Fig. 8.1
Neck ultrasound showing left sternomastoid tumor
MRI may be useful in patients with nonmuscular causes of torticollis.
Histopathologic findings include:
-
Fibrous replacement of skeletal muscle fibers that undergo atrophy.
-
The degree of fibrosis and its extent or distribution may vary.
-
Even in neonates, the fibrous tissue is mature.
-
This finding indicates that the disease began before birth.
Management
-
Medical management of torticollis involves conservative treatment.
-
Sternocleidomastoid fibrosis spontaneously resolves in the vast majority of infants (success rate of 80–95 %).
-
The management for torticollis is primarily nonoperative, generally consisting of physiotherapy.
-
Surgical management of congenital muscular torticollis is generally avoided until the child is aged at least 1 year.
-
Only about 4–5 % of patients are surgically treated, generally after the age of 1 year.
-
Indications for surgical management include:
-
Persistent sternocleidomastoid contracture limiting head movement
-
Persistent sternocleidomastoid contracture accompanied by progressive facial hemihypoplasia
Stay updated, free articles. Join our Telegram channel
-
Full access? Get Clinical Tree
