嚥下障害を来した強直性脊椎骨増殖症の2例

Ankylosing Spinal Hyperostosis of the Spine Causing Dysphagia : Report of Two Cases

　われわれは嚥下障害を来した強直性脊椎骨増殖症(以下ASH)の2例を経験したので報告する．症例は77歳および73歳の男性で，両者とも誤嚥を伴う嚥下障害を主訴とし，頚椎単純X線で椎体前面に著明な骨化巣を認めた．腫瘍による通過障害や，嚥下障害を起こす脳神経疾患などを除外し，嚥下造影で骨化巣による嚥下障害と診断し，これを切除し症状は改善した．ASHに伴う嚥下障害は，保存治療は成績不良で，嚥下障害のメカニズムから長期の罹患は改善を妨げる傾向がある．

　We report two cases of ankylosing spinal hyperostosis (ASH) that caused dysphagia.　The patients were a 77-years-old male and a 73-years-old male, who both complained of difficulty swallowing.　No tumors or nervous system disease that might have caused the dysphagia was detected in either patient.　However, obvious hyperostosis was seen on the anterior aspect of the bodies of the cervical vertebrae on plain radiographs.　The dysphagia was diagnosed as secondary to ASH based on a videofluoroscopic examination of swallowing function.　The ossification was subsequently surgically excised, and the dysphagia immediately improved.　In view of the mechanism of the dysphagia, conservative treatment would not have been effective, and long-term contraction may worsen the surgical outcome.