선천성 근성 시경으로 인해 발생된 안모변형의 외과적 교정

Surgical correction of the facial deformity seconday to congenital muscular torticollis : report of a case

Intramuscular fibromatosis of stermocleidomastoid muscle causes muscular torticollis, i.e. wry neck. The etiology is not well established, but related to multiple factors such as abnormal intrauterine position, birth trauma, vascular accidents like venous obstruction or arterial occlusion, infection, heredity, etc. Facial asymmetry usually developes with flattening of the occipital portion of the skull on the contralateral side, depression of the zygoma, and inferior positioning of the orbit, ear, and corner of the mouth on the ipsilateral side. The cause of this asymmetry is supposed to be multifactorial. One suggested cause is the imbalance of muscle forces on the head in the rotated and tilted position, and another is sleep position. In this paper, we report a case of facial asymmetry secondary to congenital muscular torticollis which had been treated in three stages-bipolar sternocleidomastoid muscle release followed by use of a cervical splint and physical therapy ; bimaxillary osteotomy to bring the jaw midline toward the true mid-facial line ; septorhinoplasty.