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Abstract
Study Design
This is a retrospective study determining the surgical result of the partial resection of the sternocleidomastoid (SCM) muscle for the congenital muscular torticollis.
Objectives
To evaluate the efficacy of the partial resection of the sternocleidomastoid muscle for the correction of the congenital muscular torticollis.
Materials and Methods
W e reviewed 19 patients who were treated by the partial resection of the sternocleidomastoid muscle from 1990 to 1997. The mean age at the time of the operation was 8 year 3 months. Each patient was examined the range of the motion of the neck for the functional results by the modified Ling's criteria, and the tilt of the head, facial asymmetry, presence of the lateral band, loss of the sternomastoid column and quality of the scar for the cosmetic results by the modified Ling's criteria. The overall cosmetic and functional results were analyzed by the criteria similar to those described by Canale et al.
Results
Functionally, 5 patients (26.3%) were excellent, 10 (52.6%) good, 2 (10.5%) fair, and 2 (10.5%) poor. Cosmetically, 7 patients (30.8%) were excellent, 9 (47.4%) good, 1 (5.3%) fair, and 2 (10.5%) poor. The complication was one lymphatic leakage. Seven of 8 patients were good and one patient was fair under the age of 5. Six of 7 patients were good and one patient was poor between the age of 6 and 10. Two of 4 patients were good and two patients were poor over the age of 11.
Conclusion
The partial resection of sternocleidomastoid muscle for the congenital muscular torticollis would be recommendable, because it is a simple, safe procedure and usually produces satisfactory results. All partial rescetion of the sternal and clavicular head of the sternocleidomastoid muscle may prevent the unsatisfactory cosmetic result which is lateral band due to the clavicular head of the sternocleidomastoid muscle. The good results were achieved in case of under the age 10 years.
REFERENCES
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Figures and Tables%
Fig. 1.
Preoperative photograph of a 8-year-old girl with the congenital muscular torticollis on the right side showed moderate degree of facial asymmetry and head tilt A. Three years after the partial resection of the sternocleidomastoid muscle, the facial asymmetry and head tilt were disappeared B. The overall result was good.
Fig. 2.
Postoperative photograph of a 17-year-old girl treated with the partial resection of the sternocleidomastoid muscle 7 years ago showed the prominent lateral band (clavicular head).
Table 1.
Criteria of functional evaluation; Modefied Ling's criteria
| result | LOM∗ of lateral bending (degree) | LOM∗ of rotation (degree) | End result |
|---|---|---|---|
| Excellent | 0 | 0 | satisfactory |
| Good | 1~10 | 1~10 | |
| Fair | 11~20 | 11~20 | unsatisfactoty |
| Poor | >20 | > 20 | unsatisfactoty |
Table 2.
Criteria of cosmetic evaluation; Modefied Ling's criteria
Table 3.
Functional results according to modefied Ling's criteria
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