经腋窝内镜下小儿持续性肌性斜颈的筋膜下手术：台湾地区一项13年的回顾性研究

Transaxillary endoscopic subfascial operation for persistent muscular torticollis in pediatric patients: A 13-year retrospective study in Taiwan.

作者信息

Cheng Nai-Chen, Chen Yu-Han, Wu Yu-Ling, Chang Yu-Tang

机构信息

Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Pediatr Neonatol. 2024 May;65(3):298-302. doi: 10.1016/j.pedneo.2023.06.010. Epub 2023 Nov 11.

DOI:10.1016/j.pedneo.2023.06.010

PMID:38453564

Abstract

BACKGROUND

The endoscopic surgery for persistent muscular torticollis has been well-described and most are subcutaneous working caverns. As the sternocleidomastoid muscle is located beneath the deep cervical fascia that corresponds to the pectoral fascia, this study aimed to review our results of the transaxillary approach under the pectoral fascia and the deep cervical fascia.

METHODS

Between November 2009 and January 2022, pediatric patients with persistent muscular torticollis receiving transaxillary endoscopic subfascial operation were retrospectively reviewed and analyzed.

RESULTS

There were thirty-three consecutive patients with median age of 6.5 years (range, 5.5 months-15.7 years). The median operating time was 90.0 min. With a median follow-up of 14.8 months (range, 5.0-127.7), the final outcomes showed excellent-to-good results in 90.9%, fair results in 6.1%, and poor results in 3.0%. Univariate analysis revealed that the long-term outcomes of the operation were independent of gender, age, involved side and previously open myotomy (p = 0.662, 0.818, 0.740 and 0.596, respectively).

CONCLUSIONS

The subfascial working cavern would be technically achievable for the transaxillary endoscopic approach with good functional and cosmetic outcomes.

摘要

背景

持续性肌性斜颈的内镜手术已有详细描述，大多数是皮下操作腔隙。由于胸锁乳突肌位于与胸肌筋膜相对应的颈深筋膜下方，本研究旨在回顾我们在胸肌筋膜和颈深筋膜下经腋窝入路的手术结果。

方法

回顾性分析2009年11月至2022年1月间接受经腋窝内镜下筋膜下手术的持续性肌性斜颈患儿的资料。

结果

连续纳入33例患者，中位年龄6.5岁（范围5.5个月至15.7岁）。中位手术时间为90.0分钟。中位随访14.8个月（范围5.0至127.7个月），最终结果显示优至良的比例为90.9%，尚可的比例为6.1%，差的比例为3.0%。单因素分析显示，手术的长期效果与性别、年龄、受累侧别及既往开放性肌切开术无关（p值分别为0.662、0.818、0.740和0.596）。