Al-Driweesh T, Altheyab F, Alenezi M, Alanazy S, Aldrees T. Grisel's syndrome post otolaryngology procedures: A systematic review.
Int J Pediatr Otorhinolaryngol 2020;
137:110225. [PMID:
32658805 DOI:
10.1016/j.ijporl.2020.110225]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE
To increase awareness and the index of suspicion regarding Grisel's syndrome among otolaryngologists after otolaryngology procedures.
METHOD
We conducted a search of MEDLINE/PubMed for articles published through January 2020 utilizing the following terms: Grisel's syndrome, Grisel syndrome, and atlantoaxial subluxation alone and in combination with other terms like ENT, otolaryngology, head & neck, tonsillectomy, adenoidectomy, adenotonsillectomy, mastoidectomy, tympanoplasty, and tympanomastoidectomy. We included English-language cases that occurred after surgical procedures and contained the following data: age, onset, common presenting symptoms, diagnostic approach, management options, and the presence of complications.
RESULT
We found 39 papers that met our criteria. Most cases occurred after adenotonsillectomy with or without ventilation tube insertion (55.6%). The majority of the affected population was the pediatric age group, and the main presenting symptom was torticollis that presents as early-onset. In regard to management, most of the cases were treated with medical therapy with or without adjunctive measures (e.g., a cervical collar). No neurological complications were recorded except in one case that was treated with no long term sequel.
CONCLUSION
Grisel's syndrome is a rare complication that occurs after otolaryngology procedures and can result in serious neurological complications and death. A high index of suspicion is an important factor for early diagnosis and management to prevent such complications. In most cases, conservative management is successful with a good prognosis.
Collapse