Management of neglected cases of congenital muscular torticollis with bipolar release

2016 ◽  
Vol 2 (4) ◽  
pp. 400
Author(s):  
Ranajit Panigrahi ◽  
Biswajit Sahu ◽  
Saswat Samant
Keyword(s):  
Head Tilt ◽  
Postoperative Management ◽  
Functional Improvement ◽  
Mastoid Process ◽  
Inclusion Criteria ◽  
Congenital Muscular Torticollis ◽  
Congenital Torticollis ◽  
One Year ◽  
Muscular Torticollis

<p class="abstract"><strong>Background:</strong> Congenital muscular torticollis (CMT) is the third most common congenital musculoskeletal anomaly in children. After the age of one year functional and cosmetic benefits require corrective surgery. Neglected congenital torticollis is commoner in developing countries. The purpose of this study was to evaluate the results of bipolar release in this age group<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> 16 cases were operated on for<strong> </strong>neglected congenital muscular torticollis. Inclusion criteria<strong> </strong>included age of more than ten years, absence of any previous<strong> </strong>surgery, and absence of any known pathology. Inferior release<strong> </strong>was done through an incision 1 cm above the medial<strong> </strong>third of the clavicle. The clavicular head was released<strong> </strong>completely while the sternal head was lengthened by<strong> </strong>z-plasty. The mastoid head was released though an incision<strong> </strong>just below the tip of the mastoid process. The postoperative management included physiotherapy with halter traction. Neck ROM, head tilt, craniofacial asymmetry were assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Excellent results were noted in four patients, good in eight, fair in two, and poor in two<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> We believe that bipolar release is a very viable option for correcting neglected CMT as it brought about both functional improvement as well as improvement in cosmesis, resulting in improved quality of life<span lang="EN-IN">.</span></p>

scholarly journals Management of congential muscular toticollis under one year of age

2012 ◽  
Vol 1 (2) ◽  
pp. 2-5
Author(s):  
Abdul Matin ◽  
Md Rafiqul Islam ◽  
Ranjit Ranjan Roy ◽  
Bijoy Krishna Das ◽  
Sudesh Chandra Rakshit ◽  
...  
Keyword(s):  
Head And Neck ◽  
Sternocleidomastoid Muscle ◽  
Medical College Hospital ◽  
College Hospital ◽  
Congenital Muscular Torticollis ◽  
Medical College ◽  
One Year ◽  
Neonates And Infants ◽  
Muscular Torticollis ◽  
Postural Deformity

Background and study aim: Torticollis is the postural deformity of head and neck. Congenital Muscular Torticollis (CMT) is a postural deformity of head and neck detected at birth or shortly after birth, primarily resulting from unilateral shortening of Sternocleidomastoid muscle (SCM), In neonates and infants, patient may cure conservatively by physiotherapy but surgery is the treatment of choice for children and adolescents. Here we show our experience regarding management of congenital muscular torticollis with physiotherapy. Patients and Methods: This is an observational descriptive study. Verbal consent from parents was taken. Patients of congenital muscular torticollis with other disease or other congenital anomaly were excluded from study. Twenty patients of congenital muscular torticollis were treated. The cases were enrolled between Nov' 2005 to Oct' 2008 in Bangabandhu Sheikh Mujib Medical University, Gonosasthaya Somaj Vittik Medical College Hospital, ZH Sikder Women's Medical College Hospital, Shaheed Shurawardy Medical College Hospital. Neonates and infants were treated conservatively with physiotherapy and non responsive cases were referred for surgery. Results: Patients age range from 5 days to 1 year of which eleven were females and nine were males. Sternocleidomastoid muscle (SCM) was shortened in all cases (12 on right side and 8 on left side). Of 20 patients 6 neonates, rest 14 infants within 1 year age. Out of 20 neonates and infants 17 were cured conservatively with physiotherapy and rest 3 were referred for surgery. Conclusion: Most of the patient of congenital muscular torticollis can be treated conservatively during infancy. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12157 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.2-5

scholarly journals Results of Minimally Invasive Bipolar Tenotomy of Congenital Muscular Torticollis

2019 ◽  
Vol 60 (01) ◽  
pp. 016-020
Author(s):  
Ramji Sahu
Keyword(s):  
Postoperative Complications ◽  
Orthopedic Surgery ◽  
Head Tilt ◽  
Good Method ◽  
Range Of Movement ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis ◽  
Postural Deformity ◽  
Difficult Cases

