title: Nontraumatic atlantoaxial rotary subluxation in the pediatric otolaryngology patient. A report of four cases.
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Holcomb
authors.forename: D M
authors.initials: DM
authors.lastname: Jaffe
authors.forename: J H
authors.initials: JH
authors.lastname: Greinwald
authors.forename: N M
authors.initials: NM
authors.lastname: Bauman
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008297:Male; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy