Pseudo-Grisel’s syndrome as a complication of adenotonsillectomy
More details
Hide details
Department of Otolaryngology – Head and Neck Surgery, Prof. Dr Stanisław Popowski Regional Specialised Children’s Hospital in Olsztyn, Poland
Submission date: 2017-05-19
Acceptance date: 2017-12-06
Online publication date: 2018-09-27
Publication date: 2019-10-31
Corresponding author
Natalia Żuchowska   

Department of Otolaryngology – Head and Neck Surgery, Provincial Specialist Children’s Hospital in Olsztyn, Żołnierska 18 A, 10-561 Olsztyn, Poland.
Pol. Ann. Med. 2019;26(1):51-54
Grisel’s syndrome is non-traumatic subluxation of the atlanto-axial joint unrelated to any disorder of the skeletal system. It is a rare complication of infections in the ENT region and surgeries in the head and neck region. Symptoms of Grisel’s syndrome include: pain in the neck, nuchal rigidity or torticollis.

The aim of the study is to present Grisel’s syndrome as one of possible complications following surgeries in the ENT region.

Case study:
In our article we present a case of a child, who was suspected to suffer from Grisel’s syndrome after adenotonsillotomy.

Results and discussion:
Grisel’s syndrome can be a consequence of nasal, throat and ear infections; and it can result from head and neck surgeries, such as tonsillectomy, adenoidectomy, mastoidectomy. Symptoms of Grisel’s syndrome are: nuchal rigidity or torticollis, and pain in the neck which occurs a few days after the infection or surgical procedure. When diagnosing Grisel’s syndrome, it is recommended to perform X-ray images in AP and lateral projection on the atlas, as well as a CT scan and MRI scan of the neck. The treatment can be conservative or operative and it is is based on the degree of subluxation and the severity of clinical symptoms.

Medical imaging and comprehensive treatment as soon as possible is of paramount importance in order to avoid dangerous consequences, such as permanent deformation of the neck or neurological losses which would require extensive surgical procedures.

None declared.
Beyazal MS, Demirok G, Capkin E, Usul H, Tosun M, Sari A. Grisel’s syndrome – a case report. Turk J Rheumatol. 2011;26(3):243–247.
Bocciolini C, Dall’Olio D, Cunsolo E, Cavazutii PP, Laudadio P. Grisel’s syndrome: a rare complication following adenoidectomy. Acta Otorhinolaryngol Ital. 2005;25(4):245–249.
Bucak A, Ulu S, Aycicek A, Kacar E, Miman MC. Grisel’s syndrome: a rare complication following adenotonsillectomy. Case Rep Otolaryngol. 2014.
Elyajouri A, Assermouh A, Abilkacem R, Agadr A, Mahraoui C. Case report – Grisel’s syndrome a rare complication following traditional uvulectomy. Pan Afr Med J. 2015;20:62.
Wang JCC, Malic C, Reily C, Verchere C. Microtia reconstruction and postsurgical Grisel’s syndrome: a rare cause of torticollis in a child. Plast Reconstr Surg Glob Open. 2014;2(6):e176.
Sasi S, Larrier DR, Crous H. Common postoperative complications in otolaryngology presenting to the Pediatric Emergency Department. Clin Pediatr Emerg Med. 2010;11(2):131–136.
Dagtekin A, Kara E, Vayisoglu Y, et al. The importance of early diagnosis and appropriate treatment in Grisel’s syndrome: report of two cases. Turk Neurosurg. 2011;21(4):680–684.
Martinez-Lage JF, Morales T, Fernandez Cornejo V. Inflammatory C2-3 subluxation: a Grisel’s syndrome variant. Arch Dis Child. 2003;88(7):628–629.
Deichmueller CMC, Wielkoborsky JJ. Grisel’s syndrome – a rare complication following “small” operations and infections in the ENT region. Eur Arch Otorhinolaryngol. 2010;267(9):1467–1473.
Journals System - logo
Scroll to top