Head rotation as an effective compensatory technique for dysphagia caused by unilateral cervical osteophytes

Abstract

Objective Dysphagia is common in patients with cervical osteophytes. We aimed to determine whether head rotation as a compensatory technique is effective for dysphagia caused by unilateral cervical osteophytes. Methods We retrospectively analyzed videofluoroscopic swallowing study (VFSS) data obtained in one university hospital. Patients whose VFSS showed pharyngeal stasis by mechanical obstruction due to cervical osteophytes were selected. They were divided into a unilateral skewed osteophyte group and a diffuse central osteophyte group as confirmed by laryngoscopy or computed tomography. The effect of head rotation on swallowing was investigated. Fisher's exact test was used for statistical analysis. Results Among 2876 patients who underwent VFSSs, we identified 48 patients with osteophyte-induced dysphagia. The osteophytes were centrally located in 36 patients and unilateral in the remaining 12. Ten of the patients with unilateral osteophytes showed improvement when they swallowed with head rotation toward the osteophyte side, but none of the patients with central osteophytes showed effective swallowing. A statistically significant relationship was found between swallowing with head rotation and skewed cervical osteophytes. Conclusion Swallowing with head rotation was safe, easy, and effective for patients with dysphagia caused by unilateral cervical osteophytes. We advise attempting this method prior to considering surgical approaches.