Sternocleidomastoidectomy

Chest scapular mastectomy is often used to correct congenital muscular torticollis. There are two types of congenital torticollis: congenital skeletal neck and muscular torticollis. Congenital skeletal torticollis is caused by congenital cervical spine development defects such as cervical unsegmented, semi-vertebral deformity, occipital or vertebral and intervertebral fusion, etc. Such torticollis is extremely rare. Congenital muscular torticollis is a deformity formed after fibrotic contracture of one side of the sternocleidomastoid muscle, mostly due to birth injury, clinically more common; it is considered to be related to heredity. Treatment of diseases: congenital torticollis Indication Indications for congenital muscular torticollis surgery vary with different stages of the disease. 1. Early torticollis (after birth to 2 years old), the deformity is light, and the correct non-surgical treatment can receive satisfactory results. A small number of babies have early head and face asymmetry. The sternocleidomastoid muscle cutting should be performed early (3-6 months after birth) to correct the asymmetrical deformity of facial paralysis. Children and juvenile torticollis after 2.2 years of age, have a head and face asymmetry (middle) should be treated surgically. 3. Some adult patients have only torticollis deformity without facial asymmetry. Good results can still be obtained after correction with sternocleidomastoidectomy. 4. Adult advanced torticollis deformity combined with head and face asymmetry or secondary cervical wedge deformity and scoliosis deformity should not be used for surgical orthopedics. Surgery is not beneficial, but harmful. After such torticollis correction, facial asymmetry will be more obvious, and some may also have strabismus and diplopia. Preoperative preparation 1. Shave the hair around the head of the sick side. 2. Prepare the skin of the neck for 2 days to prevent postoperative infection. 3. Neck radiographs except cervical deformities and other lesions. Surgical procedure 1. Position: supine position, neck high, head slightly to the healthy side. 2. Incision: A transverse incision parallel to the bone above the medial end of the clavicle, about 5 cm long. 3. Expose the muscle origin: Cut the platysma along the incision, and separate and reveal the clavicular head and sternum of the sternocleidomastoid muscle. The sarcolemma was cut longitudinally, and the muscles were separated and picked up by the hemostatic forceps or other blunt instruments. The muscles were cut along the upper and lower edges of the hemostatic forceps and excised 1 to 2 cm. The bleeding point of the broken end is sewed. If the fascia is still contracted, it will also be cut off. At this time, further tests should be carried out. The head should be turned to the affected side, and the lower jaw should be moved backwards. When the finger touches the fascia of the residual contracture, it should be cut under direct vision until it can be overcorrected. The subcutaneous tissue and skin can then be sutured layer by layer. 4. Gypsum fixation: Immediately after the operation, the head and neck gypsum is fixed, and the head is fixed to the overcorrection position opposite to the deformity.