DISH syndrome in ORL practice
18 April 2018 (online)
Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification of ligaments and ligament and tendon insertion sites, mainly affecting the vertebral column. Ossification of the anterior longitudinal ligament is common, usually in the thoracolumbar spine, however, isolated and predominant cervical spinal involvement may also occur. DISH peaks in elderly population and is often associated with osteoarthritis.
We would like to share our experience with DISH syndrome patients with anterior cervical ligament involvement. They may have swallowing problems and sometimes even airway obstruction. The posterior pharyngeal wall swelling on laryngoscopy may raise concern for malignancy.
The condition should be recognized and diagnosed by means of imaging, the best option being CT. Careful clinical evaluation of the airway before intubation is mandatory.