Korean J Otorhinolaryngol-Head Neck Surg.  2016 Aug;59(8):604-608. 10.3342/kjorl-hns.2016.59.8.604.

A Case of Atlanto-Axial Joint Subluxation Following Tonsillectomy in Patient of Tonsillar Cancer with Preoperative Radiotherapy: Grisel's Syndrome

• Choi YS
• Bae CH
• Kim YD
• Song SY

• KMID: 2350484
• DOI: http://doi.org/10.3342/kjorl-hns.2016.59.8.604

Abstract

Grisel's syndrome, defined as the atlanto-axial joint subluxation not associated with a trauma or bone disease, is a rare complication following operative procedure and/or infections of the upper aerodigestive tract. Pathogenetically, it may occur in association with any condition that results in hyperemia and pathological relaxation of the transverse ligament of the atlanto-axial joint. When an inflammation heals, Grisel's syndrome can probably result in a fixation in the rotated position. It is diagnosed by physical and radiological findings. Early management, consisting of cervical immobilization and medical treatment, is considered a key factor for satisfactory outcome. Inappropriate treatment can result in a catastrophic consequence. Recently, we experienced a case of Grisel's syndrome following tonsillectomy in a patient with left palatine tonsillar cancer with preoperative radiotherapy. We report this case with a literature review.

Keyword

Atlanto-axial joint subluxation; Radiotherapy; Tonsillar cancer; Tonsillectomy

MeSH Terms

Atlanto-Axial Joint*
Bone Diseases
Humans
Hyperemia
Immobilization
Inflammation
Ligaments
Radiotherapy*
Relaxation
Surgical Procedures, Operative
Tonsillar Neoplasms*
Tonsillectomy*