The Transaxillary Subcutaneous Endoscopic Sternocleidomastoid Muscle Division as an Approach for the Surgical Treatment of Congenital Muscular Torticollis in Children

Pan, Pradyumna

doi:10.1007/s12070-019-01770-3

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…Eine weitere Option liegt in der Kombination der biterminalen Tenotomie mit zusätzlicher Z‑Plastik im distalen Muskelbereich [ 9 ]. Zudem wurden verschiedene endoskopische Verfahren beschrieben [ 3 , 19 ].…”

Section: Vorbemerkungenunclassified

Operative Behandlung des Torticollis muscularis congenitus

Plöeger

Trillhaase

Rommelspacher

et al. 2023

Oper Orthop Traumatol

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Zusammenfassung Operationsziel Operative Korrektur des Torticollis muscularis congenitus (TMC) mit triterminaler Tenotomie des M. sternocleidomastoideus (SCM) sowie postoperativer Behandlung in der Spiegel-Orthese. Indikationen Muskulär bedingter Torticollis im Rahmen einer Kontraktur des SCM, nach Versagen der konservativen Therapie ab dem 2. Lebensjahr. Kontraindikationen Torticollis im Rahmen einer ossären Anomalie oder aufgrund anderer muskulärer Kontrakturen Operationstechnik Durchtrennung des M. sternocleidomastoideus (SCM) am Ursprung und Ansatz (klavikulär und sternal) mit Resektion der Sehne von ca. 1 cm im Bereich des Ansatzes. Weiterbehandlung Postoperative Anlage der Spiegel-Orthese. Tragen der Orthese 24 h/Tag für die ersten 6 Wochen postoperativ, danach Tragen der Orthese 12 h/Tag für weitere 6 Wochen. Ergebnisse Operiert wurden n = 13 Patienten mit TMC. Das Follow-up betrug im Durchschnitt 25,7 Monate, bei 1 Patienten kam es nach 3 Jahren zu einem Rezidiv. Weder intra- noch postoperative Komplikationen wurden beobachtet.

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Section: Vorbemerkungenunclassified

Operative Behandlung des Torticollis muscularis congenitus

Plöeger

Trillhaase

Rommelspacher

et al. 2023

Oper Orthop Traumatol

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“…Surgical treatment is performed when conservative methods fail to improve the condition. Indications that surgery is needed include a marked shortening of the SCM muscle, persistent muscle fibrosis, persistent head and facial asymmetry, and rotation or lateral flexion in the cervical spine region restricted by >15° [ 27 , 29 ]. Most authors believe that surgery should be performed around one year of age.…”

Section: Introductionmentioning

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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“…However, in cases where conservative methods are ineffective, additional therapies, including non-invasive and surgical interventions, are necessary ( 6 , 7 ). For optimal outcomes, surgical intervention is recommended within the age range of one to four years ( 8 - 10 ). Indications for surgical intervention in CMT include children who are more than one year old with cervical passive or active limitations in rotation or/and side flexion ranging from ten to fifteen degrees, those who are more than seven months old with sternocleidomastoid muscle (SCM) mass, and those who have shown poor response to conservative treatment ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with postoperative muscle reconnection in children’s congenital muscular torticollis

Guo,

Zheng,

Zhang

et al. 2023

Transl Pediatr

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Background In prior studies, there has been no report of clinical observation of postoperative reconnection of the sternocleidomastoid muscle (SCM) in children with congenital muscular torticollis (CMT). Therefore, the objective of this study is to investigate the factors associated with postoperative reconnection of the SCM in children with CMT, and to provide clinical evidence. Methods A retrospective study was conducted, wherein 83 CMT children without any missing data were followed up from November 2019 to June 2021. The age at the time of surgery, sex, preoperative and postoperative follow-up duration, laterality, neck mass history, preoperative physical therapy history, and severity type were recorded. The severity classification of CMT was based on clinical features and ultrasound images of SCM. The postoperative reconnection of SCM was measured. Results Out of 83 patients, ten had postoperative reconnection. The rate of postoperative reconnection of SCM in children with CMT who had undergone unipolar SCM release surgery was 18.994 times higher than in patients who had not undergone such surgery. This difference was statistically significant [odds ratio (OR) =18.994, 95% confidence interval (CI): 1.583 to 227.897, P=0.020]. Conclusions The history of SCM release surgery in CMT children can predict the postoperative reconnection of SCM, which will aid in determining the optimal surgical approach for recurrent CMT patients.

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The Transaxillary Subcutaneous Endoscopic Sternocleidomastoid Muscle Division as an Approach for the Surgical Treatment of Congenital Muscular Torticollis in Children

Cited by 8 publications

References 14 publications

Operative Behandlung des Torticollis muscularis congenitus

Operative Behandlung des Torticollis muscularis congenitus

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

Factors associated with postoperative muscle reconnection in children’s congenital muscular torticollis

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