An unusual case of dysphagia.

A 90-year-old man presented to us with a 2-year history of progressive dysphagia. He was on a liquid diet because he was unable to swallow solids. He had lost a significant amount of weight during the previous 2 years.

Flexible nasendoscopy detected a smooth midline swelling in the posterior pharyngeal wall. The mucosa was normal from the nasopharynx down to the hypopharynx. A barium swallow examination (figure) and computed tomography (CT) revealed that a large anterior cervical osteophyte was present from C3 down to C7 and had indented the pharynx.

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The patient was managed conservatively, and he did well on a diet of pureed foods. Had his symptoms been more severe, we would have considered cervical osteophytectomy.

From the Department of Otolaryngology, Russells Hall Hospital, West Midlands, U.K.

Lekha Agarwal, MBBS, DLO, MRCS; Eu Chin Ho, MBBCh, MRCS, DOHNS; Lawrence P. Glossop, FRCS