Grisel Syndrome in Otolaryngology: A Case Series with Literature Review

Das, Soumyajit; Chakraborty, Swastika; Das, Sayan

doi:10.1007/s12070-016-1030-0

Cited by 7 publications

(11 citation statements)

References 15 publications

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“…Patients are overwhelmingly pediatric, with 90% under twenty-one and of those, approximately 68% under twelve [2,3]. Children are more vulnerable due to their larger head size, more flexible joints and ligaments, shallow and more horizontally positioned facet joints, more retropharyngeal lymph nodes, and generally richer lymphatic systems [4]. Patients tend to have a history of head or neck infections or may have had recent maxillofacial or otorhinolaryngology procedures [1].…”

Section: Introductionmentioning

confidence: 99%

“…Regardless of etiology, the majority present with persistent torticollis, sometimes painful, along with neck stiffness and headaches [4,7]. They may have an abnormal head posture, or "Cock-Robin" tilt, in which the chin is rotated or turned to one direction while the neck is tilted to the opposing side [4]. However, early signs of C1-C2 subluxation may only show slight rotational deformity of the atlanto-axial joint as described by the Fielding and Hawkins's graded classification ( Figure 1) [8].…”

Section: Introductionmentioning

confidence: 99%

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C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

Snee¹,

Mazzola²

2020

SCR

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We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI) did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1- C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period. During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper cervical spine alignment and resolution of C1-C2 subluxation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

Snee¹,

Mazzola²

2020

SCR

View full text Add to dashboard Cite

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“…The overwhelming majority of those who suffer AAS are pediatric, with 90% of patients under twenty-one [2] and of those, approximately 68% under twelve [3]. Children are more vulnerable due to their larger head size, more lexible joints and ligaments, a shallower and more horizontally positioned facet joint, more retropharyngeal lymph nodes, and generally richer lymphatic system [4]. Patients tend to have a history of head or neck infection or recent maxillofacial or otorhinolaryngology procedures [1].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The majority of patients present with persistent torticollis, sometimes painful, along with neck stiffness [4,7]. They also have an abnormal head posture, or "Cock Robin" tilt, in which the chin is rotated to one direction while the neck has been tilted or lexed to the opposite side [4]. Early GS may only show rotational deformity of the atlantoaxial joint as described by the Fielding and Hawkins's graded classi ication, each type requiring speci ic treatment ( Figure 1) [8].…”

Section: Introductionmentioning

confidence: 99%

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Atlantoaxial subluxation in the pediatric patient: Case series and literature review

Mazzola¹,

Christie²,

Snee³

et al. 2020

J Neurosci Neurol Disord

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Objective: Atlantoaxial subluxation (AAS) occurs when there is misalignment of the atlantoaxial joint. Several etiologies confer increased risk of AAS in children, including neck trauma, inflammation, infection, or inherent ligamentous laxity of the cervical spine. Methods: A single-center, retrospective case review was performed. Thirty-four patients with an ICD-10 diagnosis of S13.1 were identified. Demographics and clinical data were reviewed for etiology, imaging techniques, treatment, and clinical outcome. Results: Out of thirty-four patients, twenty-two suffered cervical spine trauma, seven presented with Grisel’s Syndrome, four presented with ligamentous laxity, and one had an unrecognizable etiology. Most diagnoses of cervical spine subluxation and/or instability were detected on computerized tomography (CT), while radiography and magnetic resonance imaging (MRI) were largely performed for follow-up monitoring. Six patients underwent cervical spine fusion, five had halo traction, twelve wore a hard and/or soft collar without having surgery or halo traction, and eight were referred to physical therapy without other interventions. Conclusion: Pediatric patients with atlantoaxial subluxation may benefit from limited 3D CT scans of the upper cervical spine for accurate diagnosis. Conservative treatment with hard cervical collar and immobilization after reduction may be attempted, but halo traction and halo vest immobilization may be necessary. If non-operative treatment fails, cervical spine internal reduction and fixation may be necessary to maintain normal C1-C2 alignment.

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A case of atlantoaxial instability following skull base osteomyelitis: Tips for diagnosis and management

Roohollahi

Iranmehr

Andabili

2022

Clinical Case Reports

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Skull base osteomyelitis is a rare but dangerous consequence of untreated malignant otitis externa. Pseudomonas aeruginosa is responsible for most cases with typical presentation. Here, we discuss a diabetic 54‐year‐old female presented with malignant otitis externa and bilateral facial paresis followed by cervical spondylitis and C1‐C2 instability. Skull base osteomyelitis confirmed by clinical presentation, imaging, and laboratory data. Fortunately, she responded well to antibacterial and antifungal therapy. Due to limited data, there is no confirmed standard of treatment for cervical instability secondary to SBO. It seems antibiotic therapy is the mainstay of treatment. In case of poor response to antibiotic therapy, surgical intervention is inevitable. This article introduces the first case of SBO‐related AAI successfully managed with conservative treatment.

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Grisel Syndrome in Otolaryngology: A Case Series with Literature Review

Cited by 7 publications

References 15 publications

C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

Atlantoaxial subluxation in the pediatric patient: Case series and literature review

A case of atlantoaxial instability following skull base osteomyelitis: Tips for diagnosis and management

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