Sternocleidomastoid Muscle in Fetuses: Classification, Morphometric Analysis, and Clinical Significance

Abstract

This study aimed to examine variations and morphometric properties of the sternocleidomastoid muscle (SCM) in fetuses in terms of infancy and early childhood surgeries. Neck regions of 27 fetuses (mean age: 23.30±3.40wk, sex: 11 boys and 16 girls) fixed with 10% formalin were dissected bilaterally. Photographs of the dissected fetuses were taken in the standard position. Morphometric measurements, such as length, width, and angle, were performed on the photographs using the ImageJ software. In addition, the origin and insertion of SCM were detected. Taking into account the studies in the literature, a classification consisting of 10 types associated with the origin of SCM was carried out. No statistically significant difference was observed in the parameters in terms of side and sex ( P >0.05), except from the linear distance between the clavicle and motor point where the accessory nerve enters SCM (20.10±3.76 for male, 17.53±4.05 for female, P =0.022). Two-headed SCM (Type 1) was detected in 42 out of 54 sides. Two-headed clavicular head (Type 2a) was detected on 9 sides, and 3-headed (Type 2b) on 1 side. A 2-headed sternal head (Type 3) was detected on 1 side. A single-headed SCM (Type 5) was also detected on 1 side. Knowledge related to variations of the origin and insertion of fetal SCM may be helpful in preventing complications during treatments of pathologies such as congenital muscular torticollis in early period of life. Moreover, the calculated formulas may be useful to estimate the size of SCM in newborns.