Background: Congenital muscular torticollis (CMT), primarily a neck deformity resulting from shortening of the sternocleidomastoid muscle that leads the head to turn towards the affected side and the chin points to the opposite side. In developing countries, the parent often neglects and present late, when conservative management has a limited role. Various surgical procedures have been described for the correction of the deformity. The purpose of this study is to find out the result of SCM release followed by definite rehabilitation protocol.
Materials and methods: Twelve cases confirming to inclusion criteria were operated on for congenital muscular torticollis. The affected side, either unipolar or bipolar sternocleidomastoid muscle release was done, depending on preoperative assessment. The sternal head was lengthening by Z-plasty method to maintain the shape of suprasternal notch. Postoperatively all the patients had followed a definite rehabilitation protocol.
Results: Clinical and functional results were assessed using modified Lee\'s scoring system and Tanabe\'s assessment criteria for torticollis. Results were satisfactory in all the cases except two cases.
Conclusion: The sternocleidomastoid release is an effective technique for the management of congenital muscular torticollis. The procedure is relatively complication free and safe method with predictable outcomes.
Cheng JCY, Tang SP, Chen TMK, et al. The clinical presentation and outcome of treatment of Congenital muscular torticollis in infants–A study of 1086 cases. J Pediatr Surg 2000;35(7):1091- 1099
Cheng JCY, Wong MWN, Tang SP, et al. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. J Bone Joint Surg Am 2001;83:679-687
Hollier L, Kim J, Grayson B, et al. Congenital muscular torticollis and the associated craniofacial changes. Plast Reconstr Surg 2000;105:827-835.
Arsalan H, Gunduz S, Subasi M, et al. Frontal cephalometric analysis in the evaluation of facial asymmetry in torticollis and outcome of bipolar release in patients over 6 years of age. Arch Orthop Trauma Surg 2002;122:489-493.
Do TT. Congenital muscular torticollis: Current concept and review of treatment. Curr Opin Pediatr 2006;18(1):26-29.
Lee EH, Kang YK, Bose K. Surgical correction of muscular torticollis in the older child. J Pediatr Orthop 1986;6(5): 585-589.
Tanabe G, Imai T, Oda K. Late outcome of myotomy of the sternocleidomastoid muscle for congenital muscular torticollis. Seikei Geka 1968;19:900-905
Amemiya M, Kikkawa I, Watanabe H, et al. Outcome of treatment for congenital muscular torticollis: A study on ages for treatment, treatment methods and postoperative therapy. Eur J Orthop Surg Traumatol 2009;19:303-307.
Sonmez K, Turkyilmaz Z, Demirogullary B, et al. Congenital muscular torticollis in children. ORL J Otorhinolaryngol Relat Spec 2005;67(6):344-347.
Sudesh P, Bali K, Mootha AK, et al. Result of bipolar release in the treatment of congenital muscular torticollis in patients older than 10 years age. J Child Orthop 2010;4(3):227-232.
Ling CM. The influence of age on the result of open steromastoidtenotomy in muscular torticollis. Clin Orthop Relat Res 1976;116:142-148
Tse P, Cheng J, Chow Y, et al. Surgery for neglected congenital torticollis. Acta Orthop Scand 1987;58:270-272.
Lim KS, Shim JS, Lee YS. Is sternocleidomastoid muscle release effective in adults with neglected congenital muscular torticollis. Clin Orthop Relat Research 2014;472:1271-1278.
Kim HJ, Ahn HS, Yim SY. Effectiveness of surgical treatment for neglected congenital muscular torticollis: a systemic review and meta-analysis. Plast Reconstr Surg 2015;136:67-77.
Kubo T, Ueda S, Nakamura M, et al. Clinical result of surgical treatment for muscular torticollis in the older children. Seikei Geka 1993;44:378-382
Kamegaya M. Congenital muscular torticollis: recent views and management. Jpn J Pediatr Surg 2005;37:1326-1332.
Jong SS, Kyu CN, Seung JP. Treatment of congenital muscular torticollis in patients older than 8 years. J Pediatr Orthop. 2004;24:683-688.
Lee IJ, Lim SY, Song HS. Complete tight fibrous band release and resection in congenital muscular torticollis. J Plast Reconstr Aesthet Surg. 2010;63:947-953.
Chin-En C, Jih-Yang K. Surgical treatment of muscular torticollis for patients above 6 years age. Arch Orthop trauma Surg 2000;120:149-151
Huseyin A, Seher G, Mehmet S, et al. Frontal cephalometric analysis in the evaluation of facial asymmetry in torticollis, and outcome of bipolar release in patients over 6 years age. Arch Orthop Trauma Surg 2002;122:489-493.
Panigrahi R, Sahu B, Samant S. Management of neglected case of congenital muscular torticollis with bipolar release. Int J of Res in Orthop 2016;2(4):400-403.