Grisel's syndrome post otolaryngology procedures: A systematic review.

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.

[Study on the clinical value of cervical spondylosis with articulatio atlantoepistrophica sublaxation].

OBJECTIVE: To explore the effect of articulatio atlantoepistrophica sublaxation on the pathogenesis of cervical spondylosis, and provide a thread for diagnosis and treatment of cervical spondylosis with manipulation. METHODS: There were two groups in the study, which were non cervical spondylosis group and cervical spondylosis group. There were 333 patients in cervical spondylosis group, included 119 males and 214 females with the mean age of(48.11±12.21) years old. The patients were recruited from clinic service of orthopaedics in Shuguang Hospital between March 2006 and December 2008. There were 73 subjects in non cervical spondylosis group, included 18 males and 55 females with the mean of(45.99±11.47) years old. The subjects were recruited from undergraduate students, postgraduate, advanced study persons, and community personnel. The position relation of the atlanto axial joint was observed by cervical X rays with opening position, and the incidence rate of articulatio atlantoepistrophica sublaxation was compared between two groups, and their clinical characteristics were analyzed. RESULTS: The incidence of articulatio atlantoepistrophica sublaxation in cervical spondylosis group was 81.38%(271/333)and was more than non cervical spondylosis group(P<0.01). Furthermore, the pattern of the articulatio atlantoepistrophica sublaxation in cervical spondylosis group was complicated and diversified, which was 50.55% (137/271)with single moving sublaxation, 7.01%(19/271) with revolving sublaxation, 42.44%(115/271) with single moving and revolving sublaxation. CONCLUSIONS: The articulatio atlantoepistrophica sublaxation may be a X ray diagnostic indication to the cervical spondylosis, which should be grouping studied in clinic. It will provide guidance for the diagnosis and treatment of cervical spondylosis.

Study on the clinical value of cervical spondylosis with articulatio atlantoepistrophica sublaxation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effect of articulatio atlantoepistrophica sublaxation on the pathogenesis of cervical spondylosis, and provide a thread for diagnosis and treatment of cervical spondylosis with manipulation.</p><p><b>METHODS</b>There were two groups in the study, which were non cervical spondylosis group and cervical spondylosis group. There were 333 patients in cervical spondylosis group, included 119 males and 214 females with the mean age of(48.11±12.21) years old. The patients were recruited from clinic service of orthopaedics in Shuguang Hospital between March 2006 and December 2008. There were 73 subjects in non cervical spondylosis group, included 18 males and 55 females with the mean of(45.99±11.47) years old. The subjects were recruited from undergraduate students, postgraduate, advanced study persons, and community personnel. The position relation of the atlanto axial joint was observed by cervical X rays with opening position, and the incidence rate of articulatio atlantoepistrophica sublaxation was compared between two groups, and their clinical characteristics were analyzed.</p><p><b>RESULTS</b>The incidence of articulatio atlantoepistrophica sublaxation in cervical spondylosis group was 81.38%(271/333)and was more than non cervical spondylosis group(<0.01). Furthermore, the pattern of the articulatio atlantoepistrophica sublaxation in cervical spondylosis group was complicated and diversified, which was 50.55% (137/271)with single moving sublaxation, 7.01%(19/271) with revolving sublaxation, 42.44%(115/271) with single moving and revolving sublaxation.</p><p><b>CONCLUSIONS</b>The articulatio atlantoepistrophica sublaxation may be a X ray diagnostic indication to the cervical spondylosis, which should be grouping studied in clinic. It will provide guidance for the diagnosis and treatment of cervical spondylosis.</p>