Background Congenital muscular torticollis is the postural deformity of the head and of the neck. The purpose of the present study is to evaluate the results of bipolar sternocleidomastoid (SCM) muscle tenotomy in children. Methods The present prospective study was conducted at the Department of Orthopedic Surgery from December 2010 to December 2014. A total of 34 children with congenital muscular torticollis and a mean age of 4.8 years (range: 1–14 years) were recruited from the Outpatient Department. They were treated with bipolar SCM muscle release under general anesthesia. The functional and cosmetic results were rated on a scoring system modified from Lim et al (2014). All of the children were followed-up for 2 years. Results At the final follow-up, the neck range of movement and head tilt improved and their appearance were cosmetically improved despite the long-standing nature of the deformity. The results were excellent in 30 patients (88.23%) and good in 4 patients (11.76%). No postoperative complications were found in any of the 34 patients. Conclusion Bipolar tenotomy of the SCM muscle is a good method for correcting difficult cases of congenital muscular torticollis. It is a safe, effective and complication-free method for these patients.

Effectiveness of hydrotherapy in congenital muscular torticollis

2021 ◽  
pp. 83-85
Keyword(s):  
Physical Therapy ◽  
Conservative Treatment ◽  
Surgical Intervention ◽  
Musculoskeletal Diseases ◽  
Head Tilt ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis

Congenital muscular torticollis (CMT); is one of the musculoskeletal diseases seen in the neonatal and infant period. It is formed as a result of stretching the sternocleidomastoid (SCM) muscle in childhood. Due to unilateral contraction of the SCM muscle, ipsilateral head tilt, contralateral face and jaw rotation occur. Exercise and positioning in physical therapy constitute the conservative treatment of CMT. Hydrotherapy treatment has not been used in CMT cases. However, most of the CMT which are not treated early are resolved by surgical intervention. In this case, the effectiveness and success of exercise and hydrotherapy on the patient with CMT were presented.

Ipsilateral Hypertrophy of the Mastoid Process in Surgical Cases of Congenital Muscular Torticollis

2019 ◽  
Vol 56 (10) ◽  
pp. 1295-1301 ◽  
Author(s):  
Hyun Gi Kim ◽  
Shin-Young Yim
Keyword(s):  
Linear Regression Analysis ◽  
Cross Sectional Study ◽  
Linear Increase ◽  
Mastoid Process ◽  
Control Group ◽  
Cross Sectional ◽  
Congenital Muscular Torticollis ◽  
Significant Difference ◽  
Muscular Torticollis ◽  
Volume Difference

Objective:This study was to investigate ipsilateral hypertrophy of the mastoid process in the patients with congenital muscular torticollis (CMT).Design:Retrospective cross-sectional study.Patients:Children with CMT.Methods:A total of 212 surgical cases of patients with CMT (age: 50.9 ± 44.3 months) and 212 age- and gender-matched controls (age: 50.4 ± 44.2 months) were included. The mastoid process volume was calculated and compared for both groups on the computed tomography axial images. A linear regression analysis was performed between the age and the intrasubject volume difference in the mastoid process.Results:The volume of the mastoid process in the CMT side was significantly larger than that of the non-CMT side in the CMT group (32.2 ± 30.3 cm3vs 21.9 ± 22.8 cm3; P < .001). In the control group, there was no significant difference between the volume of the right and left mastoid process (21.6 ± 24.6 cm3vs 21.2 ± 23.8 cm3; P = .472). The intrasubject volume difference in the mastoid process in the CMT group showed a linear increase with the age (adjusted R2= 0.286; P < .001), and the volumetric asymmetry of the mastoid process became more severe over age compared to the control group.Conclusion:We showed ipsilateral hypertrophy of the mastoid process in patients with CMT and demonstrated that the volumetric asymmetry increased with age.

