Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 2
Congenital Muscular Torticollis
Abdülkerim GÖKOĞLU1, Ali DALGIÇ2
1KHB Kastamonu Dr. Münif İslamoğlu Devlet Hastanesi, Nöroşirürji Kliniği, Kastamonu, Türkiye
2KHB Ankara Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye
Congenital muscular torticollis, a common congenital disorder of the musculoskeletal system in neonates and infants, is the most common cause of torticollis in childhood. Tightening of the sternocleidomastoid muscle with or without a palpable mass results in head tilt and contralateral rotation of the face and chin. A prominent increase in the incidence of this pathology has attracted attention recently. Although the etiology remains unknown in contrast with current improvements in medicine and technology, diagnostic tools have revealed important data on the classification and severity of pathology, management and duration of therapy, and the prognosis. Despite its benign nature, neglected cases may cause severe craniofacial and spinal deformities and neurological deficits. Spontaneous regression may occur and the condition resolves mostly with conservative therapy in the first year of life. Botox therapy is becoming more popular but further studies for the evaluation of its efficacy in large series are required. The best time for surgery is 1-4 years of age following unsuccessful and/or unsatisfactory conservative treatment. Acquired deformities mostly persist in cases that have undergone surgery after 5 years of age. The goals of surgery are good functional and cosmetic outcomes with minimum or no additional vascular or neural injury after an early, safe and practical procedure. Algorithmic early diagnosis and treatment, objective measurements and clinical evaluation during the follow-up period and the adherence of the parents, caregivers and clinicians to the treatment are essential for the improvement of outcomes. Anahtar Kelimeler : Congenital muscular torticollis, Pediatric, Craniofacial deformity, Spinal deformity