• Journal of Korean Medicine Rehabilitation
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• v.34 no.2
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• pp.29-49
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• 2024

Objectives The purpose of this study is to systemically review the recent studies in the Korean medicine treatments for torticollis. Methods We search the clinical studies from January 1, 2018 to December 31, 2023. The studies were searched through 10 databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service, Korean Medical Database, ScienceON, PubMed, Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure). Results A total of 19 studies were included in the study. 12 studies were case report studies, 5 studies were randomized controlled trials, 2 studies were non-randomized controlled trials. Of the 19 interventions, Chuna was the most used in this study and of the 28 evaluation tools, Sternocleidomastoid thickness was the most used in this study except efficiency rate. All 19 studies had improvements after treatment, and 8 studies had statistically significant improvements. As a result of the study, we found that Chuna, GB, GB20, BL10, Glycyrrhiza uralensis were commonly used Korean medicine treatments for torticollis. Conclusions We analyzed the Korean medicine treatments for torticollis. Through this study, we found that the Korean medicine was effective for torticollis. However, more research is needed to confirm the more detailed effect.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.176-189
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• 2020

Purpose To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. Materials and Methods Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. Results Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. Conclusion RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.133-138
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• 2017

PURPOSE: The purpose of this study was to investigate the effect of modified motor developmental intervention on the SCM muscle thickness and the range of motion (ROM) of neck in subjects with congenital muscular torticollis. METHODS: Thirteen subjects who had congenital muscular torticollis were participated in this study and they were offered the modified motor developmental interventions for 8 weeks by pediatric physical therapist. SCM thickness of affected and non-affected side and ROM of neck rotation were collected between before and after intervention. SCM thickness was measured by using Ultrasound Unit (IU 22, Ultrasound system, Philips, Netherlands) and ROM of neck was measured by using the goniometer (Arthrodial protractor, North coast, USA). Data were represented as means ${\pm}SD$. Paired t-test was used to determine the effect of interventions on the SCM muscle thickness and neck ROM. RESULTS: SCM thickness of affected side was significantly decreased after the modified motor developmental interventions and that of non-affected side was generally increased but it was not significantly difference between pre and post interventions. ROM of neck rotation and lateral flexion was significantly increased after interventions. CONCLUSION: These results suggested that the modified motor developmental interventions could improve the recovery of SCM muscle thickness and neck ROM.

• Korean Journal of Acupuncture
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• v.23 no.4
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• pp.111-122
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• 2006

Objectives : Therapeutic effect of Balance Appliance of functional crebrospinal technique (FCST for meridian and neurologic yinyang balance was observed in two refractory torticollis cases. Methods : A unidentified severe torticollis two cases with several months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after $3{\sim}5$ months of therapy, which effect was reported to maintain for 6 months. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.88-91
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• 2015

In adult congenital muscular torticollis (CMT) patients, physical therapy is not as effective because the development of sternocleidomastoid muscle (SCM) muscle is complete. While surgical release can address CMT in adult patients, the risk of general anesthesia and visible postoperative scar is a concern, expecially in patients with mild symptoms. In this paper, we report our experience in treating such patients with minimal-incision myotomy under local anesthesia. A review was performed for all adult patients who had undergone the simple myotomy procedure. Surgical indication was reserved for patients with mild fibrotic band in the SCM muscle with minimal lengthdiscrepancybetween the muscles. All patients had recognizable head tiltand palpation of fibrotic band on affected side of the neck. Surgical details are described in the main body of text. Three female patients had undergone the procedure. Torticollis was resolve in all patients with complete restoration of ranage of motion. There were no postoperative complications, and patient satisfaction was high. We have reported three cases of mild CMT in adult female patients, who had undergone minimal-incision myotomy under local anesthesia. Outcomes were satisafactory with no morbidity to report. With careful patient selection, this method offers an alternate treatment option for adult CMT patients with mild symptoms.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.38-45
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• 2009

