Kozlov Yury, Yakovlev Andrey, Novogilov Vladimir, Aleynikova Natalya, Yurkov Pavel, Kovalev Vitaly, Weber Irina
Department of Newborn Surgery, Municipal Pediatric Hospital, Irkutsk, Russia.
J Laparoendosc Adv Surg Tech A. 2009 Apr;19 Suppl 1:S179-81. doi: 10.1089/lap.2008.0177.supp.
Surgical correction of the congenital muscular torticollis (CMT) is recommended for patients with unsuccessful conservative treatment. Open operative techniques all leave noticeable scars. Tenotomy can be performed endoscopically. We proposed the modified endoscopic two-trocar transaxillary approach for the treatment of CMT.
We have applied a technique of endoscopic release of the sternocleidomastoid (SCM) muscle in 5 pediatric patients. We performed the tunnelization of the space over the clavicular and sternal heads of the SCM muscle applied balloon inflation of the Foley catheter (Fr. 16). The sternal and clavicular attachments were dissected and divided by electrocautery hook.
An excellent result was found in all 5 patients. There were no complications to be seen. The neurovascular structures were preserved in all cases.
We believe that the subcutaneous endoscopic transaxcillary tenotomy procedure is a good method for the treatment of congenital muscular torticollis. This endoscopic technique avoids injury to the neurovascular structures and does not leave visible scars.
对于保守治疗失败的先天性肌性斜颈（CMT）患者，建议进行手术矫正。开放手术技术都会留下明显的疤痕。胸锁乳突肌切断术可通过内镜进行。我们提出了改良的内镜双套管针经腋窝入路治疗CMT。
我们对5例儿科患者应用了内镜下松解胸锁乳突肌（SCM）的技术。我们对SCM肌锁骨和胸骨头部上方的间隙进行隧道化处理，应用Foley导管（16F）球囊扩张。胸骨和锁骨附着点用电灼钩进行解剖和分离。
所有5例患者均取得了优异的效果。未见并发症。所有病例的神经血管结构均得以保留。
我们认为皮下内镜经腋窝胸锁乳突肌切断术是治疗先天性肌性斜颈的一种良好方法。这种内镜技术避免了对神经血管结构的损伤，且不会留下可见的疤痕。
