Congenital muscular torticollis, commonly known as “worried neck”, is caused by fibromatosis in the sternocleidomastoid muscle. The mass is palpated at birth or within the first two weeks after birth. The right side is more common than the left side. The lesions can affect all muscles, but more lesions only affect the attachment point near the clavicle of the sternocleidomastoid muscle. The mass is the largest within 2 months after birth, and its volume remains the same or slightly shrinks, and usually becomes smaller or disappears within 1 year. If the mass does not disappear, the muscle will undergo permanent fibrosis and contracture. If not treated, it will cause permanent torticollis.
The treatment of congenital muscular torticollis includes non-surgical treatment and surgical treatment.
Non-surgical therapy: Under the guidance of a physician, parents will perform passive neck traction activities for the child. The head is first moved to the healthy side, and then the mandible is turned to the affected side. Each movement is performed slowly, and passive neck movements are performed 3 to 4 daily. Times, about 10 minutes each time. In addition, the affected side leaned against the mother’s chest during breastfeeding. When teasing the baby, standing on the side of the affected side is also a way to stretch the sternocleidomastoid muscle. After about one year of conservative treatment, 76% to 86% of children can be corrected.
Surgical treatment: Children over 1 year old who have failed conservative treatment or have not been treated have facial deformities due to muscle fibrosis. Only surgery can correct their deformities. The optimal age for surgery is 1 to 5 years old. For those over 5 years old, it is difficult to recover from facial deformities due to severe secondary deformities.