Background: Congenital muscular torticollis is a disease with influences on cosmesis and function of the face. Objectives: (1) Remarks syndrom of congenital muscular torticollis; and (2) Evaluate Ferkel\u2019s technique to treatment torticollis in children. Subjects and method: During 10 years period (from January 1996 to December 2005), there were 68 patients with congenital muscular torticollis (39 female and 29 male); Age from 02 to 14 years old. The patients were operated by Ferkel\u2019s technique. Results: All patients have a palpable contrature of the sternocleidomastoid muscle, elevating shoulders, limitation of neck mouvements more than 30 degree. Our results: Excellent in 06,6%; Good in 52,4%; Fair in 37,7% and Poor in 3,3%. Conclusion: Limitation of neck mouvements, facial asymmetry and persistence of an intramuscular tumor are the principal clinical signs. Age of surgical indication is older than 1 year old. Those patients were operated by Ferkel\u2019s technique with functionally and cosmetically good result.
Torticollis/ surgery ; Child ;

A case of spasmodic torticollis in a 48-year-old man cured by micovascular decompression of the spinal accessory nerve with selective dorsal cervical rhizotomy of the first and second cervical nerves. The 11th nerve was compressed by the posterior inferior cerebellar artery originating from the vertebral artery at the C1 level. After intraoperative identification of each posterior rootlets of C1 and C2 nerves exclusively related with the involved sternocleidomastoid muscle(SCM) using the monopolar electric nerve stimulator, microvascular decompression with selective dorsal cervical rhizotomy was done using the Teflon felt and electrobipolar coagulator. The patient was significantly relieved from symptoms 1 week after operation.
Accessory Nerve ; Arteries ; Decompression ; Humans ; Microvascular Decompression Surgery* ; Middle Aged ; Polytetrafluoroethylene ; Rhizotomy ; Torticollis* ; Vertebral Artery

OBJECTIVETo investigate a new endoscopic transaxillary technique for release of the sternocleidomastoid (SCM) in congenital muscular torticollis (CMT).

METHODSFrom May 2008 to March 2014, a total of 25 cases (male 7 and female 18), ranging in age from 14 to 31 years (mean age, 17.6 years), were operated for torticollis by endoscopic-assisted surgery. The sternal and clavicular attachments of the sternocleidomastoid were released by skin lift approach.

RESULTSThe primary healing was achieved in all the 25 cases with no injury of major vessels or nerves. The patients were followed up for 6 months with satisfactory result and invisible scar.

CONCLUSIONSThe subcutaneous endoscopic transaxillary and skin lift approach for the CMT provides good functional and cosmetic outcomes.

Adolescent ; Adult ; Axilla ; Cicatrix ; Clavicle ; Endoscopy ; methods ; Female ; Humans ; Male ; Neck Muscles ; surgery ; Torticollis ; congenital ; surgery ; Treatment Outcome ; Young Adult

PURPOSE: Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment. METHODS: The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher's exact test. RESULTS: The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003). CONCLUSIONS: Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.
Adolescent ; Adult ; Child ; Child, Preschool ; Diplopia/*surgery ; Female ; Head Movements ; Humans ; Infant ; Male ; Oculomotor Muscles/*surgery ; Retrospective Studies ; Strabismus/*surgery ; Torticollis/*surgery ; Treatment Outcome ; Trochlear Nerve Diseases/*surgery

BACKGROUND: The results of 51 cases of trial spinal cord stimulation which had been carried out for relief of intractable pain were analyzed. METHODS: Most patients were referred due to failure of conventional pain treatment modalities. They consisted of 35 men and 16 women, ranging in age from 21 to 74 years. In 17 cases pain was associated with postherpetic neuralgia, 14 with failed back surgery syndrome, 3 with cauda equina syndrome, 3 with reflex sympathetic dystrophy, 3 with spinal cord injury, 2 with brachial plexus injury, 2 with torticollis, 2 with vertebral injury, 1 with phantom limb pain, 1 with myelitis, 1 with paraplegia, 1 with low back pain, and 1 with cancer metastasis to the vertebra. An electrode tip was positioned at varying sites from C1-2 to T11 dictated by the location of pain. T3, T6, and T8 were the most frequent sites. RESULTS: Pain due to postherpetic neuralgia, failed back surgery syndrome, cauda equina syndrome, reflex sympathetic dystrophy, and brachial plexus injury was well controlled. Noticeable complications included wound infection and electrode displacement. Following a trial period of stimulation, 10 patients had permanent stimulators implanted, while one patient died as a result of unrelated causes. CONCLUSIONS: We may suggest that spinal cord stimulation represents a useful technique in a well- selected group of patients with no other treatment options.
Brachial Plexus ; Electrodes ; Failed Back Surgery Syndrome ; Female ; Humans ; Low Back Pain ; Male ; Myelitis ; Neoplasm Metastasis ; Neuralgia, Postherpetic ; Pain, Intractable ; Paraplegia ; Phantom Limb ; Polyradiculopathy ; Reflex Sympathetic Dystrophy ; Spinal Cord Injuries ; Spinal Cord Stimulation ; Spinal Cord* ; Spine ; Torticollis ; Wound Infection