Das Grisel-Syndrom: Eine seltene Komplikation HNO-ärztlicher Eingriffe

Abstract

Although there are several theories concerning the actual pathogenesis, it is generally agreed that an inflammatory process is the primary cause of Grisel's syndrome. Therefore, early antibiotic treatment is recommended. Further treatment depends on clinical findings and Fielding classification of the degree of the subluxation and includes muscle relaxations, soft collar or stiff neck, cervical traction or even arthrodesis of C1 and C2. If recognised early and appropriate treatment is applied, the prognosis is excellent. Severe cases can present with degenerative disorders of the cervical spine or even with neurological malfunction.

A novel technique to treat Grisel’s syndrome: results of a simplified, therapeutical algorithm

“…In type III closed reposition and immobilization in a halo brace for up to 12 weeks is necessary, type IV is primarily treated surgically with fusion of C1 Pat No.5 9 y/o girl after otoplast (protruding ears). Three days after surgery she complains about a wryneck with the chin tilted to the left and her head flexed to the right and C2 [9,12,[15][16][17]20]. After surgical stabilization, persistent neurological complications occur in up to 15 % of all patients [21].…”

“…This classification was introduced in 1977 to assess the degree of subluxation between C1 and C2. Thus, instability increases from type I to IV and higher stages may require surgical interventions (Tables 1 and 2) [9,12,15,16]. Adjuvant antibiotic treatment is considered to be beneficial [4,5,10].…”