CORR Insights^®: Is Sternocleidomastoid Muscle Release Effective in Adults with Neglected Congenital Muscular Torticollis?

Excerpt

The treatment of neglected or unresolved congenital muscular torticollis in adults has been an unresolved question. Many authors [1, 2] have recommended against treatment in the past because of high complication rates, poor improvement, and persistent deformity. The current study by Lim and colleagues answers many of these controversies, and represents a major step forward in our understanding of what is possible in the treatment of this rare condition in adults. By analyzing results with outcomes tools that measure function and cosmesis, Lim et al. clarify how treatment will affect patients in the ways that matter most to them. Patients find cosmesis, pain, and function to be of gradually decreasing importance in seeking out treatment, according to Lim and colleagues. While craniofacial deformity itself cannot be expected to improve after cessation of growth, there are important improvements in other parameters that affect cosmesis, primarily axial shift of the head and head tilt. Many patients experience neck and/or shoulder pain due to asymmetry. A surgical procedure to correct torticollis can alleviate such pain. Finally, the improvement achieved in lateral tilt and rotation is astounding, given the majority of these procedures were performed by unipolar release only allowing preservation of the neck line contour. …