Congenital Muscular Torticollis

1996 ◽  
Vol 17 (10) ◽  
pp. 374-375
Author(s):  
Nathaniel H. Robin
Keyword(s):  
Range Of Motion ◽  
Head Tilt ◽  
Facial Asymmetry ◽  
Newborn Period ◽  
Congenital Muscular Torticollis ◽  
Thoracic Scoliosis ◽  
Affected Side ◽  
Head Control ◽  
Muscular Torticollis

Congenital muscular torticollis (CMT) refers to unilateral contracture of the sternocleidomastoid (SCM) muscle that restricts the infant's range of motion at the neck, with the head tilted toward the shortened SCM and the chin rotated to point away from the affected side. Although a mass often is palpable in the inferior part of the affected SCM, in many cases this is not appreciated in the immediate newborn period; the condition may be recognized only as the infant develops better head control over the first few weeks of life, making the head tilt more obvious. Potential complications of CMT include facial asymmetry and plagiocephaly from the uneven tension produced by the contracted SCM as well as cervical scoliosis, with a compensatory thoracic scoliosis.

scholarly journals Congenital Muscular Torticollis: A Descriptive Study of 16 Cases

2012 ◽  
Vol 34 (3) ◽  
pp. 92-98
Author(s):  
Bijoy Krishna Das ◽  
Abdul Matin ◽  
Ranjit Ranjan Roy ◽  
Md Rafiqul Islam ◽  
Rezaul Islam ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Head And Neck ◽  
Older Children ◽  
College Hospital ◽  
Congenital Muscular Torticollis ◽  
Medical College ◽  
One Year ◽  
Neonates And Infants ◽  
Muscular Torticollis ◽  
Postural Deformity

Background and study aim: Torticollis is the postural deformity of head and neck. Congenital Muscular Torticollis (CMT) is a postural deformity of head and neck detected at birth or shortly after birth, primarily resulting from unilateral shortening of Sternocleidomastoid muscle (SCM). In neonates and infants, patient may be cured conservatively by physiotherapy but surgery is the treatment of choice for children and adolescents. There are various techniques of surgery. Division of both sternal and clavicular head of SCM is very easy method which was practiced in this study. Here we show our experience regarding conservative and surgical management of congenital muscular torticollis in neonates, infants and older children. Patients and Methods: This is a retrospective case study among sixteen patients of congenital muscular torticollis. The cases were enrolled consecutively between Nov’ 2005 to Oct’ 2008 in Bangabandhu Sheikh Mujib Medical University, Gonosasthaya Somaj Vittik Medical College Hospital, ZH Sikder Women’s Medical College Hospital and different private clinics of Dhaka city of Bangladesh. Neonates and infants of were treated conservatively with physiotherapy by manual stretching and others (more than one year) were treated surgically by transection of both sternal and clavicular head of SCM under ganeral anesthesia. Operated patients were released on following post operative day with advice to start physiotherapy on same day. Acquired torticollis, ocular torticollis, neurogenic torticllis, osteogenic torticollis, congenital muscular torticollis with other diseases were excluded from the study. Parents were the informants. Purpose of the study was explained and verbal consent was taken. Written consent was taken before surgical intervention. Results: Patients age ranged from 5 days to 15 years of which eleven were female and five male. SCM was shortened in all cases (9 on right side and 7 on left side). Of 16 patients, 3 neonates, 8 infants and 5 were more than 1 year of age. There was no associated anomaly. Out of 11 neonates and infants 10 cured conservatively with physiotherapy and another one significantly improved. Six were treated surgically including one failed physiotherapy till the age of one year. Post operative period was uneventful and there was no complication. Results were evaluated clinically and on the comments of parents. Conclusion: Most of the patients of congenital muscular torticollis can be treated conservatively during infancy. Division of both sternal and clavicular head of SCM is easy and safe surgical technique for the treatment of CMT of older children and adolescents. DOI: http://dx.doi.org/10.3329/bjch.v34i3.10359 BJCH 2010; 34(3): 92-98

scholarly journals A Surgical Treatment for Adult Muscular Torticollis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Song Ho Chang ◽  
Seiji Ohtori ◽  
Akihiko Okawa ◽  
Koui Kawamura ◽  
Hiroshi Saiki ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Treatment Option ◽  
Male Patient ◽  
Head Tilt ◽  
Sternocleidomastoid Muscle ◽  
Neck Movement ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis ◽  
Adult Presentation

Adult presentation of neglected congenital muscular torticollis (CMT) is rare. Therefore, efficacy of surgical treatment for adult CMT is unclear. We experienced a case of neglected CMT in a 28-year-old male patient and report the surgical result here. We conducted unipolar resection at the distal end of the sternocleidomastoid muscle (SCM). After surgery, the range of neck movement and head tilt improved, and his appearance was cosmetically improved despite the long-standing nature of the deformity. We concluded that surgical management of adult patients with neglected congenital muscular torticollis may be a treatment option.

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