Research Article| Volume 60, ISSUE 1, P95-98, January 2007

Transaxillary endoscopic release of restricting bands in congenital muscular torticollis – a novel technique


      Congenital muscular torticollis is due to fibrosis of one or both the heads of sternocleidomastoid muscle. This may also involve the platysma, scalene muscles, and the carotid sheath and may be associated with cervical scoliosis. Conventional surgical procedures leave visible scars. Ramirez, who used the posterior part of the traditional face-lift incision, made perhaps the first attempt at concealing scars. Burstein et al. reported a large series of subcutaneous endoscopic release of torticollis through a hairline approach. Sasaki described an endoscopic two-incision, posterior auricular fold and hairline approach. A technique of transaxillary subcutaneous endoscopy for the release of the sternocleidomastoid muscle in congenital muscular torticollis is described here. This procedure provides direct access to the fibrous bands, enables release without risk of damage to the spinal accessory nerve, external jugular vein, or greater auricular nerve, and leaves no visible neck scars.
      Two cases of congenital muscular torticollis presenting in adulthood were managed successfully by this technique. The fibrotic part of sternocleidomastoid muscle was released and the normal range of head motion was restored. There were no surgical complications encountered and the patients achieved complete pain free range of movement in six weeks.
      This technique provides direct and quick access, perpendicular to the line of the fibrotic bands, avoids injury to neurovascular structures and does not leave visible neck scars.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Luther B.L.
        Congenital muscular torticollis.
        Orthop Nurs. 2002 May–Jun; 21 ([quiz 27–29]): 21-27
        • Burstein F.D.
        • Cohen S.R.
        Endoscopic surgical treatment for congenital muscular torticollis.
        Plast Reconstr Surg. 1998 Jan; 101 ([discussion 25–26]): 20-24
        • Stassen L.F.
        • Kerawala C.J.
        New surgical technique for the correction of congenital muscular torticollis (wry neck).
        Br J Oral Maxillofac Surg. 2000 Apr; 38: 142-147
        • Sasaki S.
        • Yamamoto Y.
        • Sugihara T.
        • et al.
        Endoscopic tenotomy of the sternocleido mastoid muscle; new method for surgical correction of muscular torticollis.
        Plast Reconstr Surg. April 2000; 105: 1764-1767