Grisel's Syndrome a Rare Complication of Pharyngoplasty: A Case Report and Literature Review.

Grisel's syndrome is a rare, nontraumatic atlantoaxial subluxation typically following upper airway infections or otolaryngologic procedures. We present a case of bilateral, sequential Grisel's syndrome following pharyngoplasty for velopharyngeal insufficiency in a 6-year-old female born with a cleft palate. The patient reported neck pain and torticollis starting on day 2 postoperatively. The atlantoaxial subluxations were successfully managed with halter traction and cervical immobilization. A literature review identified 8 prior cases of Grisel's syndrome post pharyngoplasty, emphasizing the need for early recognition to allow conservative treatment. This case report highlights a rare but serious complication of pharyngoplasty and the need to further investigate a patient who presents with postoperative torticollis.