Congenital muscular torticollis: Use of gaze angle and translational deformity in assessment of facial asymmetry
| العنوان: | Congenital muscular torticollis: Use of gaze angle and translational deformity in assessment of facial asymmetry |
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| المؤلفون: | Harish U, Atul Bhaskar, Hardik Desai |
| المصدر: | Indian Journal of Orthopaedics Indian Journal of Orthopaedics, Vol 51, Iss 2, Pp 123-130 (2017) |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | gaze angle, medicine.medical_specialty, wryneck, translational deformity, Congenital, 03 medical and health sciences, 0302 clinical medicine, facial asymmetry MeSH terms: Neck muscles, lcsh:Orthopedic surgery, Congenital muscular torticollis, medicine, Deformity, mesh:neuromuscular, mesh:torticollis, mesh:Neck muscles, Orthopedics and Sports Medicine, 030212 general & internal medicine, 030222 orthopedics, biology, business.industry, torticollis, Wryneck, Cosmesis, mesh:congenital, medicine.disease, biology.organism_classification, Gaze, Surgery, lcsh:RD701-811, mesh:wryneck, Orthopedic surgery, muscular, facial asymmetry, Original Article, neuromuscular, medicine.symptom, Nuclear medicine, business, Torticollis, Facial symmetry |
| الوصف: | Background: Assessment of facial asymmetry is challenging in torticollis deformity. Neck tilt in toroticollis is associated with deviation of horizontal ocular gaze and translation of neck from the midline. These deviations can be assessed clinically and can be used as surrogate marker for facial asymmetry. Materials and Methods: Thirty five children with congenital muscular torticollis (CMT) were classified into three grades of severity based on the new clinical score. The parameters included in the scoring system included rotational deficit, side flexion deficit, gaze angle (GA), and translational deformity (TD). Seven children had Grade I (mild), 18 had Grade II (moderate), and 10 had Grade III (severe) CMT. There were 21 girls and 14 boys with a mean age of 8.46 years (range 3–16 years). Twenty two children underwent a bipolar release, and 13 had unipolar surgery. Facial asymmetry (FA) signs were noted and based on GA and TD; all children had a deviation from the neutral angles (GA of 90° and 0 mm translation from the midsterna plumb line were considered neutral angle). The final outcome was based on the modified Cheng and Tang Score. Results: The mean GA in Grade I, II, and III improved from 81.71 to 90, 72.77 to 89.16, and 66.60 to 88, respectively (Chi-square P < 0.0001). The TD improved from 15 mm to 0 mm, 25.83 mm to 3.05 mm, and 36.6 mm to 6 mm in Grade I, II, and III, respectively (Chi-square P < 0.05). The rotational and side flexion deficits also improved across all grades of severity but were not statistically significant (P < 0.911 and P < 0.04). Twenty four children had an excellent outcome with complete correction of their GA and TD. Four children with Grade II CMT and seven children with Grade III who had a residual translation of 5 mm or more and GA less than neutral horizontal had a good outcome. No child had problems with scar cosmesis or prominent lateral bands, and there was no recurrence of deformity at a mean followup of 28 months (range 24–32 months). Conclusion: The GA and TD can be used to assess FA in torticollis management and significant improvement can be expected even in severe cases. |
| تدمد: | 1998-3727 0019-5413 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3e48d2e279caf5ddce8c2e6a640401f3 https://doi.org/10.4103/ortho.ijortho_114_16 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3e48d2e279caf5ddce8c2e6a640401f3 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 19983727 00195413 |
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