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Congenital muscular torticollis.

Nilesh K, Mukherji S - Ann Maxillofac Surg (2013)

Bottom Line: It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%.Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin.This article reports a case of CMT in a 3½-year-old male child successfully managed by surgical release of the involved SCM followed by physiotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India.

ABSTRACT
Congenital muscular torticollis (CMT) is a rare congenital musculoskeletal disorder characterized by unilateral shortening of the sternocleidomastoid muscle (SCM). It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%. Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin. This article reports a case of CMT in a 3½-year-old male child successfully managed by surgical release of the involved SCM followed by physiotherapy.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photographs. (a) Incision place over mastoid region, the overlying greater auricular nerve (arrow) was identified and protected during dissection. (b) Bot h the clavicular and sternal heads of the sternocleidomastoid muscle were identified and then divided. Sternal end was then sutured to the clavicular cut end in an oblique line to achieve muscle lengthening. (c) The excised lower end of SCM. (d) Closure done and complete neck extension was achieved without any strain intraoperatively
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Figure 2: Intraoperative photographs. (a) Incision place over mastoid region, the overlying greater auricular nerve (arrow) was identified and protected during dissection. (b) Bot h the clavicular and sternal heads of the sternocleidomastoid muscle were identified and then divided. Sternal end was then sutured to the clavicular cut end in an oblique line to achieve muscle lengthening. (c) The excised lower end of SCM. (d) Closure done and complete neck extension was achieved without any strain intraoperatively

Mentions: Physiotherapy was started for the patient to achieve SCM muscle stretching. However, after 8 weeks of exercise, there was no improvement in the condition. Subsequently release of unilateral SCM by bipolar tenotomy was planned. Patient was prepared and taken up for the surgery under general anesthesia. A 2 cm incision was made below the mastoid on the right side. The attachment of SCM muscle to mastoid bone was identified and completely stripped from its bony attachment, protecting the underlying vital structures and overlying greater auricular nerve. A transverse incision of about 2.5 cm was placed above the clavicle-sternum junction on the right side and the platysma was incised. Both the heads of SCM were identified and then divided under direct vision together with deep fascia. The muscle was allowed to retract. The Sternal end was sutured to the clavicular cut end in an oblique line using 4/0 vicryl suture. Hemostasis was attained and skin closed by 4/0 prolene. Complete neck extension was achieved without any strain [Figure 2].


Congenital muscular torticollis.

Nilesh K, Mukherji S - Ann Maxillofac Surg (2013)

Intraoperative photographs. (a) Incision place over mastoid region, the overlying greater auricular nerve (arrow) was identified and protected during dissection. (b) Bot h the clavicular and sternal heads of the sternocleidomastoid muscle were identified and then divided. Sternal end was then sutured to the clavicular cut end in an oblique line to achieve muscle lengthening. (c) The excised lower end of SCM. (d) Closure done and complete neck extension was achieved without any strain intraoperatively
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814673&req=5

Figure 2: Intraoperative photographs. (a) Incision place over mastoid region, the overlying greater auricular nerve (arrow) was identified and protected during dissection. (b) Bot h the clavicular and sternal heads of the sternocleidomastoid muscle were identified and then divided. Sternal end was then sutured to the clavicular cut end in an oblique line to achieve muscle lengthening. (c) The excised lower end of SCM. (d) Closure done and complete neck extension was achieved without any strain intraoperatively
Mentions: Physiotherapy was started for the patient to achieve SCM muscle stretching. However, after 8 weeks of exercise, there was no improvement in the condition. Subsequently release of unilateral SCM by bipolar tenotomy was planned. Patient was prepared and taken up for the surgery under general anesthesia. A 2 cm incision was made below the mastoid on the right side. The attachment of SCM muscle to mastoid bone was identified and completely stripped from its bony attachment, protecting the underlying vital structures and overlying greater auricular nerve. A transverse incision of about 2.5 cm was placed above the clavicle-sternum junction on the right side and the platysma was incised. Both the heads of SCM were identified and then divided under direct vision together with deep fascia. The muscle was allowed to retract. The Sternal end was sutured to the clavicular cut end in an oblique line using 4/0 vicryl suture. Hemostasis was attained and skin closed by 4/0 prolene. Complete neck extension was achieved without any strain [Figure 2].

Bottom Line: It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%.Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin.This article reports a case of CMT in a 3½-year-old male child successfully managed by surgical release of the involved SCM followed by physiotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India.

ABSTRACT
Congenital muscular torticollis (CMT) is a rare congenital musculoskeletal disorder characterized by unilateral shortening of the sternocleidomastoid muscle (SCM). It presents in newborn infants or young children with reported incidence ranging from 0.3% to 2%. Owing to effective shortening of SCM on the involved side there is ipsilateral head tilt and contralateral rotation of the face and chin. This article reports a case of CMT in a 3½-year-old male child successfully managed by surgical release of the involved SCM followed by physiotherapy.

No MeSH data available.


Related in: MedlinePlus