Rotational dislocation C1-C2 after otoplasty under local anesthesia

Non-traumatic rotational atlantoaxial subluxation (NTARS) is rare and mostly reported after infection of the upper respiratory tract and named Grisel's syndrome. NTARS has also been reported after head-and-neck surgery, but it is extremely rare after otoplasty. A case of NTARS after bilateral otoplasty is reported under local anesthesia, a 15-year-old female being presented with painful torticollis. The diagnosis of atlantoaxial rotatory subluxation was performed using radiographs and computed tomography 2 weeks after the surgery. Closed reduction was performed by traction of the head and transoral direct pressure over an anterior dislocated C1 mass. The reposition of the joint was achieved, but it was very unstable, and it was not possible to keep the reduction. Open posterior reduction and posterior C1-C2 arthrodesis were performed followed by the use of a soft collar during 3 months.