Atlanto-axial subluxation (Grisel's syndrome) following otolaryngological diseases and procedures

1995 ◽  
Vol 109 (10) ◽  
pp. 1005-1009 ◽  
Author(s):  
D. Samuel ◽  
D. M. Thomas ◽  
P. A. Tierney ◽  
K. S. Patel

AbstractGrisel's syndrome is a rare condition of uncertain aetiology characterized by atlanto-axial subluxation following an infection in the head and neck region. The condition most frequently affects children and characteristically presents in the post-operative period with cervical pain and torticollis. We describe three cases and discuss the aetiology and pathogenesis. A high index of suspicion may lead to early diagnosis in its natural history thereby preventing potentially serious complications.

2021 ◽  
Vol 20 (4) ◽  
pp. 914-917
Author(s):  
Siti Nuradliah Jamil ◽  
Ilham Ameera Ismail ◽  
Siti Fatimah Badlishah Sham ◽  
Norliana Dalila Mohamad Ali

Cat scratch disease is a communicable disease caused by the Bartonella henselae bacteria. Regional lymphadenopathy is the hallmark of cat scratch disease and about 75% of lymphadenopathy cases are localized in the head and neck region. An epitrochlear lymphadenopathy is a rare condition at any age and often misdiagnosed as it is not normally palpable. External compression of an enlarged epitrochlear lymph node compromising vascularity was not mentioned in any literature before. We present a case of a 13-year-old girl with right positional ipsilateral hand pallor and epitrochlear lymphadenitis with serological evidence of Bartonella henselae infection. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.914-917


2020 ◽  
Vol 28 (2) ◽  
pp. 144-150
Author(s):  
Vandana P Thorawade ◽  
S A Jaiswal ◽  
Seema Ramlakhan Gupta

Introduction  Tuberculosis can involve any organ or site. Otorhinolaryngologist may encounter tuberculosis affecting lymph nodes, ear, larynx, deep neck spaces, salivary glands etc. which can mimic other chronic granulomatous conditions or malignancy. To ensure early diagnosis, it is important to recognize its cardinal signs and symptoms and to be aware of potential pitfalls in diagnosis. This study was done to learn the clinical presentation of tuberculosis in ear, nose, throat and head and neck region, and to assess the effectiveness of various investigations and treatment done for the same. Materials and Methods  A retrospective study done in our institution involving 120 patients suffering from tuberculosis in ear, nose, throat and head and neck region who attended pulmonary medicine or ENT OPD or ward between January 2008 to December 2017 that is, 10 years. Study period for data collection and analysis was 1 month. Results Total 120 patients-69 males and 51 females. Most common site was cervical lymph nodes(77.5% patients), followed by larynx(8.3%),middle ear(7.5%),deep neck spaces(2.5%) and salivary glands and nose(1.7% each). Histopathology was highly sensitive(99. 1%).All except one patient responded to first-line antitubercular drugs, the other patient was given treatment for MDR-TB to which he responded. Conclusion Tuberculosis can involve any site in the head and neck region, most common being cervical lymph nodes mainly presenting as neck swelling. Variable nature of manifestations of tuberculosis makes it essential to have high degree of suspicion for early diagnosis.


2018 ◽  
Vol 132 (9) ◽  
pp. 827-831 ◽  
Author(s):  
K Mahawerawat ◽  
P Kasemsiri

AbstractBackgroundAlthough melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.ObjectivesTo report the clinical presentation and management of melioidosis in the head and neck.MethodA retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.ResultsMedical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).ConclusionCareful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.


2007 ◽  
Vol 121 (8) ◽  
pp. 800-802 ◽  
Author(s):  
J Doshi ◽  
S Anari ◽  
I Zammit-Maempel ◽  
V Paleri

AbstractGrisel syndrome is a rare condition characterised by atlanto-axial subluxation following an inflammatory process in the head and neck region. It occurs more commonly in children and usually presents with cervical pain and torticollis, in addition to symptoms of the primary infection. We present the case of an asymptomatic 78-year-old man who was incidentally found to have atlanto-axial subluxation on a routine follow-up computed tomography scan, three months following successful treatment of a skull base infection. This case emphasises the importance of appropriate follow-up imaging for patients with skull base infections, even if they respond clinically to medical treatment.


2009 ◽  
Vol 21 (1) ◽  
pp. 53-55
Author(s):  
Md Mozaffer Hossain ◽  
SMA Alim ◽  
Muslema Begum ◽  
Nasiruddin Ahmed ◽  
UH Shahera Khatun

Neuromuscular weakness in critically ill patients is diagnostic challenge. Septic Polyneuropathy is an important cause of failure to wean from artificial ventilation. We studied patient of septic polyneuropathy to highlight the importance of regular neurological examination in the early diagnosis of this conditions. Availability of facilities for bed side electrophysiological study & histopathology of muscle are important to diagnose these entity. A 56 years old lady was admitted in gastro-enterology unit with complains of abdominal pain & fever, subsequently she was diagnosed as a case of burst appendix with septicemia in Surgery Unit. Appendicectomy and surgical toileting was done under general anaesthesia. In the early post-operative period the patient developed respiratory failure and was transferred to ICU. She was on ventilator for a long time with all other investigation electrophysiological study of nerve conduction showed septic polyneuropathy. On 21st POD the patient could be withdrawn from ventilator and after T-piece trial extubation was done on the next day. Neuropathies in sepsis, an important cause of failure to wean from ventilator, a high index of suspicion and regular bed side neurological & electrophysiological examination is required to make an early diagnosis.   Journal of BSA, Vol. 21, No. 1, January 2008 53-55


