Abstract

VILLEGAS-ALZATE, F.J.  and  CUADROS-SERRANO, C.A.. Congenital muscular torticollis: point of view of plastic surgeon. Cir. plást. iberolatinoam. [online]. 2014, vol.40, n.1, pp.43-54. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922014000100007.

Congenital muscular torticollis is a relatively common disorder, presenting at birth as a fibrous band or tumor in the sternocleidomastoid muscle, which causes progressive restrictive changes reflected in head and face growth disorders, abnormal posturing, and deficits in rotation and lateral flexion of the neck. Timely diagnosis and treatment can prevent sequelae, such as amblyopia and craniofacial asymmetry, which are difficult to correct once established. Clinical cases that do not respond to conservative treatment may benefit from surgery. We present our experience of surgical treatment of torticollis reporting 16 cases ranging from 9 to 32 years of age, with follow-up ranging from 10 weeks to 15 years. Surgical treatment involved 3 tenotomies of the sternocleidomastoid muscle insertions accomplished through two small incisions. Positional results were quantified by comparing angular measurements in preoperative and postoperative photographs, using frontal and posterior views, demonstrating corrections between 53 and 100% with an average of 83% . In some cases, neck mobility measurements were performed during consultation using a handmade protractor. In all cases, substantial improvement was achieved. There were no wound-healing complications and scars were acceptable. The appearance of the lateral neck column at the sites of the muscle incisions regained its continuity without a visible sharp step-off. There was no correlation betwe en severity of the deformity (measured in degrees) or patient age and the degree of correction achieved. Despite older age and increased severity in some cases, the improvement remained substantial.

Keywords : Congenital torticollis; Neck muscles Sternocleidomastoid; Tenotomies.

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