[Facial asymmetry in children with congenital muscular torticollis after surgical treatment].
Asymmetrical position of facial skeleton and movement restriction in the cervical spine in young children could be caused by torticollis mainly muscle origin. We observe miofibrosis of sternocleidomastoid muscle. This face deformation is seen from 0.3 to 1.5% children. Torticollis could be associated with malocclusion, facial asymmetry, vision defect or vertebral body deformation. Muscle stretching is a main type of treatment at infantile age. In the case of faille and in older children sternocleidomastoid myotomy is indicated. The purpose of our study is to analyze facial asymmetry in children after torticollis surgery and determination if surgery performed after 3 years of age is associated with higher risk of facial deformity in long follow up. The study population consisted of 16 patients who underwent sternocleidomastoid tenotomy in proximal and distal part. The control group consisted of 13 persons. Booth groups underwent subjective and objective analysis consisted of computer facial symmetry analysis and measurements of range of motion in the cervical spine. The study group was divided into two subgroups--patients operated before and after 3 years of age. The follow up was 2 to 26 years (mean 13.4 years). The statistical analysis of objective evaluation revealed significant difference in horizontal face axis between subgroups (p<0.05). Range of motion at cervical vertebral column was the same in both groups. Facial asymmetry caused by muscle torticollis is persistent in horizontal axis in long follow up and is more often observed in children operated after 3 years of age, but statistical analysis does not support this thesis.
Masłoń
Adrian
A
Kliniki Ortopedii i Ortopedii Dzieciecej, Uniwersytet Medyczny w Lodzi. adian@mp.pl
Lebiedziński
Radosław
R
Domzalski
Marcin
M
Synder
Marek
M
Grzegorzewski
Andrzej
A
D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D005146:Facial Asymmetry / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009334:Neck Muscles / Q000601:surgery*; D016059:Range of Motion, Articular; D014103:Torticollis / Q000150:complications / Q000151:congenital* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult