Paper Title
AERO – Digestive Symptoms In Cervical Spine Disorders- Our Experience

Abstract
Introduction: Dysphagia in elderly could be attributable to a number of etiological causes ranging from neurologic causes like stroke, malignancies, motility disorders, cervical osteophytic compression, changes in cervical spine curvature anddiffuse idiopathic skeletal hyperostosis(DISH).Cervicogenic dysphagia, dysphonia and stridor in elderly are often an underdiagnosed entity in otorhinolaryngology practice. Aims and Objectives:To correlate the occurrence of upper aerodigestive tract symptoms with various cervical spine disorders. Methods: A retrospectivestudy of 8 patients presenting in otorhinolaryngology OPD or emergency of AVBRH with upper aerodigestive tract symptoms from January 2016 –December 2017. Results: Dysphagia and odynophagia are the most common otolaryngological manifestation of cervical spine disorders due to anterior osteophytes compressing the pharynx or esophagus or due to change in the curvature of the cervical spine. Other symptoms are dysphonia and dyspnea. The diagnosis is verified by appropriate radiological study. We have measured C2-C7angle by Cobb method and Posterior tangent technique, in dysphagia due to loss of cervical spine lordotic curvature. Treatment is mainly based on a conservative strategy. Manual therapy was beneficial and resulted in improvement in cervical spine curvature with resultant improvement in dysphagia. Conclusion: Dysphagia is a relatively common symptom of cervical osteophytes and can also occur due to change in cervical spine curvature. DISH or large projecting anterior cervical osteophytes can present with aerodigestive symptoms. Cervicogenic aerodigestive symptoms are only diagnosis of exclusion and when identified, a multidisciplinary approach should be instituted as soon as possible. Keywords - Cervical spine; Lordosis; Dysphagia; Manual therapy; Elderly; Diffuse idiopathic skeletal hyperostosis (DISH); Forestier’s disease; Vocal cord immobilization; Stridor.