EC Paediatrics

Objective: Comparing results between postoperative congenital muscular torticollis (CMT) with or without place cast, and the effectiveness of surgical bipolar muscle for congenital muscular torticollis.

Methods: This study was a retrospective study of 73 cases with sternocleidomastoid muscle from October 1994 to December 2005. Patients have divided two Variant. Postoperative variant 1 without place cast and variant with place cast. The degree of neck tilt and range of motion of the neck, flexion and limitation of rotation were recorded. The ultrasound, measure cervico-mandibular angle (CMA). Children had performed operation by bipolar Z-plasty. Post-operation, with or without immobilization. Operative results were according to assess by the score of Cheng.

Results: Seventy three patients have operated congenital muscular torticollis. Male: 31; female: 42. Right: 27; left: 46. Age at operation means 4.3698 years (± 1.6791). Age at time of last examination: 27.43836 (± 3.109065), length of follow-up (year): 23.1232 (± 2.9765). Fascial asymmetric at follow-up: No: 64; slight: 07; mild: 02. Last result: Excellent: 61; good: 10; acceptable final result (Excellent + good): variant 1 (35+5) 97.60%/variant 2 (26+5) 96.90% (P-value = 0.0218565). Improvement of limitation of rotation in variant 1/variant 2: 63.9%/52.7% (P value = 0.0856030); improvement of angle of head tilt in variant 1/variant 2: 86.6%/66.3% (P value = 0.146634). In this study, we divide two variant, compared with and without use place cast. Post-operation, the patients had bipolar Z-plasty to show the column of sternomastoid muscle, there isn’t immobilization are reduce surgical time and cost.

Conclusion: The diagnostic and evaluation of congenital muscular torticollis requires a systematic team approach with members from fields of radiology, physiotherapy, craniofacial surgery, orthopaedics, neuro- surgery and ophthalmology. Technical bipolar Z-plasty with good results and there isn’t immobilization.

 Keywords: Congenital Muscular Torticollis; Sternocleidomastoid Muscles; Translational Deformity; Facial Asymmetry

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