Osteophytes and Difficulty Swallowing

Did you know that bony changes of the spine are a common cause of dysphagia (difficulty swallowing)?  They can occur at one or more levels in the spine, usually above or at the level of the voice box.  Osteophytes occur due to degenerative changes of the spine, and sometimes as part of a disorder called diffuse idiopathic skeletal hyperostosis.  Treatment depends on the severity of symptoms, and can range from observation (most cases) to surgery to remove the bony growths. 

In this photo, the osteophyte between the vertebrae of C4 and C5 severely narrows the throat just above the voice box, leading to trouble swallowing food and pills.

Osteophytes can be diagnosed with laryngoscopy, an outpatient office-based procedure without sedation, and confirmed using an xray of the spine or a CT scan of the cervical spine.

Killian-Jamieson Diverticulum - Irvine, Orange, Newport Beach, Tustin, Los Angeles, Santa Ana, Long Beach, San Diego, Huntington Beach, Riverside, San Bernandino

Difficulty swallowing is a common complaint.  When food sticks in the lower throat, coughing or choking occurs with meals, and there are symptoms of regurgitation of food matter after meals, the diagnosis of a pharyngeal or esophageal diverticulum should be considered.  If you experience these symptoms, you should seek the care of an otolaryngologist or a gastroenterologist, and a barium esophagram should be obtained.  This consists of swallowing contrast material, which outlines the contour of the swallowing tube. 

The most common type of pharyngeal diverticulum is the Zenker's diverticulum, which occurs in the lower throat starting just above the upper esophageal sphincter.  A less common type is the Killian-Jamieson diverticulum, taking off just below the upper esophageal sphincter.  These are less commonly symptomatic, but can also present with the same symptoms as a Zenker's diverticulum.

Treatment consists of surgery if the pouch is symptomatic.  Minimally invasive surgery is preferred, including endoscopic procedures.  In some cases (smaller pouches, restricted mouth opening or neck extension) surgery through the neck is preferable.