Management of Airway Obstruction due to Diffuse Idiopathic Skeletal Hyperostosis in the Cervical Spine: A Case Report and Literature Review

Yuki Yoshimatsu; Kazunori Tobino; Ken Maeda; Kensuke Kubota; Yohei Haruta; Hiroshi Adachi; Toshiyuki Abe; Tomoka Masunaga; Takuto Sueyasu; Toshihiro Osaki

doi:10.2169/internalmedicine.1071-18

CASE REPORTS

Management of Airway Obstruction due to Diffuse Idiopathic Skeletal Hyperostosis in the Cervical Spine: A Case Report and Literature Review

Yuki Yoshimatsu, Kazunori Tobino, Ken Maeda, Kensuke Kubota, Yohei Haruta, Hiroshi Adachi, Toshiyuki Abe, Tomoka Masunaga, Takuto Sueyasu, Toshihiro Osaki

Author information

Yuki Yoshimatsu
Department of Respiratory Medicine, Iizuka Hospital, Japan
Kazunori Tobino
Department of Respiratory Medicine, Iizuka Hospital, Japan
Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
Ken Maeda
Department of Orthopedic Surgery, Spinal Injuries Center, Japan
Kensuke Kubota
Department of Orthopedic Surgery, Spinal Injuries Center, Japan
Yohei Haruta
Department of Orthopedic Surgery, Iizuka Hospital, Japan
Hiroshi Adachi
Department of Intensive Care, Iizuka Hospital, Japan
Toshiyuki Abe
Department of Gastroenterology, Iizuka Hospital, Japan
Tomoka Masunaga
Department of Respiratory Medicine, Iizuka Hospital, Japan
Takuto Sueyasu
Department of Respiratory Medicine, Iizuka Hospital, Japan
Toshihiro Osaki
Department of Thoracic Surgery, Iizuka Hospital, Japan

Keywords: diffuse idiopathic skeletal hyperostosis, airway obstruction, respiratory failure, dysphagia, surgery

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 2 Pages 271-276

DOI https://doi.org/10.2169/internalmedicine.1071-18

Browse “Advance online publication” version

Details

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is a relatively common progressive noninflammatory entheses disease. Patients are often asymptomatic or are undiagnosed due to minor chronic symptoms. We herein report a rare case in which the primary symptom was sudden-onset upper airway obstruction due to exuberant osteophytosis in the cervical spine. Treatment was successful with careful airway management and surgical osteophyectomy. Most DISH cases in the literature with airway obstruction have been managed with tracheotomy. However, the safety and necessity of this approach remain questionable. We herein discuss the possibility of conservative management as a choice of airway control. Airway obstruction due to DISH may be underrecognized. This highlights the importance of including DISH in the differential diagnosis of airway obstruction. In addition, a detailed evaluation and personalized care for each individual case is essential.

Corresponding author

Register with J-STAGE for free!