Endoscopic Transaxillary Subfascial Approach for Persistent Muscular Torticollis in Children

Chang, Yu-Tang; Lee, Jui‐Ying; Chiu, Wei-Cheng; Hsin, Yu-Mei; Chiu, Chi-Shu

doi:10.1097/sle.0b013e31820ca3a4

Cited by 5 publications

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“…Nevertheless, in our opinion, this technology has a higher risk of nerve injury. Dutta and Tang et al reported their technique of transaxillary subcutaneous endoscopic release of the sternocleidomastoid muscle for treatment of CMT [ 7 , 9 , 10 , 26 ]. Because the incision was made in the anterior axillary fold, a long subcutaneous tunnel over the clavicular and sternal heads of the SCM muscle was needed.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic release of congenital muscular torticollis with radiofrequency in teenagers

Wang¹,

Qi²,

Liu³

2018

J Orthop Surg Res

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BackgroundCongenital muscular torticollis (CMT) is due to contracture of the sternocleidomastoid muscle which may cause activity limitations of the neck, tilt of the head, craniofacial asymmetry, and deformity of the skull. The authors present their experience of arthroscopic tight fibrous band release with radiofrequency in teenagers under local anesthesia and evaluate the clinical results.MethodsA total of 69 patients who underwent arthroscopic release of CMT with radiofrequency under local anesthesia by a single surgeon could participate in this study. Before operation, surface landmarks of sternocleidomastoid muscle, bone, and neurovascular structures were marked. Local infiltrating anesthesia of the surgical region was then performed. Through a working space created by blunt dissection, the arthroscopy and radiofrequency devices were introduced. Then, the clavicular and sternal heads of the sternocleidomastoid muscle were identified and gradually transected. The patients were followed up postoperatively with Cheng’s scoring system.ResultsThere were 31 male patients and 38 female patients. The mean age of the patients was 16.1 years. The mean length of follow-up in this series was 36.7 months (range, 28 to 67 months). During the operation, 62 patients (89.9%) had no pain, 6 patients (8.7%) felt mild pain, and only 1 patient (1.4%) regarded the procedure as very painful. At all follow-up periods, there were no repeat arthroscopies for any of these patients. At the final follow-up, the average rotation deficit improved from 22.5° to 4.1° postoperatively, and the average lateral bending deficit improved from 14.6° to 3.3° (p < 0.05). Overall, the clinical result was good or excellent in 65 patients (94.2%), fair in 4 patients, and poor in 0 patients within the follow-up period according to Cheng’s scoring system. To date, no patients had any intraoperative or postoperative complications from this procedure.ConclusionThe arthroscopic release with radiofrequency under local anesthesia provides surgeons with an alternative to traditional open techniques for the management of congenital muscular torticollis (CMT). Our date shows that this method is minimally invasive and provides good functional recovery with a lower risk of complications.

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Section: Discussionmentioning

confidence: 99%

“…Burstein described the original technique of endoscopic release for CMT for the first time in 1998 [ 4 ]. Several authors then reported different endoscopic release techniques for CMT [ 5 – 10 ]. The well-known advantage of endoscopy in contrast to the open operation is less traumatized and quick rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic release of congenital muscular torticollis with radiofrequency in teenagers

Wang¹,

Qi²,

Liu³

2018

J Orthop Surg Res

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“…Konservatif tedaviden fayda görmeyen, ciddi deformitesi olan tedaviye dirençli KMT'li 3-5 yaş arası çocuklarda ise bipolar gevşetme uygulamasının sonuçları daha iyidir (2,37). Daha iyi kozmetik sonuç elde etmek için transaksiller subkütan endoskopik SKM divizyonu gibi endoskopik yaklaşımlar geliştirilmektedir (38,39). Operasyon ile boyun EHA düzelir ancak mevcut fasiyal asimetri ve skolyoz devam eder (40).…”

Section: Radyolojik İncelemeunclassified

Konjenital Musküler Tortikollis: Tanı ve Tedavi Seçenekleri

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2012

Tftr

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Novel findings of the anatomy and variations of the axillary vein and its tributaries

et al. 2012

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The anatomy and variations of the axillary vein has significant implications in various invasive procedures such as venous access, axillary block, arteriovenous fistula creation, axillary node dissection, breast augmentation, and other surgical procedures involving the axilla. To clarify the anatomy of the axillary vein and its tributaries, 40 cadaveric upper extremities were examined after dissection and were classified into several types according to the courses and terminations of brachial veins. The brachial veins ended separately (Type A; 72.5%) or made a common brachial vein (Type B; 27.5%) to enter the basilic vein or the axillary vein. The basilic vein was absent in 5.0% of the specimens. Duplication of the axillary vein was observed in 17.5% of the specimens and the lateral venous channel running along the lateral wall of the axilla was observed in 40.0% of the specimens. The most common drainage vein of the deep brachial vein was the lateral brachial vein (67.5%). The anterior circumflex humeral vein also emptied into the lateral brachial vein in 67.5% of the specimens. The posterior circumflex humeral vein crossed posterior side of the brachial plexus to join either the axillary vein (45.0%) or subscapular vein (42.5%). Perforation of the lateral root of median nerve by a lateral brachial vein, a common brachial vein, or a venous channel was observed in 15.0% of the specimens. Other venous variations accompanying the variations of the axillary artery or the brachial artery are described herein. The clinical importance of these findings is described in the discussion.

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Endoscopic Transaxillary Subfascial Approach for Persistent Muscular Torticollis in Children

Cited by 5 publications

References 0 publications

Endoscopic release of congenital muscular torticollis with radiofrequency in teenagers

Endoscopic release of congenital muscular torticollis with radiofrequency in teenagers

Konjenital Musküler Tortikollis: Tanı ve Tedavi Seçenekleri

Novel findings of the anatomy and variations of the axillary vein and its tributaries

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