Arch Otolaryngol
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A comprehensive overview of atlantoaxial instability in Down syndrome as it relates to head and neck surgery and recommendations as derived from a review of the literature. ⋯ A small percentage of patients with Down syndrome are at risk for atlantoaxial instability and subluxation. All patients with Down syndrome should have a preoperative neurologic assessment screening by the operating surgeon and/or a cervical roentgenogram in the lateral, extension, and flexion positions. Any abnormality should be investigated before surgery.