: Retrospective multicenter. Objectives: diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH. Methods: Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA. Results: 24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery. Conclusion: The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.


ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.


2000 ◽  
Vol 54 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Fahim Ahmed Shah ◽  
S. Ramakrishna ◽  
Vijendra Ingle ◽  
J.E. Dada ◽  
Mazin Al Khabori ◽  
...  

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