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Recalcitrant Torticollis: A Formidable Treatment Challenge.

Gwendolyn E Daly¹, Madeline Otto¹, Sara Alturky¹

¹Division of Plastic Surgery, Oregon Health & Science University, Portland, OR, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association

|November 11, 2024

Summary

This summary is machine-generated.

Recalcitrant torticollis (RT) often improves with early, multidisciplinary conservative therapy. Most infants diagnosed before age one achieve symptom resolution or improvement, avoiding advanced treatments.

Keywords:

bipolar release botulinum-toxin injection muscle function pediatrics physical therapy retrospective study sternocleidomastoid release torticollis

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Published on: September 18, 2011

Area of Science:

Pediatric Physical Therapy
Developmental Pediatrics
Rehabilitation Medicine

Background:

Recalcitrant torticollis (RT) lacks evidence-based guidelines, persisting past one year despite conservative care.
Current recommendations include physical therapy (PT), occupational therapy (OT), botulinum toxin injection (BTI), and surgery for severe cases.

Purpose of the Study:

To evaluate the effectiveness of conservative therapies for recalcitrant torticollis.
To identify factors influencing treatment outcomes in infants with persistent torticollis.

Main Methods:

Retrospective single-center study of 77 patients diagnosed before age one with RT.
Inclusion criteria: persistent symptoms past one year despite conservative treatment.
Data collected on diagnosis age, therapies received, and outcomes.

Main Results:

Most patients (96.1%) received physical therapy for an average of 13.3 months.
Conservative modalities resolved symptoms in 51.2% and improved symptoms in 45.5%.
Botulinum toxin injection and surgery were used in a small number of severe cases.

Conclusions:

Recalcitrant torticollis requires diligent, multidisciplinary care.
Early conservative therapy initiated before age one significantly improves outcomes.
Prompt intervention can lead to symptom resolution, often precluding advanced treatments.