びまん性特発性骨増殖症による上気道閉塞を生じた1症例

Upper-Airway Obstruction from Cervical Diffuse Idiopathic Skeletal Hyperostosis（DISH） in an Older Patient

要旨

　上気道閉塞のため呼吸困難と喘鳴を呈したびまん性特発性骨増殖症の症例を報告する。画像検査でC5-6の巨大骨棘による喉頭狭窄と声帯麻痺が確認された。気管切開や骨棘切除を行うことなく，集中治療室での保存的治療により軽快した。びまん性特発性骨増殖症は困難気道の一因だけでなく，上気道閉塞の鑑別としても重要である。

　Diffuse idiopathic skeletal hyperostosis（DISH）involving the cervical spine is an under-recognized etiology of upper airway obstruction（UAO）. We describe the case of an 89-year-old man with DISH who presented with progressive dyspnea and stridor. Laryngoscopy and CT revealed severe laryngeal narrowing caused by a massive anterior osteophyte at the C5-6 level, plus vocal cord impairment. The patient was monitored in the intensive care unit and stabilized with conservative management. His case highlights the importance of considering DISH as a differential diagnosis for UAO in the elderly. Early imaging and laryngoscopy are crucial for identifying compression and guiding airway management.