The Transaxillary Subcutaneous Endoscopic Sternocleidomastoid Muscle Division as an Approach for the Surgical Treatment of Congenital Muscular Torticollis in Children.

Traditionally congenital muscular torticollis is treated with a neck incision which results in a neck scar. The purpose of this study was to evaluate the effectiveness of the transaxillary subcutaneous endoscopic sternocleidomastoid muscle division for the treatment of congenital muscular torticollis. This is a prospective study of 7 children with torticollis treated surgically by the transaxillary endoscopic approach in the department of Pediatric Surgery between 2014 and 2018. The age at operation ranged from 5.5 to 9 years, mean 7.3 (SD ± 1.3) years. The mean operation time was 65 min. The complete muscular release was successfully completed using the endoscopic approach. There were no major complications. All patients improved in gaze angle, lateral tilt and range of motion. There was no cosmetically unacceptable scar visible at the surgical sites in all patients during follow up. All families were pleased with the cosmetic outcome. The transaxillary subcutaneous endoscopic technique can be applied as a surgical approach for children with muscular torticollis an alternative to traditional open methods. It is a technically feasible procedure in children, provides excellent cosmesis and moreover avoids scarring on the neck.