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双极松解术治疗成人先天性肌性斜颈:31例报告

Adult Patients with Congenital Muscular Torticollis Treated with Bipolar Release: Report of 31 Cases.

作者信息

Lee Gun Sang, Lee Myung Ki, Kim Woo Jae, Kim Ho Sang, Kim Jeong Ho, Kim Yun-Suk

机构信息

Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea.

出版信息

J Korean Neurosurg Soc. 2017 Jan 1;60(1):82-88. doi: 10.3340/jkns.2016.0303.018. Epub 2016 Dec 29.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.

摘要

目的

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。

方法

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。

结果

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。

结论

SCM双极松解术是治疗成人CMT的一种安全可靠的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ba6/5223763/c28574ee609e/jkns-60-1-82f1.jpg

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