Cervical osteophytes impinging on the pharynx: Importance of size and concurrent disorders for development of aspiration

OBJECTIVE. This study evaluated the clinical significance of cervical osteo phytes impinging on the pharynx in patients with dysphagia and the importan ce of concurrent disorders that may affect swallowing function. MATERIALS AND METHODS, On videofluoroscopy, anterior cervical osteophytes w ere found in 55 (32 men, 23 women; mean age, 69 years) of 3318 patients wit h dysphagia (1.7%). Coexisting diseases that affected swallowing function w ere found in 28 patients (stroke, n = 7; thyroidectomy, n = 7; tongue base or laryngeal cancer surgery, n = 5; other diseases, n = 9). Swallowing func tion was assessed with videofluoroscopy evaluating epiglottic tilting, lary ngeal closure, impression of the hypopharynx, pharyngeal residue, and aspir ation. RESULTS. With advancing age, the probability of aspiration (odds ratio, 1.0 7; p < 0.05) and of enlarging osteophytes (odds ratio, 1.26; p < 0.01) incr eased; the probability was higher for osteophytes at more than one vertebra e (odds ratio, 8.00; p < 0.01) and for concurrent dis eases (odds ratio, 8. 02; p < 0.01). Aspiration was found in 75% of patients with osteophytes lar ger than 10 mm and in 34% with osteophytes smaller than or equal to 10 mm. In 88% of patients with small osteophytes who aspirated, other diseases aff ected swallowing function. CONCLUSION. Aspiration is common in patients with dysphagia and cervical os teophytes larger than 10 mm. Aspiration is rare in patients with osteophyte s smaller than or equal to 10 mm unless these patients suffer from other di sorders that may affect swallowing.