Yuji KOYAMA, Shin-Ichi IZUMI, Akira ISHIDA, Kazuo SAKAIZUMI, Kiichi TAKEMOTO

Department of Rehabiltation Medicine, Tokai University School of Medicine

(Received 4 April 2000; accepted 4 August 2000)

Abstract: We experienced rehabilitation of two patients with pharyngeal stage dysphagia due to diffuse idiopathic skeletal hyperostosis (DISH). Videofluoroscopic examination of swallow function (VF) revealed that large cervical osteophytes interfered with the downward tilt of the epiglotis and the opening of the cricopharyngeal sphincter. Anterolateral osteophytectomy was performed for the two patients to whom supraglottic swallow was taught. However, 2 month postoperative VF demonstrated residue in the vallecula after the swallow of liquid and jelly. We continued to lead the effortful swallow and range of motion tongue exercises for the two patients. As a result, it was suggested that these approach were effective for the improvement of epiglottic movement.

Key words: dysphagia, cervical osteophyte, Forestier disease, rehabilitation