Quantitative Analysis of Magnetic Resonance Imaging of the Neck and Its Usefulness in Management of Congenital Muscular Torticollis

Kim, Jong Woo; Kim, Seung Hyun; Yim, Shin-Young

doi:10.5535/arm.2015.39.2.294

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…After remission of swelling of the affected SCM, even if atrophic or hyperechogenic changes of SCM muscle are found, their presence alone is not sufficient to confirm the diagnosis. Moreover, if subjects are hesitant to undergo surgery, MRI is used to determine the necessity for operation [ 21 ]. Because most of our subjects were diagnosed after 5 years of age and could be operated upon, MRI was used mainly for diagnosis of CMT, with all enrolled patients undergoing MRI before surgical release.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…The results obtained by Kim et al demonstrated that CMT is more frequently associated with the left SCM muscle [ 41 ]. In this study, with a small difference, there were more cases of left-sided torticollis ( n = 57; 51%) than right-sided torticollis ( n = 54; 49%).…”

Section: Discussionmentioning

confidence: 99%

Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis

Płomiński,

Olesińska,

Kamelska-Sadowska

et al. 2023

Healthcare

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Introduction: Congenital muscular torticollis (CMT) is an asymmetrical head position resulting from structural changes in the sternocleidomastoid (SCM) muscle that occurs early during a child’s development or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. In a typical clinical picture, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. An early diagnosis of CMT in newborns and the implementation of treatment offer the chance of a complete resolution. Torticollis treatment aims to restore the SCM’s normal function. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. The indications that surgery is needed include a marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by >15°. Of all the newborn and infant anomalies, congenital torticollis is the third most common after hip dysplasia and equinovarus deformities. Some authors demonstrate that torticollis coexists with hip dysplasia. Aim: The aim of this study was to collect data on infants referred to paediatric rehabilitation and to identify the risk factors associated with CMT in this group of patients, as well as to assess demographic and clinical characteristics concerning risk factors. Materials and methods: The target population for this retrospective study consisted of 111 infants aged 0 to 5 months born in Poland and diagnosed with and undergoing treatment due to CMT. The following were determined: the relationship between the side of the CMT location and the type of delivery (caesarean section vs. vaginal), the relationship between the body weight at birth and the side of the CMT location, the relationship between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions: The data revealed that CMT is less common in female infants (n = 51, 46%) compared to male (n = 61, 54%) infants, in whom a greater birth weight was reported (p < 005). Seventy-six percent (76%) of the paediatric patients with CMT were the offspring of primipara mothers. More often, children born via vaginal delivery had left-sided torticollis with a more significant broadening of the SCM, as shown on ultrasound scans, than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened and systematised, and further research is needed.

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“…In future, better understanding of this 3D deformity using specialized imaging techniques and measurements can render assessments more objective and reproducible and hopefully may improve treatment outcomes. 6 14 36 …”

Section: Discussionmentioning

confidence: 99%

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

Bhaskar

Harish

Desai³

2017

IJOO

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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.

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Quantitative Analysis of Magnetic Resonance Imaging of the Neck and Its Usefulness in Management of Congenital Muscular Torticollis

Cited by 7 publications

References 18 publications

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

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

Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis

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

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