A review of delayed surgical release of congenital muscular torticollis

Background: Congenital muscular torticollis is a postural deformity resulting from unilateral shortening and fibrosis of the sternocleidomastoid muscle .Early diagnosis helps in achieving good results with conservative treatment. Delayed treatment of this condition results in suboptimal correction of torticollis & persistence of associated secondary deformities. Aims: The aim of this study was to determine the efficacy of surgery in patients presenting late for the treatment. Materials and Methods: This study was conducted from august 2011 to July 2013. 10 patients were included in the study. Data was collected in terms of age, sex, clinical presentation, additional deformities, range of neck movements pre& post operatively, history of previous treatment attempts, findings at operation and surgical procedures. All the patients underwent bipolar release of torticollis as described by ferkel. Results: The mean age of the patients who were operated for CMT (6 females, 4 males) was 13.9 years (range: 7 yrs to 30 yrs).6 pts had rt side torticollis & 4 pts had lt side torticollis. mean follow up period was 1 year . All pts were diagnosed to have this deformity in early childhood. The most common complaints at presentation were restriction of neck motion, head tilt & fascial asymmetry. 1 pt had h/o previous surgical release & remaining pts did not undergo any treatment previously. All pts had shortening of sternomastoid muscle with thickening of both origin & insertion of the muscle. Significant improvement in neck movements & tilting of the head were noted after the surgical release. No significant complications were noted with the surgical procedure. Conclusion: surgical release of CMT in neglected cases improves the quality of life by improving neck motion & resolving the head tilt & it is a relatively complication free method.