Neck pain following adenotonsillectomy: consider Grisel’s syndrome

Objective: “La maladie de Grisel” (Grisel's syndrome) is a spontaneously occurring atlantoaxial subluxation with torticollis. We present a case of atlantoaxial subluxation occurring in a 20-year period of pharyngoplasty surgery. The occurrence of a “spontaneous” atlantoaxial subluxation after oral cavity or pharynx operations is rare. Because some neck pain and stiffness are commonly seen after these kinds of operations, we would like to draw attention to this unusual complication. Symptoms associated with a torticollis after an operation in the oral cavity or pharynx requires additional investigation to exclude this rare complication. A review of the available literature concerning etiology and treatment of la maladie de Grisel is presented.

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Retropharyngeal abscess causing grisel’s syndrome secondary to tuberculosis of cervical spine, a rare form of torticollis: case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211584 ◽

2021 ◽

Vol 7 (5) ◽

pp. 871

Author(s):

Reegina Sivarajan ◽

Mohammad Fuaz Mahfuz ◽

Siti Hajar Sanudin

Keyword(s):

Case Report ◽

Neck Pain ◽

Neurological Complications ◽

Retropharyngeal Abscess ◽

Atlantoaxial Joint ◽

Neck Movement ◽

Neck Stiffness ◽

Rare Type ◽

Neck Infection ◽

Grisel’S Syndrome

<p>Grisel’s syndrome is a rare type of non-traumatic subluxation of an atlantoaxial joint characterized by torticollis, neck pain, and reduced neck movement. The common causes of Grisel’s syndrome are head and neck infection or post-otorhinolaryngology (ORL) procedures. We are reporting a case of a 3-year-old boy with a gradual worsening of neck stiffness, neck pain, and restricted neck movement for more than one month. The patient had no history of trauma. The computerized tomographic (CT) showed a retropharyngeal abscess with a bony erosion causing atlantoaxial subluxation. The management and progress of this patient are discussed. The objective of this case report is to emphasize that Grisel’s syndrome should be considered a differential in a painful torticollis to prompt an early diagnosis and treatment to prevent serious neurological complications.</p>

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A Case of Prolonged Neck Pain Diagnosed with Grisel's syndrome as a Differential Diagnosed with Juvenile Idiopathic Arthritis

Annals of Paediatric Rheumatology ◽

10.5455/apr.011420151040 ◽

2015 ◽

Vol 4 (1) ◽

pp. 17 ◽

Cited By ~ 1

Author(s):

Gonca Keskindemirci ◽

Nuray Ayaz ◽

Seyma Murtezaoglu ◽

Ali Er ◽

Ibrahim Alatas ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Neck Pain ◽

Grisel’S Syndrome

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Does Increased Electrocautery during Adenoidectomy Lead to Neck Pain?

Otolaryngology ◽

10.1016/j.otohns.2005.07.008 ◽

2005 ◽

Vol 133 (4) ◽

pp. 556-561 ◽

Cited By ~ 8

Author(s):

Lakeisha R. Henry ◽

Thomas J. Gal ◽

Eric A. Mair

Keyword(s):

Neck Pain ◽

Prospective Study ◽

Retrospective Analysis ◽

Velopharyngeal Insufficiency ◽

Temperature Changes ◽

Grisel’S Syndrome ◽

Prevertebral Fascia ◽

A Prospective Study ◽

The Impact

OBJECTIVES: The objective was to assess the impact of electrocautery on complications in adenoidectomy. We sought to quantify cautery-related temperature changes in prevertebral fascia that may occur during the procedure, retrospectively evaluate the incidence of cautery-related complications, and prospectively assess the role of cautery in postoperative neck pain. METHODS: Three consecutive related trials were performed. Initially, adenoidectomy was performed on 20 fresh cadavers, using a thermister to evaluate temperature changes in the prevertebral fascia after electrocautery (30 watts over a 30-second period). Next, retrospective analysis of adenoidectomy complications in 1206 children over a 5-year period was performed. Based on these findings, a prospective study of the incidence of neck pain following adenoidectomy was performed in a cohort of 276 children. Adenoidectomy technique, wattage, and duration of electro-cautery were recorded for each child. Children with significant neck pain were evaluated with MRI. RESULTS: Peak thermister readings averaged 74°C, for a mean change of 51.8°C. Complications observed in retrospective analysis included neck pain (3), Grisel's syndrome (1), prolonged velopharyngeal insufficiency (1), retropharyngeal edema (1), and severe nasopharyngeal stenosis (1). The incidence of neck pain in the prospective study was 12% (33 pts), and was independent of adenoidectomy technique, cautery wattage, or duration of cautery use. MRIs revealed edema without abscess. CONCLUSIONS: Cautery can result in substantial temperature changes in the surgical adenoid bed. Despite this, the incidence of complications, specifically neck pain, associated with adenoidectomy is low, although underreported. Complications appear to be independent of adenoidectomy technique and cautery use.

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