Understanding Bilateral Vocal Fold Motion Impairment and DISH
As a speech-language pathologist, staying informed about the latest research is crucial for improving patient outcomes. A recent study titled "Bilateral Vocal Fold Motion Impairment Associated With Diffuse Idiopathic Skeletal Hyperostosis" sheds light on a rare but significant condition affecting vocal fold mobility. This blog post will explore the findings of this study and how they can be applied in clinical practice.
What is Diffuse Idiopathic Skeletal Hyperostosis (DISH)?
Diffuse Idiopathic Skeletal Hyperostosis, commonly known as DISH or Forestier disease, is characterized by the ossification of anterior vertebral ligaments. Although often asymptomatic, DISH can lead to severe complications, including bilateral vocal fold motion impairment (BVFMI). The condition predominantly affects older males and is associated with comorbidities like hypertension and diabetes mellitus.
Key Findings from the Study
The study conducted a retrospective chart review of four male patients with symptomatic BVFMI attributed to cervical spine DISH. The average age was 70 years, and common symptoms included dysphagia, dyspnea, and dysphonia. Treatment approaches varied, with two patients undergoing surgical osteophyte removal and two opting for conservative management.
- All patients showed symptomatic BVFMI due to cervical spine DISH.
- Symptoms ranged from life-threatening dyspnea to breathy dysphonia.
- Surgical intervention led to improved vocal fold mobility and symptom relief.
- Conservative management was viable for patients with manageable symptoms.
Implications for Practice
For practitioners, this study highlights the importance of considering DISH as a potential cause of BVFMI, especially in older male patients with relevant comorbidities. Early diagnosis and appropriate intervention can prevent severe complications and improve patient quality of life.
Here are some practical steps practitioners can take:
- Be vigilant for symptoms of BVFMI in patients with known DISH.
- Consider a multidisciplinary approach involving otolaryngologists and spine surgeons.
- Use diagnostic tools like flexible laryngoscopy and CT scans to assess the extent of impairment.
- Discuss both surgical and conservative treatment options with patients.
Encouraging Further Research
While the study provides valuable insights, further research is needed to establish standardized management protocols for BVFMI secondary to DISH. Understanding the pathomechanism and exploring the role of metabolic disorders in DISH could lead to better prevention and treatment strategies.
To read the original research paper, please follow this link: Bilateral Vocal Fold Motion Impairment Associated With Diffuse Idiopathic Skeletal Hyperostosis.