Purpose: The congenital muscular torticollis is a neck deformity involving shortening of the sternocleidomastoid muscle, which is detected at birth or shortly after birth. This childhood disease is the third most common congenital musculoskeletal anomaly. The indication for surgery is a persistent head tilt with dificit of passive rotation and lateral bending of the neck and a tight band or tumor in the sternocleidomastoid muscle even after physical therapy. The purpose of this article is to report surgical outcomes with patients who had no or little response to physical therapy. Methods: Surgery was performed on 29 patients and their average age was 4.1 years (from 6 months to 20.1 years). The unipolar open release and partial myectomy were done in 28 cases and the muscle lengthening was done in 1 case. Physical therapy was started from postoperative seventh day. Follow - up period was ranged from 2 months to 5.4 years(mean follow - up, 20.4 months). Result: There were neither rotation nor lateral bending deficit after surgical treatment. Mild head tilt was noticed in 3 cases and residual bend was observed in 4 cases. The subjective assessments of surgical results by parents were excellent. Conclusion: Our surgical outcome encourages the surgical treatment of congenital muscular torticollis for patients who failed to respond to physical therapy.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.65-70
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• 2009

Purpose: The pathophysiology of congenital muscular torticollis (CMT) is that the sternoclavicularmastoid (SCM) is shortened on the involved side by fibrosis, leading to an ipsilateral tilt and contralateral rotation of the face and chin. The aim of this study was to examine the effect of physical therapy and develop a mass diameter prediction model for infants with CMT. Methods: Fifty six patients were diagnosed with CMT between April 2003 and December 2008. Infants with neurological complications, and spasmodic and ocular torticollis were excluded. Physical therapy was applied to those masses in the SCM muscles of those infants after checking their physical findings and the diameter of the mass with ultrasonography. Their physical findings and mass diameter was reevaluated when their neck tilt was under $5^{\circ}$. Results: The mean age when physical therapy was started was 35 days. After a mean 90 days of treatment, the subjects showed improvement in the neck tilt. Subjects whose neck tilted above $15^{\circ}$ showed significant improvement in neck tilt decreased their mass diameter (p<0.01). Facial symmetric infants showed a shorter recovery duration than the facial asymmetric infants (p<0.05). A mass decreasing model based on the diameter of the mass, facial symmetry or not and the physical therapy start day after birth was developed by linear regression. Conclusion: Physical therapy is an effective treatment for CMT. The change in the diameter of the mass on the SCM muscles after treatment can be predicted.

• Journal of Interdisciplinary Genomics
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• v.1 no.2
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• pp.19-22
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• 2019

CATCH 22 syndrome is rare genetic disease that has various manifestations. Cervical vertebral anomaly, such as Klippel-Feil anomaly, is frequently observed in the patients with CATCH22 syndrome. We present the case of an 11-year-old female patient with CATCH22 syndrome and Klippel-Feil anomaly who had been treated torticollis using the customized soft neck collar. During the patient's first visit to our clinic, she presented with low ear set, skull deformity, intellectual disability, and tilting of the head to the left by approximately 25 degrees. Imaging studies revealed multisegmental fusion and C3 hemivertebrae of the cervical spine and left thoracic scoliosis at T4 with 50 degrees of Cobb's angle. We instructed passive stretching and applied the customized soft neck collar we invented. The ipsilateral aspect of the neck collar is designed to provide vertical support between the clavicle and mandibular angle and is adjustable in height. The Velcro was attached to the neck collar at the point of contact with the ipsilesional mandibular angle, which provides negative sensory feedback, inducing her to tilt neck to the contralesional side. We applied the neck collar for 2 hours a day. After 1 year of treatment, her neck inclination angle improved from 25 to 10 degrees. Providing negative sensory feedback using the customized soft neck collar can be one of the treatment options of postural management in patients with torticollis in cases of CATCH 22 syndrome combined with Klippel-Feil anomaly.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.77-91
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• 2023

Background: Congenital muscular torticollis results in reduced head mobility, such as cervical rotation, due to the abnormal size and contraction of the sternocleidomastoid muscle. Korea Pediatric integrative manual therapy and stretching are recommended to improve head rotation upper cervical spine mobility. Therefore, in this study, the effect of the new PIMT was investigated. Methods: The patient is a 3.5 month-old diagnosed with congenital muscular torticollis (CMT). Due to the limitation of head rotation and cervical spine rotation and flexion mobility, the child visited a rehabilitation center and after diagnosis, Pediatric integrative manual therapy (PIMT) treatment was performed five times a week for a total of 15 weeks. The child's head rotation and flexion limitation and plagiocephaly were evaluated. Results: In conclusion, this study shows that compared to other treatments, PIMT approach is a more effective treatment for improving head rotation and cervical limitation for range of motion in CMT infants. Conclusion: PIMT approach was effective in improving cervical rotation and Head lateral flexion mobility and plagiocephaly in CMT patients.

• Clinical Pain
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• v.18 no.2
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• pp.92-96
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• 2019

Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.