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Cervical Osteophytes Impinging on the Pharynx

Importance of Size and Concurrent Disorders for Development of Aspiration

G. Strasser1, W. Schima1, E. Schober1, P. Pokieser1, A. Kaider2 and D.-M. Denk3

1 Department of Radiology and Ludwig Boltzmann-Institute for Radiologic Tumor Research, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
2 Department of Medical Computer Sciences, University of Vienna, A-1090 Vienna, Austria.
3 Department of Otolaryngology, University of Vienna, A-1090 Vienna, Austria.



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  		Fig. 1A. —51-year-old man with long-standing dysphagia for solids and liquids. Double-contrast pharyngogram shows severe impression of pharynx and pharyngoesophageal sphincter by bridging bony spurs (arrows).

 


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  		Fig. 1B. —51-year-old man with long-standing dysphagia for solids and liquids. Videofluoroscopy shows obstruction by osteophytes of pharyngeal flow during swallowing. Epiglottic tilting is impaired (long arrow). Note incomplete laryngeal closure with aspiration of contrast material (short arrow) into trachea.

 


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  		Fig. 1C. —51-year-old man with long-standing dysphagia for solids and liquids. Videofluoroscopy shows severe retention of contrast material in valleculae (short black arrow) and piriform sinuses (long black arrow) and overflow aspiration (white arrow).

 


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  		Fig. 1D. —51-year-old man with long-standing dysphagia for solids and liquids. Videofluoroscopy in anteroposterior direction shows severe compression of pharyngoesophageal segment with lateral displacement (arrow).

 


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  		Fig. 2. —73-year-old man who had previous resection of carcinoma of tongue base and epiglottis. Videofluoroscopy shows moderate impression of pharyngoesophageal segment by 7-mm osteophytes of lower cervical spine (short arrows). However, aspiration (long arrow) is caused by incomplete tilting of thickened epiglottis and deficient laryngeal closure postoperatively (curved arrow).

 

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