Endoscopic-Assisted Surgical Correction for Congenital Muscular Torticollis

Abstract

Various surgical approaches have been advocated to release, lengthen, or excise a segment of the sternocleidomastoid (SCM) muscle for the treatment of congenital muscular torticollis (CMT). However, all those conventional methods make noticeable scars on the clavicle or neck area. We proposed the endoscopic-assisted postauricular approach for the treatment of CMT that provides good functional and cosmetic outcomes and less learning curve. Endoscopic-assisted release of the SCM muscle was performed in 15 children. Ages at operation ranged from 9 months to 6 years, with a mean of 17.6 months. The sternal and clavicular attachments of the SCM muscle were dissected and resected at 1-cm segments near to the insertion area, through the endoscopic view. To prevent relapse, neck splint was applied after operation for 6 months. The mean operative time was 40 minutes. During the procedure, great auricular nerve and spinal accessory nerve were preserved well and there were no complications. Follow-up for 6 months in all patients showed complete muscular release and satisfactory correction with no recurrence. The neck scars were not visible after the procedure. The incision scar was well obscured on the posterior auricular sulcus. Endoscopic correction for the CMT is a feasible and easy-to-learn procedure. This method is a safe and effective procedure that provides good functional and cosmetic outcomes.