Congenital Muscular Torticollis in Children: Analysis of 12 Delayed Cases

Year 2008, Volume: 10 Issue: 2, 4 - 7, 01.07.2008

Hayrettin Öztürk Hanifi Okur Hülya Öztürk Murat Kemal Çiğdem Hatun Duran Abdurrahman Önen Ali İhsan Dokucu

Abstract

Purpose: The aim of this study was to estimate the records of patients treated for congenital muscular torticollis (CMT) in the period between 1986 and 2005. At this point we report our clinical experience with delayed CMT in the light of current literature. Methods: We retrospectively evaluated the records of our patients in terms of age, sex, clinical presentation, localization of the lesion, diagnostic tests, additional abnormalities, findings at operation and surgical procedures. Results: The mean age of the patients (7 girls, 5 boys) was 6.7 years (range: 1.5- 12 years). Most of the lesions were seen on the left aspect of the neck (58%). The most encountered complaint at application was restriction of neck motion (83%). Sternocleidomastoid tumor accounted for only 17% of the patients’ complaints. All patients in this study were treated by surgical intervention. Conclusions: In this study, neck motion and head tilt showed marked improvement with surgical and conservative treatment in majority of children with CMT who admitted to the hospital lately

Keywords

Torticollis, Child

Çocuklarda Konjenital Musküler Tortikollis: GeÇ Başvuran 12 Olgunun Analizi

Abstract

Amaç: Bu çalışmadaki amacımız geç başvuran konjenital musküler tortikollis (KMT)’li hastalarımızın klinik, tanı ve tedavi özelliklerini analiz etmek ve literatür ile karşılaştırmaktır. Yöntem: Retrospektif olarak hastalarımız yaş, cinsiyet, klinik bulgular, yüzde ikincil biçim değişiklikleri, şişliğin yerleşimi, tanı yöntemleri, ek anomaliler, cerrahi girişimde karşılaşılan bulgular, sağaltım amacıyla uygulanan cerrahi girişimler açısından değerlendirildi. Bulgular: Hastalarımızın (5 erkek, 7 kız) yaş ortalaması 6,7 (1,5-12 yaş) yıl idi. Lezyonların çoğunluğu solda (%58) görüldü. Olgularımızın ikisi küçük yaş grubundaydı. İki olguda (%17) boyunda kitle palpe edilebildi. Olguların çoğunluğunda boyun hareketlerinde kısıtlılık (%83) en sık bulgu idi. Serimizdeki hastaların tümü cerrahi girişimle tedavi edildi ve ayrıca fizik-tedavi egzersizleri de uygulandı. Sonuç: Bu çalışmada, geç başvuran KMT’li çocuklarımızın çoğunluğunda cerrahi tedavi ve konservatif tedavi ile boyun hareketleri ve boyun eğriliğinde belirgin bir düzelme oldu

Keywords

Tortikollis, Çocuk

References

• Waldhausen JHT and Trapper D. Head and neck sinuses and masses. In: Ashcraft KW, eds. Pediatric Surgery. 3rd ed. Philadelphia: WB Saunders, 987-999. 2000
• Beasley SW. Torticollis. In: Welch KJ, eds. Pediatric surgery. 5th end. St. Louis: Mosby Year Book, Mosby Publication, 773-778, 1998
• Cheng JC, Au AW. Infantile torticollis: a review of 624 cases. J Pediatr Orthop, 14: 802-808, 1994
• Jones PG. Torticollis. In: Welch KJ eds. Pediatric surgery. 4th end. Chicago: Year Book, Medical, 552-556, 1986
• Tang SF, Hsu KH, Wong AM, et al. Longitudinal followup study of ultrasonography in congenital muscular torticollis. Clin Orthop Relat Res, 403: 179-185, 2002
• Cheng JC, Tang SP, Chen TM, et al. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants – a study of 1,086 cases. J Pediatr Surg, 35: 1091–1096, 2000
• Wolfort FG, Kanter MA, Miller LB. Torticollis. Plast Reconstr Surg, 84: 682- 692, 1989
• Cheng JC, Wong MW, Tang SP, et al. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. A prospective study of eight hundred and twenty-one cases. J Bone Joint Surg Am, 83: 679–687, 2001
• Sonmez K, Turkyilmaz Z, Demirogullari B, et al. Congenital muscular torticollis in children. ORL J Otorhinolaryngol Relat Spec, 7: 344-347, 2005
• Demirbilek S, Atayurt HF. Congenital muscular torticollis and sternomastoid tumor: results of nonoperative treatment. J Pediatr Surg, 34: 549–551, 1999
• Wei JL, Schwartz KM, Weaver AL, Orvidas LJ. Pseudotumor of infancy and congenital muscular torticollis: 170 cases. Laryngoscope, 111: 688–695, 2001
• Lin JN, Chou ML. Ultrasonographic study of the sternocleidomastoid muscle in the management of congenital muscular torticollis. J Pediatr Surg, 32: 1648–1651, 1997
• Hollier L, Kim J, Grayson BH, et al. Congenital muscular torticollis and the associated craniofacial changes. Plast Reconstr Surg, 105: 827-835, 2000
• Davids JR, Wenger DR, Mubarak SJ. Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome. J Pediatr Orthop, 13: 141-147, 1993
• Nicholson P, Higgins T, Forgarty E, et al. Three-dimensional spiral CT scanning in children with acute torticollis. Int Orthop, 23: 47-50, 1999
• Özer T, Uzun L, Numanoğlu V ve ark. Konjenital müsküler tortikolliste kranyofasiyal ve servikal vertebra anomalilerinin 3B-BT ile incelenmesi Tanısal ve Girişimsel Radyoloji, 10: 272-279, 2004
• Chen CE, Ko JY. Surgical treatment of muscular torticollis for patients above 6 years of age. Arch Orthop Trauma Surg, 120: 149-151, 2000
• Ling CM. The influence of age on the results of open sternomastoid tenotomy in muscular torticollis. Clin Orthop, 116: 142–148, 1976
• Wirth CJ, Hagena FW, Siebert WF. Biterminal tenotomy for the treatment of congenital muscular tortocollis. Long-term results. J Bone Joint Surg, 74: 427-434, 1992
• Hulbert KF. Congenital muscular torticollis. J Bone Joint Surg, 32: 50-59, 1960
• Hellstadius A. Torticollis congenita. Acta Clin Scand, 62: 586-589, 1972
• Soeur R. Treatment of congenital torticollis. J Bone Joint Surg, 22: 35-42, 1940
• Wirth CJ, Hagena FW, Wuelker N, et al. Biterminal tenotomy for the treatment of congenital muscular torticollis. Long-term results. J Bone Joint Surg Am, 74: 427- 434, 1992