Atlanto-axial rotatory fixation following pharyngeal flap plasty in a patient with 22q11 deletion syndrome

MUKAI Takao, YAMANISHI Tadashi, YOKOTA Yusuke, HIRANO Yoshiko, NISHIO Juntaro

doi:10.5794/jjoms.51.172

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Other Title

咽頭弁形成術後に環軸椎回旋位固定を生じた２２ｑ１１欠失症候群患者の１例
ショウレイホウコクイントウベンケイセイジュツゴニカンジクツイカイセンイコテイオショウジタ 22q11 ケツシツショウコウグンカンジャノ 1レイ

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Abstract

We describe an 8-year girl with atlanto-axial rotatory fixation (AARF) caused accidentally after pharyngeal flap plasty under general anesthesia. On the third postoperative day, she had torticollis without neurologic damage and complained of neck pain when she rotated her head. AARF was diagnosed on the basis of the computed tomographic findings. Glisson traction with 1.5 kilograms of weight for 2 weeks reduced the dislocation, but further treatment was reguired. The deformity was corrected by manipulation under general anesthesia and the patient's head and neck were immoblilized in a Minerva jacket for 6 weeks. A cervical collar was used subsequently in an attempt to maintain normal spinal alignment, and the reduction remained.<BR>AARF is a rare disorder caused by a variety of conditions. Diagnosis is often difficult and delayed. During operation, hyperextension of the neck should be avoided. It is important to be aware of AARF and to begin treatment as soon as possible in patients with postoperative manifestations such as head tilt, neck pain, and inability to rotate the head.

Journal

Japanese Journal of Oral and Maxillofacial Surgery

Japanese Journal of Oral and Maxillofacial Surgery 51 (4), 172-175, 2005

Japanese Society of Oral and Maxillofacial Surgeons

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