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Unusual cause of dysphagia and dysphonia
  1. Anup Singh1,
  2. Gaurav Khatri2 and
  3. Kumud Kumar Handa2
  1. 1Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Otorhinolaryngology and Head and Neck Surgery, Medanta The Medicity, Gurgaon, Haryana, India
  1. Correspondence to Dr Anup Singh; anoop.aiims1{at}


Forestier’s disease is an idiopathic noninflammatory condition associated with enthesopathy leading to hyperostosis of the vertebrae and peripheral skeletal system. The disease tends to affect elderly individuals and remains asymptomatic in most of the cases. Uncommonly, the patient may present with upper aerodigestive symptomatology, usually dysphagia. In elderly individuals, the disease may closely mimic upper aerodigestive tract malignancy, which should be actively excluded. In our patient, the hypopharyngeal soft tissue distortions created by the bony hypertrophy shifted the clinicoradiological suspicion towards malignant pathology. The current case presents the diagnostic dilemma associated with the disease and the need to keep the possibility of severe cervical bony hypertrophy as a cause of upper aerodigestive symptoms in mind.

  • ear
  • nose and throat/otolaryngology
  • endoscopy
  • oesophageal cancer
  • orthopaedics
  • radiology

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  • Contributors The contribution of the authors of the script is as follows: AS had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AS, GK, KKH. Acquisition, analysis or interpretation of data: AS, GK, KKH. Drafting of the manuscript: AS, KKH. Critical revision of the manuscript for important intellectual content: AS, GK, KKH. Administrative, technical or material support: AS, GK, KKH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.