Lee Gun Sang, Lee Myung Ki, Kim Woo Jae, Kim Ho Sang, Kim Jeong Ho, Kim Yun-Suk
Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea.
J Korean Neurosurg Soc. 2017 Jan 1;60(1):82-88. doi: 10.3340/jkns.2016.0303.018. Epub 2016 Dec 29.
We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up.
Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting.
The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (<0.05). The preoperative mean CMA was 15.4° (range, 5.4-29.0), which was reduced to a mean of CMA of 6.3° (range, 0-25) after surgery (<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred.
Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.
我们评估了31例未经矫正的先天性肌性斜颈(CMT)成年患者行双极松解术的手术效果,并进行了超过12个月的随访。
对31例行胸锁乳突肌(SCM)双极松解术的患者进行回顾性分析。平均随访时间为14.9个月(范围12 - 30个月)。手术时的平均年龄为30.3岁(范围20 - 54岁)。采用改良Lee评分系统、测量颈颌角(CMA)以及患者自我报告的整体满意度量表对患者进行评估。
术后末次随访时,改良Lee评分系统显示4例(12.9%)患者结果为优,18例(58.1%)为良,9例(29.0%)为中。颈部活动和头部倾斜的改善具有统计学意义(<0.05)。术前平均CMA为15.4°(范围5.4 - 29.0°),术后降至平均CMA为6.3°(范围0 - 25°)(<0.05)。整体满意度量表评分为93.7%(范围90 - 100)。3例患者出现同侧耳垂下方短暂性感觉缺失。未发生明显的永久性并发症。
SCM双极松解术是治疗成人CMT的一种安全可靠的技术。