RESUMEN
INTRODUCTION AND IMPORTANCE: The manifestation of acute upper airway obstruction, coupled with dysphagia and potential vocal cord paresis, typically raises suspicion of advanced laryngeal or pharyngeal malignancy. However, this case report illuminates an unusual systemic condition- diffuse idiopathic skeletal hyperostosis (DISH) with cervical osteophytes-that can resemble the clinical presentation of these malignancies. CASE PRESENTATION: Two cases involving 78-year and 82-year-old males exhibiting progressive dysphagia, dysphonia, and acute upper airway obstruction due to substantial osteophytes at the C2-C4 levels are presented. CLINICAL DISCUSSION AND CONCLUSION: Clinicians should consider DISH in the differential diagnosis of dysphagia and upper airway obstruction after ruling out laryngeal and pharyngeal malignancies. Timely recognition and appropriate management of DISH has proven effective in relieving symptoms and restoring normal swallowing and breathing, preventing acute life-saving interventions, contributing to improved patient outcomes.