Outcome of surgical treatment for neglected congenital muscular torticollis: a series of 28 adolescent patients

Kamboh, U. A., Ashraf, M. , Zahra, S. G., Raza, M. A., Manzoor, M., Mehboob, M., Farooq, M., Ahmad, M., Hussain, S. S. and Ashraf, N. (2022) Outcome of surgical treatment for neglected congenital muscular torticollis: a series of 28 adolescent patients. Surgical Neurology International, 13, 292. (doi: 10.25259/sni_314_2022) (PMID:35855133) (PMCID:PMC9282755)

Abstract

Background: Congenital muscular torticollis (CMT) is a common musculoskeletal anomaly that can be excellently managed at birth with conservative physiotherapy; as a result, literature on neglected cases of CMT in older patients is sparse, and there is controversy regarding the ideal surgical approach. This report aims to provide the outcome of 28 adolescent patients with neglected CMT who underwent unipolar release at the distal sternocleidomastoid muscle (SCM). Methods: Twenty-eight adolescent patients with untreated CMT presented to our department between 2016 and 2019 and underwent unipolar release at the distal end of their SCM. All patients had no other anomaly based on clinical examination and radiological investigations. At the time of surgery, the mean age of patients was 15.8 years (range 13–18 years). There were 10 male and 18 female patients with the right side affected in 20 cases. All patients were followed up for 2 years. Patients were evaluated using an adapted version of the modified Lee’s scoring system to assess cosmesis and the cervical-mandibular angle (CMA) to assess radiological change. Results: The adapted modified Lee’s scoring system indicated 17 patients (60.7%) had an excellent outcome, 6 patients (21.4%) had a good outcome, and 5 patients (17.9%) had a fair outcome. In particular, scarring was fine in 23 patients (82.1%) and only slight in the remaining. Independent to the categorical outcome, all patients subjectively reported high satisfaction with their cosmesis. The preoperative mean CMA was 19.6° (range, 8.5–31.5°), which was reduced to a mean of CMA of 14.0° (range, 3–28°) after surgery (P Conclusion: In uncomplicated cases of neglected CMT in adolescent patients, unipolar tenotomy of the distal SCM is a safe and reliable technique with good clinical outcomes.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ashraf, Dr Mohammad
• Authors: Kamboh, U. A., Ashraf, M., Zahra, S. G., Raza, M. A., Manzoor, M., Mehboob, M., Farooq, M., Ahmad, M., Hussain, S. S., and Ashraf, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Surgical Neurology International
• Publisher: Scientific Scholar
• ISSN: 2229-5097
• ISSN (Online): 2152-7806
• Published Online: 08 July 2022
• Copyright Holders: Copyright © 2023 Surgical Neurology International
• First Published: First published in Surgical Neurology International 13:292
• Publisher Policy: Reproduced under a Creative Commons license