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Atlantoaxial rotary subluxation after tympanoplasty
So Young Kim1, Jin Woong Choi, Byung Yoon Choi
1Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Objective:
To describe a case of the atlantoaxial rotary subluxation (AARS) after tympanoplasty and discuss its mechanism and management.
Patients:
A 10-year-old boy.
Interventions:
Cervical spine plain radiography followed by cervical traction.
Main Outcome Measures:
Range of motion and radiologic follow-up.
Results:
The patient showed painful torticollis and rotation and fixation of the head to the right side (cock robin sign). Increased atlantodens interval and asymmetry between facet joints were found on cervical plain radiography. Full functional recovery and reduction of subluxation were achieved by conservative cervical traction.
Conclusion:
Forced surgical positioning of head rotation to the contralateral ear down and restriction during otologic surgery under general anesthesia may complicate AARS, especially in pediatric otologic surgery patients.
