Differential Diagnosis for Acute Postoperative Torticollis after Mastoid Surgery
Single Most Likely Diagnosis
- Muscle spasm or hematoma: This is the most likely diagnosis due to the proximity of the surgical site to the muscles of the neck, which can lead to spasm or hematoma formation, causing torticollis.
Other Likely Diagnoses
- Infection or abscess: Postoperative infections can occur, leading to inflammation and torticollis. The mastoid area is close to critical structures, making infection a plausible cause.
- Nerve injury: Damage to the nerves in the neck during surgery can result in muscle weakness or spasm, leading to torticollis.
- Soft tissue injury: Injury to the soft tissues of the neck during surgery can cause pain and stiffness, resulting in torticollis.
Do Not Miss Diagnoses
- Cerebral venous sinus thrombosis: Although rare, this is a potentially life-threatening condition that can occur after mastoid surgery, especially if there is a history of coagulopathy or infection.
- Meningitis: Postoperative meningitis is a serious complication that can present with neck stiffness, among other symptoms.
- Stroke or cerebral vasospasm: These conditions can occur due to surgical complications or pre-existing vascular conditions, and it is crucial to rule them out in the case of acute postoperative torticollis.
Rare Diagnoses
- Atlantoaxial subluxation: This is a rare condition that can occur due to ligamentous laxity or bony abnormalities, potentially exacerbated by surgery.
- Eagle syndrome: This condition, caused by an elongated styloid process, can lead to neck pain and torticollis, although it is relatively rare.
- Dystonic reaction: Certain medications used during or after surgery can cause dystonic reactions, leading to abnormal posturing, including torticollis.