Dysphagia in a patient with cervical diffuse idiopathic skeletal hyperostosis. Case report.
Disfagia en paciente con hiperostosis esquelética difusa idiopática cervical. Reporte de caso
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Idiopathic diffuse skeletal hyperostosis is a condition characterized by ossification of the anterior longitudinal ligament. Although it may be asymptomatic, its clinical course can be associated with compressive symptoms affecting the digestive and/or respiratory tracts, which justify speech and language therapy as an initial conservative treatment or as part of postoperative management. We report the case of a 58-year-old man who presented to a private clinical practice with cervical stiffness and progressive dysphagia. Computed tomography revealed cervical (C3–C7) and upper thoracic (T1–T3) ossifications compressing the esophagus. Following the diagnosis of cervical extrinsic mechanical dysphagia, medical treatment was initiated together with management of the digestive symptoms through speech and language rehabilitation therapy.
A discussion of the case is presented based on a review of the scientific literature related to the topic, with the aim of providing updated information on this disease and its associated compressive symptoms, while further examining the therapeutic approach implemented from the perspective of speech-language pathology for the management of dysphagia in this context.
The swallowing rehabilitation strategies applied are described in detail, including postural modifications during swallowing, adaptation of bolus consistency according to the classification of the International Dysphagia Diet Standardisation Initiative, and exercises aimed at improving respiration–swallow coordination and their impact on the patient’s functional outcome. These strategies resulted in a significant improvement of symptoms within the first month after initiation and avoided the need for surgical treatment after seven months of follow-up, demonstrating that conservative therapy is a non-invasive option that may yield favorable outcomes in this condition.
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