Updated: Sep 13, 2022
This clip is a great example of why SLPs really need instrumentals to adequately assess dysphagia signs and symptoms. This patient presented with coughing, multiple swallows per bolus, and lots of complaints about feeling like food and pills were getting stuck in his throat. (Sound familiar?) He had been treated clinically for a few weeks with no change and was then referred for an MBS which showed this rather large cervical osteophyte.
It’s important to remember that osteophytes don’t grow overnight, so we can’t really decide based just on the presence of an osteophyte that the patient needs to be NPO or on altered diet, since he was probably eating and drinking just fine for years, even with the osteophyte present. We also can’t just chalk up the dysphagia to the osteophyte and decide that we shouldn’t bother with this patient. However, an osteophyte is something that would warrant a referral, since they can cause other difficulties if they are impinging on the spinal cord, blood vessels, or cranial nerves. It’s definitely something we need to know about before deciding on a plan of care to address signs of dysphagia. Here are some links with information on cervical osteophytes in general, as well as some studies on dysphagia with osteophytes, and outcomes following their surgical removal:
(PS Nearly all work done with regard to dysphagia and cervical osteophytes are small or single case studies. We still don’t really know how often they really do “cause” dysphagia.)