Torticollis, or wry neck, is a condition that occurs when the sternocleidomastoid muscle of the neck becomes scarred and shortened. Typically, the head is tilted toward one side, and the chin is elevated and turned toward the opposite side. In about 20 percent of cases, torticollis is accompanied by plagiocephaly, or twisting of the head.
The problem occurs when a muscle in the womb or during birth is damaged and leads to scarring. This causes the muscle to tighten and shorten, which in turn pulls one side of the head toward the shoulder as the chin tilts in the opposite direction. The Children’s Center for Craniofacial Disorders uses endoscopic surgery, or keyhole surgery, for children with this serious condition.
Typically, endoscopic surgery involves inserting a tiny telescope into the body. The telescope, usually a quarter inch in diameter—the width of a pencil, features an attached video camera.
For many children suffering from torticollis, physical therapy alone may be adequate to restore muscle length and function. If plagiocephaly is present, the use of a molding helmet may help to restore normal head shape. In addition, botulinum toxin (Botox) may be helpful in some cases to relax the muscles. If conservative measures fail to resolve torticollis, endoscopic surgery is recommended.
Endoscopic Surgery for Children
Typically, endoscopic surgery involves inserting a tiny endoscopic telescope into the body. The telescope, usually five to 10 millimeters in diameter, features an attached video camera. Using this tube-like instrument, surgeons are able to make small, hidden incisions in the body to treat a variety of complex conditions including benign cysts and vascular and lymphatic tumors.
Surgeons at Children's completed the nation's first comprehensive study detailing the successful use of endoscopic techniques in a variety of pediatric surgical procedures. The study tracked more than 40 patients ranging in age from 7 months to 15 years.
By using endoscopic surgical techniques, surgeons are able to minimize the size of the incision, thereby decreasing morbidity, recovery time and scarring for the patient. The procedures included a variety of reconstructive surgeries, ranging from the excision of vascular lesions and facial tumors to the correction of torticollis, a condition that restricts movement of the neck.
These results strongly indicate that pediatric endoscopic surgery will soon become the standard treatment for a variety of pediatric disorders, both aesthetic and reconstructive in nature.