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Tonsillectomy is one of the most common operations performed by the otolaryngologist. Deep-neck infections are among the possible complications associated with this procedure. We encountered a case of osteomyelitis of the cervical spine occurring subsequent to an otherwise uncomplicated tonsillectomy. Although never previously reported with tonsillectomy to our knowledge, cervical osteomyelitis has been associated with other procedures and infections of the head, neck, and maxillofacial regions. Mechanisms that might explain this occurrence include direct extension via fascial planes, direct venous and lymphatic spread, and hematogenous dissemination from the contaminated surgical site. Treatment consisted of drainage and débridement of the infection, cervical immobilization, and long-term antibiotic administration. Healing was complete and cervical mobility and stability were normal at three months. Early recognition of this unusual complication of tonsillectomy is imperative to avoid potential neurologic sequelae.
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