Torticollis, also known as “wryneck”, is a condition in which an infant or child’s head is tilted to one side. Generally, the chin points towards one shoulder (usually the left) while the head tilts towards the other, although other presentations are possible. Torticollis can be a clinical symptom of any one of a number of different conditions, both congenital and acquired. For example, some cases of congenital torticollis are caused by a bone problem in the neck portion of the spine. However in infants this condition is most commonly the result of a shortening of the sternocleidomastoid muscle, which runs up the back of the neck, and is specifically known as congenital muscular torticollis. Left untreated, this condition can cause nerve and muscle pain in the neck and, ultimately, craniofacial asymmetry.
It is unclear what causes the shortening of the neck muscle. It is possible that the muscle may be injured before or during the baby’s birth, causing it to bleed and swell. Scar tissue then would replace some of the muscle, making it shorter. The symptoms become evident when the caregiver notices that the infant always holds his or her head tilted to one side. Early examination is important, however, because other conditions may also cause this head position.
Congenital muscular torticollis can usually be treated by nonsurgical means using physical therapy techniques aimed at gradual restoration of muscle length. A physical therapist generally works with the parents to formulate a daily routine of safe stretching exercises. Surgical intervention is reserved for those patients that fail to respond to physical therapy or have a worsening of their facial deformities as torticollis is progressive and will become more severe with age.
Dr. Fernando Burstein, double board-certified in plastic surgery and otolaryngology with over twenty-five years of experience specializing in facial cosmetic and reconstructive surgery, has developed a minimally invasive endoscopic technique through which torticollis can be corrected by releasing the sternocleidomastoid muscle to eliminate restricted movement and allow for a full range of motion of the head and neck. By using an endoscopic approach, scarring is hidden behind the ear and within the hairline and post-operative complication risks are decreased.
If you are interested in learning about this procedure, or any other facial procedure that Dr. Burstein performs, please contact us today to schedule a consultation. Also be sure to connect with Dr. Burstein on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.