Morita T, Fujiki N, Shiomi Y, Kurata K, Oda N
Department of Otolaryngology, Kyoto University Hospital, Sakyo-ku 606-8507, Kyoto, Japan.
Auris Nasus Larynx. 2001 Apr;28(2):177-9. doi: 10.1016/s0385-8146(00)00101-2.
Atlantoaxial subluxation secondary to a retropharyngeal abscess is well described in children, but very rare in adults. Only two adult cases have been reported in the literature. We present a case of severe atlantoaxial subluxation in an adult secondary to retropharyngeal abscess. His atlas-dens interval was very large, up to 10 mm in flexion. We tried external fixation with a neck collar initially, but for remaining instability, surgical fusion was performed. The mechanism of subluxation is attributed to softening of the ligament allowing greater mobility at the joint. The etiology of this process is speculative.
继发于咽后脓肿的寰枢椎半脱位在儿童中已有充分描述，但在成人中极为罕见。文献中仅报道过两例成人病例。我们报告一例成人继发于咽后脓肿的严重寰枢椎半脱位病例。其寰椎前弓与齿突间距非常大，前屈时可达10毫米。我们最初尝试用颈托进行外固定，但因仍存在不稳定情况，遂进行了手术融合。半脱位的机制归因于韧带软化，使关节处活动度增大。这一过程的病因尚属推测。
