Endoscopic surgical treatment for congenital muscular torticollis.

Muscular torticollis, if untreated, may result in significant permanent craniofacial deformities. Surgical release of the sternocleidomastoid muscle is recommended for patients who fail to respond to physical therapy. Current surgical techniques all leave noticeable scars, and provide limited exposure. These limitations make complete muscular release and visualization of the spinal accessory nerve difficult. We have applied a new technique of endoscopic release of the sternocleidomastoid muscle in 12 infants and children ages 4 to 18 months and one adolescent with muscular torticollis. Complete muscular release was achieved in all patients with one minor complication. The spinal accessory nerve was preserved in all cases. Our endoscopic approach allows precise division of the muscle fibers and preservation of neurovascular structures, leaving an inconspicuous scar in the scalp.