Transaxillary subcutaneous endoscopic release of the sternocleidomastoid muscle for treatment of persistent torticollis.

Abstract:

PURPOSE:Surgical correction of torticollis is occasionally necessary to curtail the facial deformity that can result from this condition. The resultant neck scar can be of suboptimal cosmesis, with consequent psychological distress for the child. We have previously described an endoscopic approach to forehead and brow lesions through scalp incisions. We now describe a transaxillary subcutaneous endoscopic approach to division of the fibrotic sternocleidomastoid muscle. METHODS:This study involved a retrospective chart review of 3 consecutive outpatient procedures (male-to-female ratio, 1:2; age range, 8 months to 7 years) from March to October of 2005. The 2 older patients had established sternocleidomastoid fibrosis, and 1 had complicated torticollis refractory to medical management. All procedures were performed using standard 3-mm-laparoscopic instrumentation through hidden incisions in the ipsilateral axilla. Outcome measures included need for conversion, operative time, cosmetic outcome, and complications. RESULTS:All patients were successfully treated endoscopically. Mean operative time was 50 minutes (range, 45-55 minutes). There were no intraoperative or postoperative complications. All families were pleased with the cosmetic outcome. CONCLUSION:This case series demonstrates the simplicity and effectiveness of a transaxillary endoscopic subcutaneous approach to torticollis.

journal_name

J Pediatr Surg

authors

Dutta S,Albanese CT

doi

10.1016/j.jpedsurg.2007.10.008

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

447-50

issue

3

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(07)00817-2

journal_volume

43

pub_type

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