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Rehabilitation Practice and Science

Baii-Jia Yang

Translated Title

先天性肌性斜頸超音波掃瞄檢查之結果及其追踪

Abstract

Of 65 cases of congenital muscular torticollis, normal and affected. Stern-cleido-mastoid muscle were examined by Aloka realtime sect scan (5m K HZ) for muscle echogram.The patients were divided into four groups according to the severity and age during their first visiting to OPD. A follow up study was done about 6 – 10 months later by echogram and clinical examination. In Group 1, of the 9 infants, with grade I wry neck, head tilting and the affected SCM muscle reveled firm with elasticity. The muscle echogram showed no definite abnormality. Therefore, no follow up echogram was given. In Group 2, of the 11 infants with grade II wry neck, head tilting, firm to hard mass over SCM muscle, partial neck range of motion limitation, or face asymmetry were found. The echogram showed slight hypodense area over mass area in 10 cases. Only one case showed marked hypodense with some derangement of muscle. Follow up study by echogram showed normal SCM in 7 cases, nearly normal in one case, and 2 cases were loss follow up. An operation was performed in one case without any treatment previously. In Group 3, of 38 infants with grade II wry neck, hard mass over SCM muscle, head tilting, neck ROM limitation, and face asymmetry were noted. Muscle echogram over affected SCM muscle showed marked hypodense area over mass with scattered and patchy isodense area. It means sporadic deranged muscle fibers over mass area with diffuse fibrosis. After treatment, echogram follow up showed 20 cases in normal picture; 4 case revealed borderline abnormality; 3 case were abnormal of which the echogram of affected SCM revealed partial hypodense with some scattered isodense area; 7 cases were loss follow up; 3 cases received operation due to unsatisfactory results. In Group 4, of 7 cases children, age 1.5 years old with cord like SCM muscle, firm or hard with fibrotic band, marked head tilting & ROM limitation were found. Muscle echogram was done in 4 severe case with hypodense area, no abnormal muscle density and thinner than normal on the affected side. Of 3 cases with less severity, isodense normal muscle pattern echogram was found but still with some hypodense area. No follow up study was done. From the findings of muscle echogram, the structure of normal and abnormal SCM muscle can be seen. Early detection and early treatment give a good result of resolution of the hypodense fibrotic area and growth of normal muscle density was also found progressively. In Group 4, patient were not treated before. Although the tumor over SCM muscle disappeared spontaneously. The SCM muscle became contracted with fibrotic band. Echogram of SCM revealed hypotrophic or atrophic muscle density with hypodense fibrotic area. An operation is necessary to cut out the fibrotic area. An operation is necessary to cut out the fibrotic band. Early treatment can reverse this condition to develop normal muscle. It is proved in the case of group 3. Although the patients of group 1 of part of group 2 will recover spontaneously.

Language

Traditional Chinese

First Page

9

Last Page

18

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