Ann Rehabil Med.  2011 Oct;35(5):641-647. 10.5535/arm.2011.35.5.641.

Comparison of Clinical Severity of Congenital Muscular Torticollis Based on the Method of Child Birth

• Lee SJ
• Han JD
• Lee HB
• Hwang JH
• Kim SY
• Park MC
• Yim SY

• KMID: 2267225
• DOI: http://doi.org/10.5535/arm.2011.35.5.641

Abstract

OBJECTIVE
To compare the clinical severity of congenital muscular torticollis (CMT) based on the method of child birth. METHOD: Children diagnosed with CMT and who were < 6-years-of-age at the time of their first visit at the Center for Torticollis, Ajou Medical Center, were included in this study. The medical records were retrospectively reviewed with reference to the method of child birth and the clinical severity of CMT. The clinical severity of CMT was determined either by whether stretching exercises were needed for the children <6-month-of-age or whether surgical release was required for the children > or =6-months-of-age at the time of the first visit.
RESULTS
One hundred seventy eight subjects with CMT were enrolled. There was no significant difference in the rate of surgical release according to the method of child birth. For 132 patients <6-month-of-age there was also no significant difference in the rate of stretching exercises.
CONCLUSION
There was no significant difference in the clinical severity of CMT based on the method of child birth. This finding suggests that prenatal factors alone could be a cause of CMT and that the clinical severity of CMT in children delivered by Cesarean section is not different when compared with the severity of CMT in children born through vaginal delivery.

Keyword

Congenital torticollis; Vaginal delivery; Cesarean section

MeSH Terms

Cesarean Section
Child
Exercise
Female
Humans
Medical Records
Parturition
Pregnancy
Retrospective Studies
Torticollis
Torticollis

Figure

• 

  Fig. 1 Neck ultrasonography and MRI of the subjects who were born via either vaginal delivery (A) or cesarean section (B). (A) The ultrasonography and axial T1-weighted MRI of an 8-month-old boy with left CMT shows enlargement of the left SCM and low signal intensities (arrows). (B) The ultrasonography and axial T1-weighted MRI of a 9-month-old girl with right CMT shows enlargement of the right SCM and low signal intensities (arrows).

• 

  Fig. 2 The clinical pathways for the treatment of children with CMT.

• 

  Fig. 3 The enrollment algorithm for the subjects from January 2009 to December 2009.

Reference

1. Chen MM, Chang HC, Hsieh CF, Yen MF, Chen TH. Predictive model for congenital muscular torticollis: analysis of 1021 infants with sonography. Arch Phys Med Rehabil. 2005; 86:2199–2203. PMID: 16271571.

2. Hsu TC, Wang CL, Wong MK, Hsu KH, Tang FT, Chen HT. Correlation of clinical and ultrasonographic features in congenital muscular torticollis. Arch Phys Med Rehabil. 1999; 80:637–641. PMID: 10378488.

3. Yim SY, Lee IY, Cho KH, Kim JK, Lee IJ, Park MC. The laryngeal cough reflex in congenital muscular torticollis: is it a new finding? Am J Phys Med Rehabil. 2010; 89:147–152. PMID: 19730356.

4. Binder H, Eng GD, Gaiser JF, Koch B. Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil. 1987; 68:222–225. PMID: 3566514.

5. Canale ST, Griffin DW, Hubbard CN. Congenital muscular torticollis. A long-term follow-up. J Bone Joint Surg Am. 1982; 64:810–816. PMID: 7085709.

6. Cho KH, Kim JY, Lee IY, Yim SY. Congenital muscular torticollis in siblings: a case report and literature review. J Korean Acad Rehabil Med. 2009; 33:731–734.

7. Engin C, Yavuz SS, Sahin FI. Congenital muscular torticollis: is heredity a possible factor in a family with five torticollis patients in three generations. Plast Reconstr Surg. 1997; 99:1147–1150. PMID: 9091917.

8. Lidge RT, Bechtol RC, Lambert CN. Congenital muscular torticollis; etiology and pathology. J Bone Joint Surg Am. 1957; 39-A:1165–1182. PMID: 13475414.

9. Suzuki S, Yamamuro T, Fujita A. The aetiological relationship between congenital torticollis and obstetrical paralysis. Int Orthop. 1984; 8:175–181. PMID: 6530313.

10. Cheng JC, Tang SP, Chen TM, Wong MW, Wong EM. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants--study of 1,086 cases. J Pediatr Surg. 2000; 35:1091–1096. PMID: 10917303.

11. Hummer CD, MacEwen GD. The coexistence of torticollis and congenital dysplasia of the hip. J Bone Joint Surg Am. 1972; 54:1255–1256. PMID: 4652057.

12. Davids JR, Wenger DR, Mubarak SJ. Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome. J Pediatr Orthop. 1993; 13:141–147. PMID: 8459000.

13. Do TT. Congenital muscular torticollis: current concepts and review of treatment. Curr Opin Pediatr. 2006; 18:26–29. PMID: 16470158.

14. Yim SY, Lee IY, Park MC, Kim JH. Differential diagnosis and management of abnormal posture of the head and neck. J Korean Med Assoc. 2009; 52:705–718.