Atlanto-axial subluxation and cervical osteomyelitis: two unusual complications of adenoidectomy

Abstract

Grisel's syndrome (atlanto-axial subluxation) and cervical osteomyelitis are two unusual complications of adenoidectomy. We present two patients; one with atlanto-axial subluxation following uncomplicated tonsillectomy and adenoidectomy, and one with cervical osteomyelitis following uncomplicated adenoidectomy. Both patients presented with persistent postoperative neck pain. Surgical intervention, as well as long-term intravenous antibiotics, was required. A high index of suspicion, as well as cervical spinal series with flexion-extension views, is necessary for diagnosis. Flexible nasopharyngoscopy and computed tomography of the cervical spine also aided in diagnosis and treatment planning. With early diagnosis and proper treatment, the prognosis is good. Neurologic sequelae were prevented in both of our patients.