Airway management of a patient with Forestier's disease
Forestier's disease, also called diffuse idiopathic skeletal hyperostosis (DISH), is a noninflammatory enthesopathy, ossifying the anterolateral spine and sparing the disc and joint space in elderly men, mostly at thoracic levels. Intubation difficulty and spinal cord injury are potential problems when managing the airway in DISH patients. We report a patient with Forestier's disease who was admitted for osteophyte resection. After taking a detailed history, we evaluated the airway carefully. Also, preparation for difficult intubation was done. After a rapid sequence induction, we performed mask ventilation and laryngoscopy without hyperextension of the neck, to prevent spinal cord injury. Although the worldwide standard for management of the airway in DISH patients is awake fiberoptic intubation, we chose conventional laryngoscopy because a fiberoptic bronchoscope was not available.
Key wordsForestier's disease Airway management Intubation difficulty
Unable to display preview. Download preview PDF.
- 1.Matge G (2005) Surgical management of cervical radiculopathy in Forestier's disease. Case report and review. Neurochirurgie 51:15–18Google Scholar
- 2.Sreedharan S, Li YH (2005) Diffuse idiopathic skeletal hyperostosis with cervical spinal cord injury—a report of three cases and a literature review. Ann Acad Med Singapore 34:257–261Google Scholar
- 3.Matan AJ, Hsu J, Fredrickson BA (2002) Management of respiratory compromise caused by cervical osteophytes: a case report and review of the literature. Spine J 2:456–459Google Scholar