Diagnosis and Conservative Management of Cervical Dysphagia Secondary to Cervical Spine Degeneration: A Case-Based Workflow

Cervical dysphagia is an uncommon but clinically significant cause of chronic swallowing difficulty that is frequently overlooked during routine otolaryngologic and gastrointestinal evaluations. Degenerative cervical spine conditions, such as cervical spondylosis and anterior longitudinal ligament calcification, may compress the esophagus and impair swallowing function. The primary goal of this protocol is to provide a standardized, diagnostic, and management workflow for identifying cervical dysphagia and differentiating it from more common gastrointestinal or neurogenic causes. This protocol outlines a comprehensive approach that integrates detailed clinical assessment, targeted cervical spine imaging using radiography and computed tomography, structured differential diagnosis, and evidence-based conservative treatment strategies. Emphasis is placed on recognizing characteristic radiologic features, correlating imaging findings with clinical symptoms, and excluding alternative etiologies through multidisciplinary evaluation. The protocol also defines criteria for conservative management, including pharmacologic therapy, dietary modification, and swallowing rehabilitation, as well as indications for surgical consideration when nonoperative treatment fails. By standardizing the diagnostic pathway and treatment decision-making process, this protocol aims to improve diagnostic accuracy, reduce delays in appropriate management, and optimize clinical outcomes for patients with cervical spine-related dysphagia.