Transoral Endoscopic Resection of High Cervical Osteophytes with Long-Term Symptom Resolution: Case Series, Imaging, and Literature Review.

Abstract

Anterior cervical osteophytes (ACOs) are a common radiologic finding in the elderly; rarely, they can cause dysphagia, dysphonia, and dyspnea. Symptomatic ACOs are most commonly found between C4 and C7 and much less commonly at higher cervical levels. Here, we present a case series, with an example case of a 57-year-old woman with high cervical osteophytes at C1-C2 causing globus sensation, dysphagia, and dysphonia. Additionally, we provide a literature review regarding the causes, diagnosis, and treatment of ACOs, with a focus on management of high ACOs. A 57-year-old smoker with a history of chronic neck pain and previous cervical spinal instrumentation presented with several months of globus sensation, dysphagia, and dysphonia. Imaging revealed 2 large anterior osteophytes at C1-C2. She underwent endoscopic transoral osteophytectomy, with resolution of symptoms. Five other patients are also presented who underwent similar procedures. ACOs are a potential cause of dysphagia, and their diagnosis is best made with computed tomographic imaging and oropharyngeal swallow study. Although high ACOs at C1-C2 are a rare finding, here we show with an exemplary case and small case series that they can be effectively treated with transoral endoscopic osteophytectomy.