Effectiveness of Surgical Treatment for Neglected Congenital Muscular Torticollis

Kim, Hyun Jung; Ahn, Hyeong Sik; Yim, Sang‐Youp

doi:10.1097/prs.0000000000001373

Cited by 34 publications

(29 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…15 The effectiveness of surgical release was significant even in patients with neglected CMT aged 15 or older. 16 Our study also has a similar result. The eldest among our study group also of 18 years age has shown an excellent result, whereas the child of 7 years age has a fair correction only.…”

Section: Discussionsupporting

confidence: 85%

Result of Sternocleidomastoid Release in the Management of Congenital Muscular Torticollis

Sahoo¹,

Sahu²,

Ujade³

et al. 2018

Indian Journal of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

Background: Congenital muscular torticollis (CMT), primarily a neck deformity resulting from shortening of the sternocleidomastoid muscle that leads the head to turn towards the affected side and the chin points to the opposite side. In developing countries, the parent often neglects and present late, when conservative management has a limited role. Various surgical procedures have been described for the correction of the deformity. The purpose of this study is to find out the result of SCM release followed by definite rehabilitation protocol. Materials and methods:Twelve cases confirming to inclusion criteria were operated on for congenital muscular torticollis. The affected side, either unipolar or bipolar sternocleidomastoid muscle release was done, depending on preoperative assessment. The sternal head was lengthening by Z-plasty method to maintain the shape of suprasternal notch. Postoperatively all the patients had followed a definite rehabilitation protocol.Results: Clinical and functional results were assessed using modified Lee's scoring system and Tanabe's assessment criteria for torticollis. Results were satisfactory in all the cases except two cases. Conclusion:The sternocleidomastoid release is an effective technique for the management of congenital muscular torticollis. The procedure is relatively complication free and safe method with predictable outcomes.

show abstract

Section: Discussionsupporting

confidence: 85%

Result of Sternocleidomastoid Release in the Management of Congenital Muscular Torticollis

Sahoo¹,

Sahu²,

Ujade³

et al. 2018

Indian Journal of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

show abstract

“…However, for various reasons some CMT patients do not proceed with surgical release even though they meet the clinical criteria. Neglected CMT is stated for those patients who did not undergo operative treatment within adequate time [ 14 , 15 ]. There has also been considerable debate over the effectiveness and necessity of invasive surgical release in patients with neglected CMT aged 5 years and older [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Surgical Release in Patients With Neglected Congenital Muscular Torticollis According to Age at the Time of Surgery

et al. 2016

Self Cite

View full text Add to dashboard Cite

ObjectiveTo identify the correlation between change in spinal deformities after surgical release and age at the time of surgery, and the effectiveness of surgical release in patients with neglected congenital muscular torticollis (CMT).MethodsThis was a retrospective study of 46 subjects with neglected CMT who had undergone surgical release at age ≥5 years at a tertiary medical center between January 2009 and January 2014. Spinal deformities were measured on anteroposterior plain radiographs of the cervical and whole spine, both preoperatively and postoperatively, to assess 3 parameters: cervicomandibular angle (CMA), lateral shift (LS), and Cobb angle (CA). We analyzed the change in spinal deformities after surgical release in consideration of age at the time of surgery.ResultsThe median age at the time of surgery was 12.87 years. All 3 parameters showed significant improvement after surgical release (median values, pre- to post-surgery: CMA, 12.13° to 4.02°; LS, 18.13 mm to 13.55 mm; CA, 6.10° to 4.80°; all p<0.05). There was no significant correlation between age at the time of surgery and change in CMA (R=0.145, p=0.341) and LS (R=0.103, p=0.608). However, CA showed significant improvement with increasing age (R=0.150, p=0.046).ConclusionWe assessed the correlation between change in spinal deformities after surgical release and age at the time of surgery. We found that that surgical release is effective for spinal deformities, even in older patients. These findings enhance our understanding of the effectiveness and timing of surgical release in patients with neglected CMT.

show abstract

“…Thus, Shim and Jang suggest that surgery for CMT may be delayed until children can comply with rigorous postoperative rehabilitation protocol 12. Moreover, complete restoration of FA is not always possible and parents of older children must be counseled accordingly before embarking on surgical intervention 1015173334…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have used radiographic parameters such as the Cobb angle or cervico-mandibular angle (CMA) to measure the neck tilt, but plastic and craniofacial surgeons have used complex cephalometric indices before planning reconstructive surgery 12131415. These changes in craniofacial deformity parameters are becoming increasingly important in future studies to assess the outcome of surgical treatment of torticollis 1617. One study has reported statistically significant facial changes in CMT compared to normal cohort using the three-dimensional (3D) photogrammetry 18…”

Section: Introductionmentioning

confidence: 99%

Congenital muscular torticollis: Use of gaze angle and translational deformity in assessment of facial asymmetry

Bhaskar

Harish

Desai³

2017

IJOO

View full text Add to dashboard Cite

Background:Assessment of facial asymmetry is challenging in torticollis deformity. Neck tilt in toroticollis is associated with deviation of horizontal ocular gaze and translation of neck from the midline. These deviations can be assessed clinically and can be used as surrogate marker for facial asymmetry.Materials and Methods:Thirty five children with congenital muscular torticollis (CMT) were classified into three grades of severity based on the new clinical score. The parameters included in the scoring system included rotational deficit, side flexion deficit, gaze angle (GA), and translational deformity (TD). Seven children had Grade I (mild), 18 had Grade II (moderate), and 10 had Grade III (severe) CMT. There were 21 girls and 14 boys with a mean age of 8.46 years (range 3–16 years). Twenty two children underwent a bipolar release, and 13 had unipolar surgery. Facial asymmetry (FA) signs were noted and based on GA and TD; all children had a deviation from the neutral angles (GA of 90° and 0 mm translation from the midsterna plumb line were considered neutral angle). The final outcome was based on the modified Cheng and Tang Score.Results:The mean GA in Grade I, II, and III improved from 81.71 to 90, 72.77 to 89.16, and 66.60 to 88, respectively (Chi-square P < 0.0001). The TD improved from 15 mm to 0 mm, 25.83 mm to 3.05 mm, and 36.6 mm to 6 mm in Grade I, II, and III, respectively (Chi-square P < 0.05). The rotational and side flexion deficits also improved across all grades of severity but were not statistically significant (P < 0.911 and P < 0.04). Twenty four children had an excellent outcome with complete correction of their GA and TD. Four children with Grade II CMT and seven children with Grade III who had a residual translation of 5 mm or more and GA less than neutral horizontal had a good outcome. No child had problems with scar cosmesis or prominent lateral bands, and there was no recurrence of deformity at a mean followup of 28 months (range 24–32 months).Conclusion:The GA and TD can be used to assess FA in torticollis management and significant improvement can be expected even in severe cases.

show abstract

Effectiveness of Surgical Treatment for Neglected Congenital Muscular Torticollis

Abstract: Therapeutic, IV.

Cited by 34 publications

References 46 publications

Result of Sternocleidomastoid Release in the Management of Congenital Muscular Torticollis

Result of Sternocleidomastoid Release in the Management of Congenital Muscular Torticollis

Effectiveness of Surgical Release in Patients With Neglected Congenital Muscular Torticollis According to Age at the Time of Surgery

Congenital muscular torticollis: Use of gaze angle and translational deformity in assessment of facial asymmetry

Contact Info

Product

Resources

About