Cervical diffuse skeletal hyperostosis as a rare cause of dysphagia: Two surgical cases

Background: Cervical diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease, is an uncommon but potentially reversible cause of dysphagia due to mechanical compression of the hypopharynx or upper esophagus. Case Description: Two male patients presented with progressive dysphagia caused by anterior cervical DISH. Radiological evaluation demonstrated extensive anterior osteophyte formation resulting in significant hypopharyngeal and esophageal compression. Both patients underwent anterior cervical osteophytectomy, which led to immediate and complete resolution of dysphagia without perioperative complications, with normalization of postoperative eating assessment tool-10 (EAT-10) and functional oral intake scale (FOIS) scores. In addition, a focused review of the literature (2015-2024) identified 41 clinical studies involving 200 patients treated surgically for cervical DISH-related dysphagia, demonstrating approximately 90% symptomatic improvement with minimal morbidity. Conclusion: Cervical DISH is a rare but surgically treatable cause of dysphagia. Early recognition and timely anterior cervical osteophytectomy result in excellent clinical outcomes and rapid symptom resolution..