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Partial Esophageal Obstruction from Anterior Cervical Spine Hardware

A 67-year-old woman presented with dysphagia for solids, which she localized to the area just below the cricoid cartilage. She did not report dysphagia for liquids . She had recently undergone revision anterior cervical spine surgery. Findings on laryngoscopy were unremarkable, and there was no visible evidence of the cervical spine hardware. The results of a flexible endoscopic evaluation of swallowing with sensory testing were also normal. A modified barium swallow study showed a slight delay of solid passage just below the cricopharyngeus muscle at the site of the cervical spine hardware, but no significant esophageal compression was noted. Transnasal esophagoscopy was performed to examine the area of abnormality noted on the barium swallow study. This demonstrated that a partial esophageal obstruction had been caused by the anterior cervical spine hardware below the cricopharyngeus muscle (figure). No other esophageal abnormalities were noted. The use of transnasal esophagoscopy added valuable diagnostic information that was not clearly yielded by other diagnostic modalities. With careful mastication, the patient was able to maintain adequate control of her dysphagia symptoms.