Grisel's syndrome: a rare complication of tonsillectomy

The Journal of Laryngology and Otology
K J SiaA Nasriah

Abstract

To discuss the pathophysiology of atlanto-axial subluxation as a rare complication of tonsillectomy, and to discuss the important radiological findings for diagnosis and treatment planning. We report a case of post-tonsillectomy atlanto-axial subluxation, also known as Grisel's syndrome, in a child. On the third day after surgery, the boy presented with torticollis with no neurological deficit. Rotatory atlanto-axial subluxation was clearly shown in computed tomography scans of the neck. Cervical traction for one week successfully reduced the subluxation, with no long-term sequelae. Pre-existing cervical ligamentous laxity and post-operative infection are believed to be the main causes of Grisel's syndrome. Although it is rare, patients are advised to seek treatment early if any neck pain or fever persists. Early diagnosis is important for better treatment outcome. Initial conservative measures are advised before more invasive cervical traction is adopted.

References

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Citations

Aug 21, 2013·Der Unfallchirurg·D KoppeW Ertel
Aug 16, 2015·Journal of Medical Case Reports·Takashi KobayashiYoichi Shimada
Oct 18, 2016·Pediatric Emergency Care·Merritt D KinonCarlos A Bagley
Jul 2, 2019·Clinical Pediatrics·Ivy TamLaurie Bernard Stover
Dec 5, 2020·Case Reports in Pediatrics·Nicole PiniLorenzo Iughetti
May 10, 2016·The Journal of Craniofacial Surgery·Shailendra Kapoor
Jul 14, 2020·International Journal of Pediatric Otorhinolaryngology·Turki Al-DriweeshTurki Aldrees

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