{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:31:01Z","timestamp":1783776661090,"version":"3.55.0"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T00:00:00Z","timestamp":1506297600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215117001918_sec_a1\"><jats:title>Background:<\/jats:title><jats:p>Atlanto-axial rotatory fixation is a persistent deformity of the C1\u20132 vertebral relationship caused by subluxation of the articular surfaces, and can occur after positioning for ENT procedures where the head is rotated \u2013 for example to access the ear or posterior triangle of the neck. If promptly recognised, it can usually be managed successfully with conservative methods, without long-lasting sequelae, but delayed or inappropriate management may lead to permanent neck deformity, neurological problems and pain.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117001918_sec_a2\" sec-type=\"methods\"><jats:title>Method:<\/jats:title><jats:p>Case review.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117001918_sec_a3\"><jats:title>Case report:<\/jats:title><jats:p>Two children with atlanto-axial rotatory fixation following ENT surgery; one child was referred early and managed successfully, and one had delayed referral resulting in permanent severe positional deformity.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117001918_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusion:<\/jats:title><jats:p>Atlanto-axial rotatory fixation is easily missed; there are significant clinical and medicolegal implications if it is not promptly recognised. A suggested management algorithm is presented.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215117001918","type":"journal-article","created":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T04:05:36Z","timestamp":1506312336000},"page":"940-945","source":"Crossref","is-referenced-by-count":6,"title":["Atlanto-axial rotatory fixation: a serious potential complication of paediatric ENT surgery that requires prompt diagnosis and treatment"],"prefix":"10.1017","volume":"131","author":[{"given":"G","family":"James","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D N P","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,9,25]]},"reference":[{"key":"S0022215117001918_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000172226.35474.fe"},{"key":"S0022215117001918_ref6","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000365800.94865.D4"},{"key":"S0022215117001918_ref12","first-page":"307","article-title":"Recurrent atlantoaxial rotatory fixation in children: a rare complication of a rare condition: report of four cases","volume":"100","author":"Crossman","year":"2004","journal-title":"J Neurosurg"},{"key":"S0022215117001918_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-010-0932-3"},{"key":"S0022215117001918_ref15","doi-asserted-by":"publisher","DOI":"10.3171\/2011.11.PEDS11147"},{"key":"S0022215117001918_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s007010100018"},{"key":"S0022215117001918_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000128"},{"key":"S0022215117001918_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198909010-00012"},{"key":"S0022215117001918_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s004020050249"},{"key":"S0022215117001918_ref13","doi-asserted-by":"publisher","DOI":"10.1080\/02688690220131778"},{"key":"S0022215117001918_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7014.1212"},{"key":"S0022215117001918_ref1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197759010-00005"},{"key":"S0022215117001918_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1241-z"},{"key":"S0022215117001918_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1254-6"},{"key":"S0022215117001918_ref14","doi-asserted-by":"publisher","DOI":"10.1148\/rg.322105143"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215117001918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T16:25:29Z","timestamp":1555431929000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215117001918\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,25]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["S0022215117001918"],"URL":"https:\/\/doi.org\/10.1017\/s0022215117001918","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,25]]}}}