Summary
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.
Keywords
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 accessOne-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:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Congenital muscular torticollis.Orthop Nurs. 2002 May–Jun; 21 ([quiz 27–29]): 21-27
- Endoscopic surgical treatment for congenital muscular torticollis.Plast Reconstr Surg. 1998 Jan; 101 ([discussion 25–26]): 20-24
- New surgical technique for the correction of congenital muscular torticollis (wry neck).Br J Oral Maxillofac Surg. 2000 Apr; 38: 142-147
- Endoscopic tenotomy of the sternocleido mastoid muscle; new method for surgical correction of muscular torticollis.Plast Reconstr Surg. April 2000; 105: 1764-1767
Article info
Publication history
Published online: May 24, 2006
Accepted:
December 9,
2005
Received:
June 21,
2005
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
