中国修复重建外科杂志

中国修复重建外科杂志

胸锁乳突肌多头切断术治疗成人先天性肌性斜颈

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【摘 要】 目的 探讨胸锁乳突肌多头切断术治疗成人先天性肌性斜颈的方法及效果。 方法 2009 年3 月-
2011 年2 月,收治19 例成人先天性肌性斜颈患者。男13 例,女6 例;年龄16 ~ 32 岁,平均23.5 岁。X 线片检查示,12
例伴不同程度颈椎侧弯及楔形改变。10 例伴患侧面部发育迟缓。4 例既往曾行胸锁乳突肌单侧头切断术。患者均采用胸
锁乳突肌多头切断术,联合术后石膏托及颈托外固定3 ~ 6 个月。 结果 术后患者切口均Ⅰ期愈合,无感染及血肿发生。
16 例患者获随访,随访时间5 个月~ 2 年,平均8 个月。患者头颈部畸形均较术前明显改善。术后2 周疗效评定:7 例无
颈椎畸形患者为优;12 例伴颈椎畸形患者优1 例,良7 例,一般4 例。术后2 周测量患侧胸锁乳突肌乳突尖至胸锁关节距
离,无颈椎畸形患者较术前延长(1.88 ± 0.30)cm,手术前后差异有统计学意义(t=6.24,P=0.00),且术后测量值与正常值比较差异无统计学意义(t=1.87,P=0.11);伴颈椎畸形患者术后较术前延长(3.38 ± 0.30)cm,差异有统计学意义(t=11.37,P=0.00),但术后测量值仍低于正常值(t=12.19,P=0.00)。 结论 采用胸锁乳突肌多头切断术治疗成人先天性肌性斜颈,能明显改善症状,恢复颈部活动功能。

【Abstract】 Objective To investigate the therapeutic method and effectiveness of multi ple sternocleidomastoid head
amputation for adult congenital muscular torticoll is. Methods Between March 2009 and February 2011, 19 patients with
congenital muscular torticoll is were treated with multi ple sternocleidomastoid head amputation. There were 13 males and 6 females, aged 16-32 years (mean, 23.5 years). The X-ray films showed that 12 cases were accompanied with some extent cervical lateral bending and wedge change. Ten patients were with i psilateral facial bradygenesis. Four patients had recieved single sternocleidomastoid head amputation. All of the 19 patients were treated with multi ple sternocleidomastoid head amputation, then plaster support and neck collar were used after operation for 3-6 months. Results The wounds of all the 19 patients healed primarily, without infection or hematoma. Sixteen patients were followed up 5 months to 2 years (mean, 8 months). The head and neck malformations were amel iorated significantly. The effectiveness was assessed 2 weeks later, in 7 patients without cervical vertebral malformation results were excellent; in 12 patients with cervical vertebral malformation, the results were excellent in 1 case, good in 7 cases, and fair in 4 cases. The length between mastoid process and sternoclavicular joints was elongated (1.88 ± 0.30) cm significantly after operation in patients without cervical vertebral malformation (t=6.24, P=0.00), showing no significant difference when compared with normal value (t=1.87, P=0.11); the length was elongated (3.38 ± 0.30) cm significantly (t=11.37, P=0.00) after operation in patients with cervical vertebral malformation, but it was significant shorter than normal value (t=12.19, P=0.00). Conclusion Multi ple sternocleidomastoid head amputation is a safe and effective method for adult congenital muscular torticoll is, which can improve the neck rotation function.

关键词: 成人先天性肌性斜颈; 胸锁乳突肌; 多头切断术; 斜颈矫正

Key words: Adult congenital muscular torticollis; Sternocleidomastoid; Multiple headamputation; Torticollis correction

引用本文: 付荣刚,殷秀清,于蓉. 胸锁乳突肌多头切断术治疗成人先天性肌性斜颈. 中国修复重建外科杂志, 2012, 26(2): 227-230. doi: 复制

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