Nontraumatic atlantoaxial rotary subluxation in the pediatric otolaryngology patient: A report of four cases
Annals of Otology, Rhinology and Laryngology
Atlantoaxial rotary subluxation; Grisel's syndrome
Nontraumatic atlantoaxial rotary subluxation (NAARS) is a relatively uncommon entity, with inconsistent presentations. It most commonly follows infectious processes or operative procedures. We present our experience with 4 pediatric otolaryngology patients with NAARS who were treated at the University of Iowa Hospitals and Clinics during a 2-year period beginning in 1997. A review of the symptoms, physical findings, and radiographic abnormalities is presented. Treatment options, varying from muscle relaxants to surgical fusion, are discussed. A high index of suspicion in evaluating children with a stiff neck or pain on attempted motion is essential in order to facilitate prompt diagnosis and appropriate intervention.
Holcomb, J., Jaffe, D., Bauman, N., Greinwald, J., & Smith, R. (2001). Nontraumatic atlantoaxial rotary subluxation in the pediatric otolaryngology patient: A report of four cases. Annals of Otology, Rhinology and Laryngology, 110 (12). http://dx.doi.org/10.1177/000348940111001210