1990 ◽  
Vol 104 (12) ◽  
pp. 977-979 ◽  
Author(s):  
J. F. Sharp ◽  
M. J. C. Rodgers ◽  
F. B. Macgregor ◽  
C. J. Meehan ◽  
K. McLaren

AbstractAngiolymphoid hyperplasia with eosinophilia is a rare condition and is poorly recognized in the otolaryngological literature. The condition is characterized by the appearance of cutaneous nodules within the head and neck region especially around the external ear. Variable lymphadenopathy and peripheral eosinophilia can occur and the condition can mimic neoplasia. It is important to be aware of this disease entity in order to avoid overtreatment. Surgical removal is the treatment of choice; however, this often multilobulated and poorly delineated lesion often precludes initial wide excision and local recurrence is common.We present three cases of this unusual condition and a brief resumé of the literature.


2009 ◽  
Vol 88 (10) ◽  
pp. 873-876 ◽  
Author(s):  
W.J. Maloney

Hutchinson-Gilford Progeria Syndrome (HGPS) was first documented in the medical literature in 1886. A HGPS patient has the physical characteristics and appearances of an elderly individual. In 1921, F. Scott Fitzgerald published a short story entitled ‘The Curious Case of Benjamin Button’. The main character of Fitzgerald’s fictional work is born with a very rare condition in which he looks like an elderly person. The main difference between the fictional individual and individuals with HGPS is that Fitzgerald’s character becomes younger as the years go by. This paper serves three purposes. The first purpose is to scientifically present the possibility that Fitzgerald consciously based his character, Benjamin Button, upon individuals with HGPS. The second purpose is to describe the rare condition of HGPS, along with its many manifestations in the head and neck region. The third purpose is to postulate that HGPS individuals might not only have the appearance of an aged person, but also might actually undergo true physical aging, which would enable researchers to gain valuable information into the treatment of ailments commonly associated with the natural process of aging.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Abdulkadir Bucak ◽  
Sahin Ulu ◽  
Abdullah Aycicek ◽  
Emre Kacar ◽  
Murat Cem Miman

Grisel’s syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel’s syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel’s syndrome after adenotonsillectomy is discussed with review of the literature.


2016 ◽  
Vol 21 (2) ◽  
pp. 127-131
Author(s):  
Muntasir Mahbub ◽  
Nabila Mannan ◽  
Md Mazharul Shaheen ◽  
Manash Ranjan Chakraborti ◽  
AKM Shaifuddin ◽  
...  

Rhabdomyosarcoma is the most common soft tissue sarcoma of childhood and adolescence. There are four histological types and among them the embryonic types are the most common. It can occur in any anatomic location, although when occurring in the head and neck region, it has an affinity to invade the cranial cavity. Patient was a 5 years old boy who was admitted with the complaints of pain and discharge from the ear, swelling on left side of the upper neck, and mastoid region and a fleshy mass protruding from the ear canal. The mass was confirmed to be Embryonal Rhabdomyosarcoma on histopathology. CT scan of the Head-Neck region, showed extension of the mass into infra-temporal fossa and in the mastoid antrum. After complete excision, the patient was referred to oncology deptt for consultation. The chemotherapy schedule comprised of Vincristine and Dactinomycine for 9-12 cycles. Otolaryngologists need to be aware of this rare condition as it may mimic the symptoms of CSOM or nasal polyp. And also long term followup is needed since recurrence can present several years after initial treatment.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 127-131


Author(s):  
Pallavi Pavithran ◽  
Mahesh S. G.

<p class="abstract"><strong>Background:</strong> The aim of the study was to highlight the varied and changing presentations of head and neck tuberculosis, discuss the difficulties in diagnosis and treatment.</p><p class="abstract"><strong>Methods:</strong> This was a 5 years retrospective analysis of patients with extrapulmonary tuberculosis (EPTB) of the head and neck region.  </p><p class="abstract"><strong>Results:</strong> 43 patients with EPTB were studied. Most had cervical lymphadenopathy (35), 9 had laryngeal, 7 tuberculous otitis media, and one patient each of PNS, oropharyngeal and retropharyngeal involvement. 8 patients had pulmonary TB, 2 had Potts spine, and 5 gave history of previous TB. FNAC was effective in nodal disease, PPD test positive in 20% and HPE was used to make the diagnosis in other types.</p><p class="abstract"><strong>Conclusions:</strong> TB is re-emerging as a significant cause of morbidity. Diagnosing EPTB requires high index of suspicion. Cervical lymphadenopathy is the commonest presentation, followed by larynx, and then ear. FNAC is a reliable and convenient way to diagnose lymphadenopathy. Hitopathological examination needed for confirmation, and for other sites. Further investigations are needed to exclude pulmonary or systemic TB. All patients should be categorised into proper category of anti-tuberculous treatment (ATT) and treated according to ATT regimen.</p>


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