{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:19:58Z","timestamp":1787807998910,"version":"build-2784847793"},"reference-count":13,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>This clinical record revisits the classical and pathognomonic features of craniocervical tetanus in a 65-year-old farmer who presented with acute-onset trismus, multiple cranial nerve pareses (III, IX, and X), risus sardonicus, and spasm of the head\u2013neck musculature. This paper explores the relevant literature and presents a brief pictorial analysis of the global epidemiologic data. With most countries successfully adopting the maternal and neonatal tetanus elimination (MNTE) program, the incidence and mortality of tetanus across age groups have sharply reduced in high-income and most middle-income nations. In adults, tetanus is now encountered in specialized situations like waning immunity and incomplete vaccination, in the resource-poor and low-income nations, in countries achieving MNTE recently, and as cluster cases in the aftermath of natural disasters involving human settlements. Therefore, present-day practicing otolaryngologists and residents who have limited exposure to the tell-tale clinical features of craniocervical tetanus should consider it during work-up of acute-onset trismus in adults in susceptible situations and with a conducive background. The clinical spectrum of craniocervical tetanus as depicted in this report, including the demonstration of the pathognomonic positive spatula test, provides valuable learning points for otolaryngologists in this regard.<\/jats:p>","DOI":"10.1177\/01455613231223895","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T05:30:05Z","timestamp":1708147805000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Craniocervical Tetanus: A Practical Consideration During Work-up of Acute-Onset Trismus"],"prefix":"10.1177","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3977-3230","authenticated-orcid":false,"given":"Mainak","family":"Dutta","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head\u2013Neck Surgery, Medical College and Hospital, Kolkata, WB, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanaya","family":"Panja","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head\u2013Neck Surgery, Medical College and Hospital, Kolkata, WB, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indranil","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine, Medical College and Hospital, Kolkata, WB, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tetanus. Updated [May 9 2018]. Accessed [October 10 2023]."},{"key":"e_1_3_2_3_2","unstructured":"Bae C Bourget D.Tetanus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459217\/. Updated [May 31 2023]. Accessed [October 25 2023]."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-5-201103010-00007"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X17000012"},{"key":"e_1_3_2_6_2","first-page":"88","article-title":"Protecting all against tetanus: guide to sustaining maternal and neonatal tetanus elimination (MNTE) and broadening tetanus protection for all populations","volume":"2019","author":"WHO","unstructured":"WHO. Protecting all against tetanus: guide to sustaining maternal and neonatal tetanus elimination (MNTE) and broadening tetanus protection for all populations. World Health Organization; 2019: 88-91.","journal-title":"World Health Organization"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.3.477"},{"key":"e_1_3_2_8_2","unstructured":"Behrens H Ochmann S Dadonaite B et al. Tetanus; 2019. Accessed October 29 2023. https:\/\/ourworldindata.org\/tetanus"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Kyu HH Mumford JE Stanaway JD et al. Mortality from tetanus between 1990 and 2015: findings from the global burden of disease study 2015. BMC Public Health 2017; 17(1). https:\/\/doi.org\/10.1186\/s12889-017-4111-4.","DOI":"10.1186\/s12889-017-4111-4"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2975"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1995.53.386"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-232344"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150170078"},{"key":"e_1_3_2_14_2","first-page":"1","volume-title":"Symposium on Tetanus in Great Britain","author":"Ablett JJ","unstructured":"Ablett JJ. Analyses and main experiences in 82 patients treated in the Leeds Tetanus Unit. In: Ellis M, ed. Symposium on Tetanus in Great Britain. Leeds General Infirmary; 1967: 1-10."}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613231223895","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613231223895","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613231223895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:38:40Z","timestamp":1787805520000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613231223895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,17]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/01455613231223895"],"URL":"https:\/\/doi.org\/10.1177\/01455613231223895","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,17]]}}}