The lymphatic drainages of the upper cervical joints are primarily into
the retropharyngeal lymphatic nodes and then into the deep cervical
chain. These nodes also drain the paranasal sinuses, the nasopharynx
and retropharyngeal area. As a result, a retrograde inflammatory change
may affect the synovial lining of the craniocervical joint complex with
resultant effusion and instability, even neurological deficit. This has
been referred to as “Grisel’s syndrome”.
It was shown that (by Parke et al.)
pharyngovertebral veins may have frequent lymphovenous anastomosis. The
periodontal venous plexus in the suboccipital epidural sinuses appears
to have a direct communication with the pharyngovertebral veins. This
may result in osteomyelitis of the craniocervical joints due to
infection in the paravertebral region. Thus, there is an added route
for septic involvement of the craniocervical junction.
Grisel P (1930) Enucleation des l’atlas et torticollis
nasopharyngien. Presse Med 38:50
ParkeWW, Rothman RH, BrownMD (1984) The pharyngovertebral veins. An
anatomical rationale for Grisel’s syndrome. J Bone Jt Surg Am
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