Abstract
Forestier's disease, or diffuse idiopathic spinal hyperostosis, can exceptionally lead to acute obstruction of the upper airways when the hyperostosis is located in the cervical region. We report the case of an 87-year-old man admitted for acute inspiratory dyspnoea and progressive dysphonia. Endoscopic examination confirmed left laryngeal paralysis and pharyngolaryngeal oedema. Imaging revealed a large anterior hyperostosis compressing the airway. This case illustrates the interaction between mechanical compression, local inflammation, and chronic laryngeal paralysis, which can lead to severe dyspnoea. Early recognition and appropriate imaging allow for rapid and effective management. LEARNING POINTS: Cervical hyperostosis can cause acute laryngeal dyspnoea through mechanical compression and associated oedema.The combination of an acute inflammatory process and pre-existing recurrent paralysis exacerbates the severity of the clinical picture.Cervicothoracic imaging and nasofibroscopy are essential for establishing the diagnosis and guiding management.