Torticollis

University of Sto. Tomas Faculty of Medicine and Surgery Section C3 – 2010 Pelino, Sharlene; Perez, Jan Ray Q.; Perez, Joel; Pineda, Czarina; Pineda, John Michael; Pingoy, Anna Katrina; Piodena, Romeo III; Pioquinto, Fatima

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Torticollis
• also known as “wryneck” • simply refers to a “twisted neck” • congenital or acquired • etiology: unknown but birth trauma is most frequently associated
Beauchamp et. al.: Sabiston Textbook of Surgery, 18th ed Brunicardi et. al.: Schwartz’s Principles of Surgery, 8th ed

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Torticollis
• lesion results from fibrosis of the sternocleidomastoid muscle • mass can be palpated within the affected muscle • Histologic findings: characterized by the deposition of collagen and Beauchamp et.fibroblasts around atrophied al.: Sabiston Textbook of Surgery, 18 ed Brunicardi et. al.: Schwartz’s Principles of muscle cells Surgery, 8 ed
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Congenital Torticollis
• typical onset: 4 to 6 weeks of age in an otherwise healthy infant • presence of a lateral neck mass in infancy in association with rotation of the head toward the opposite side of the mass • head is typically tilted toward the side of the affected muscle and Beauchamp et. al.: Sabiston Textbook of Surgery, 18 ed rotated in the Brunicardi et. al.: Schwartz’s Principles of opposite direction
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Congenital vs. Acquired
Congenital Torticollis
• Onset: Within weeks after birth (4-6 weeks) • Associated problems: Rare

Acquired Torticollis
• Onset: Occurs later in life • Associated problems:
– Neurogenic: – Inflammatory: acute myositis; infectious causes such as retropharyngeal abscess, cervical adenitis, or tonsillitis. – Neoplastic:

Beauchamp et. al.: Sabiston Textbook of Surgery, 18th ed Brunicardi et. al.: Schwartz’s Principles of
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Treatment
• Conservative • Physical therapy
– Range-of-motion exercises consist of passive stretching of the affected muscle – Curative in most infants – Average duration of required treatment - 4.7 Beauchamp et. al.: Sabiston Textbook of months Surgery, 18 ed
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Brunicardi et. al.: Schwartz’s Principles of
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Treatment
• Surgical Resection/Transection of the involved muscles
– rarely necessary – Indication: if symptoms persist beyond 1 year

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THANK YOU ^__^
Torticollis
University of Sto. Tomas Faculty of Medicine and Surgery Section C3 – 2010 Pelino, Sharlene; Perez, Jan Ray Q.; Perez, Joel; Pineda, Czarina; Pineda, John Michael; Pingoy, Anna Katrina; Piodena, Romeo III; Pioquinto, Fatima

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