Abstract：
BACKGROUND: Atlantoaxial rotatory fixation (AARF) is a rare condition that occurs most commonly in children. The torticollis caused by AARF usually presents as abnormal posturing of the head and neck, with rotation of the chin to the opposite side. AARF in children could occur due to congenital bony malformation, minor trauma, upper respiratory tract infections (Grisel\'s syndrome), postoperatively after head and neck (ENT) surgery, and unknown reasons. AARF in the postoperative patient is a rare and poorly understood entity.
METHODS: The authors present a case report of a 2-year-old boy with Crouzon Syndrome undergoing posterior calvarial vault expansion (PVE) surgery that developed AARF as a complication.
RESULTS: The authors believe that cranial vault surgery should be considered a potential risk procedure for AARF, especially if it is done in susceptible populations (syndromic craniosynostosis patients) with other underlying sequelae (tonsillar ectopia or syringomyelia). During surgery, careful attention should be paid to maintaining a neutral alignment of the patient\'s cervical spine as rotatory movements under anaesthesia and muscle relaxation may be contributory factors.
CONCLUSIONS: AARF should be suspected and investigated in children with painful torticollis after craniofacial surgery.
METHODS: The authors present a case report of a 2-year-old boy with Crouzon Syndrome undergoing posterior calvarial vault expansion (PVE) surgery that developed AARF as a complication.
RESULTS: The authors believe that cranial vault surgery should be considered a potential risk procedure for AARF, especially if it is done in susceptible populations (syndromic craniosynostosis patients) with other underlying sequelae (tonsillar ectopia or syringomyelia). During surgery, careful attention should be paid to maintaining a neutral alignment of the patient\'s cervical spine as rotatory movements under anaesthesia and muscle relaxation may be contributory factors.
CONCLUSIONS: AARF should be suspected and investigated in children with painful torticollis after craniofacial surgery.
摘要：
背景：寰枢椎旋转固定术（AARF）是一种罕见的疾病，最常见于儿童。由AARF引起的斜颈通常表现为头部和颈部的异常姿势。下巴旋转到相反的一侧。儿童AARF可能是由于先天性骨畸形而发生的，轻微的创伤,上呼吸道感染（格里尔综合征），头颈部（ENT）手术后，和未知的原因。术后患者的AARF是一种罕见且鲜为人知的实体。
方法：作者介绍了一例2岁男孩患有Crouzon综合征的病例报告，该病例接受后颅骨穹窿扩张（PVE）手术，导致AARF并发症。
结果：作者认为颅骨手术应被视为AARF的潜在风险程序，特别是如果它是在易感人群（综合征性颅骨融合患者）与其他潜在的后遗症（扁桃体异位或脊髓空洞症）。手术期间,应特别注意保持患者颈椎的中性排列，因为麻醉下的旋转运动和肌肉松弛可能是促成因素。
结论：在颅面手术后患有疼痛性斜颈的儿童中，应该怀疑和调查AARF。
方法：作者介绍了一例2岁男孩患有Crouzon综合征的病例报告，该病例接受后颅骨穹窿扩张（PVE）手术，导致AARF并发症。
结果：作者认为颅骨手术应被视为AARF的潜在风险程序，特别是如果它是在易感人群（综合征性颅骨融合患者）与其他潜在的后遗症（扁桃体异位或脊髓空洞症）。手术期间,应特别注意保持患者颈椎的中性排列，因为麻醉下的旋转运动和肌肉松弛可能是促成因素。
结论：在颅面手术后患有疼痛性斜颈的儿童中，应该怀疑和调查AARF。
