以呑嚥障礙表現之Forestier氏病

Forestier Disease Presenting as Swallowing Disturbance

蔡易錚(Yih-Jeng Tsai) ； 許信德(Hsin-Te Hsu) ； 蔡青劭(Stella Chin-Shaw Tsai) ； 詹維軒(Wei-Shung Jang)

《台灣耳鼻喉頭頸外科雜誌》 40卷4期 (2005/08) Pp. 175-178

https://doi.org/10.6286/2005.40.4.175

摘要

Forestier disease又稱做不明原因之瀰漫性骨骼過度骨化，於1950年由Forestier及Rotes-Querol所提出。通常多發生於50歲以上中老年病患，患者的頸椎及胸椎前側方縱韌帶表現出連續性的過度骨化及骨質增生，如侵犯頸雅，因病灶部位常靠近會厭、後咽壁和上部食道，所以患者會有呑嚥困難、呑嚥疼痛、聲音嘶啞以及呼吸困難等症狀。本病例為l名69歲男性病悲，因呑嚥困難及呑嚥疼痛至本科求診，理學檢查發現口咽腔後咽壁有一骨性突出之腫塊，光纖內視鏡檢查下亦發現後咽壁明顯向前隆起，電腦斷層檢查發現第二至第七頸椎前縱韌帶有嚴重過度骨化並向前擠壓後咽壁及上部食道，於是本科安排經口咽頸椎骨贅切除術，術後病人恢復良好，無呑嚥問題。病理報告呈良性骨瘤。至今追蹤3年，並無復發。因病例罕見，故提出報告，提供診斷呑嚥障礙時一個鑑別診斷的參考。

關鍵字

不明原因之瀰漫性骨骼過度骨化 ； 呑嚥疼痛

並列摘要

Forestier disease (diffuse idiopathic skeletal hyperostosis), first described by Forestier and Rotes-Querol in 1950, is a skeletal disease and affects mainly elderly persons; it is characterized by the ligamentous ossification of the anterolateral spine. It usually presents as dysphagia, odynophagia, hoarseness and stridor when the cervical spine is involved. This case was a 69-year-old male who had complained of dysphagia and odynophagia for 2 months. Physical examination revealed a mass with intact mucosa at the posterior pharyngeal wall around the oropharynx. Fiberoptic endoscopy revealed the same findings. Computed tomography of the neck showed a huge mantle of osteophytic bone anterior to the spine from C2 to C7 and this had compressed forward the posterior pharyngeal wall and upper esophagus. A peroral transpharyngeal approach to remove the osteophyte was arranged. The postoperative result was without problems and no more dysphagia has been complained of date. No recurrence has been found after 3-years of follow up. Because the case is rare, we report it here as a reference for the differential diagnosis of diseases involved in swallowing.

並列關鍵字

diffuse idiopathic skeletal hyperostosis ； dysphagia