Joh Young Hoo, Park Dong Ha, Lee Il Jae, Park Myong Chul
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea.
Arch Craniofac Surg. 2015 Aug;16(2):88-91. doi: 10.7181/acfs.2015.16.2.88. Epub 2015 Aug 11.
In adult congenital muscular torticollis (CMT) patients, physical therapy is not as effective because the development of sternocleidomastoid muscle (SCM) muscle is complete. While surgical release can address CMT in adult patients, the risk of general anesthesia and visible postoperative scar is a concern, expecially in patients with mild symptoms. In this paper, we report our experience in treating such patients with minimal-incision myotomy under local anesthesia. A review was performed for all adult patients who had undergone the simple myotomy procedure. Surgical indication was reserved for patients with mild fibrotic band in the SCM muscle with minimal lengthdiscrepancybetween the muscles. All patients had recognizable head tiltand palpation of fibrotic band on affected side of the neck. Surgical details are described in the main body of text. Three female patients had undergone the procedure. Torticollis was resolve in all patients with complete restoration of ranage of motion. There were no postoperative complications, and patient satisfaction was high. We have reported three cases of mild CMT in adult female patients, who had undergone minimal-incision myotomy under local anesthesia. Outcomes were satisafactory with no morbidity to report. With careful patient selection, this method offers an alternate treatment option for adult CMT patients with mild symptoms.
在成人先天性肌性斜颈(CMT)患者中,物理治疗效果不佳,因为胸锁乳突肌(SCM)已发育完全。虽然手术松解可治疗成人CMT患者,但全身麻醉风险和术后可见瘢痕令人担忧,尤其是对症状较轻的患者。在本文中,我们报告了局部麻醉下小切口肌切开术治疗此类患者的经验。对所有接受单纯肌切开术的成年患者进行了回顾。手术适应症为SCM肌肉中纤维化带较轻且肌肉长度差异最小的患者。所有患者均有明显的头部倾斜,且在颈部患侧可触及纤维化带。手术细节在正文部分描述。三名女性患者接受了该手术。所有患者的斜颈均得到解决,活动范围完全恢复。无术后并发症,患者满意度高。我们报告了三例成年女性轻度CMT患者,她们在局部麻醉下接受了小切口肌切开术。结果令人满意,无不良事件报告。经过仔细的患者选择,该方法为症状较轻的成人CMT患者提供了另一种治疗选择。