臺灣地區區域醫院先天性肌肉斜頸的發生率及相關因子之探討

Epidemiology and Associated Factors Related to Congenital Muscular Torticollis in a Taiwan Regional Hospital

陳妙旼(Miao-Ming Chen) ； 林頌凱(Sung-Kai Lin) ； 謝泉發(Chuan-Fa Hsieh) ； 陳秀熙(Hsiu-Hsi Chen)

《台灣復健醫學雜誌》 35卷2期 (2007/06) Pp. 91-97

https://doi.org/10.6315/2007.35(2)04

摘要

Introduction: Congenital muscular torticollis (CMT) is the common disease among newborn. The diagnosis of CMT was based on clinical presentation and physical examination, typically. In 1900, ultrasonography for the CMT had first been described and it had been found to be a more sensitive diagnostic tool. However, such data was scarcely in Taiwan.
Purpose: To measure the incidence of CMT in Taiwan and identify associated factors in order to provide evidence for a possible etiology for CMT.
Methods: We used of CMT sonography of 1021 newborns at Li-Shin hospital. Sonographic studies of the bilateral sternocleidomastoid muscle (SCM) were performed on all full term uncomplicated newborns at Li-Shin hospital from January to August 2002. A physical examination was also carried out and associated data had been recorded. According to the sonographic result, the subjects had been divided into two groups (normal and abnormal). We compared the difference between two groups based on the recorded factors. Sonography and physical examination were repeated at one to three months after birth in the abnormal group. The P＜0.05 was considered to be statistically significant.
Results: The incidence of CMT was found to be 3.92% by ultrasonography, but only 1.08% by traditional diagnosis. The associated factors are longer body length, larger body weight and longer shoulder width, nulliparturition, birth trauma, difficult labor, and craniofacial asymmetry (p＜0.05). But the head circumference, birth by caesarian section, difficult labor and cord around neck didn’t have been found significant correlation with CMT.
Conclusion: Portable ultrasonograpy is an important tool on screening for congenital muscular torticollis. Newborns with craniofacial asymmetry were the high risk group for CMT.

關鍵字

先天性肌肉斜頸 ； 胸鎖乳突肌 ； 軟組織超音波 ； 纖維化

並列摘要

Introduction: Congenital muscular torticollis (CMT) is the common disease among newborn. The diagnosis of CMT was based on clinical presentation and physical examination, typically. In 1900, ultrasonography for the CMT had first been described and it had been found to be a more sensitive diagnostic tool. However, such data was scarcely in Taiwan.
Purpose: To measure the incidence of CMT in Taiwan and identify associated factors in order to provide evidence for a possible etiology for CMT.
Methods: We used of CMT sonography of 1021 newborns at Li-Shin hospital. Sonographic studies of the bilateral sternocleidomastoid muscle (SCM) were performed on all full term uncomplicated newborns at Li-Shin hospital from January to August 2002. A physical examination was also carried out and associated data had been recorded. According to the sonographic result, the subjects had been divided into two groups (normal and abnormal). We compared the difference between two groups based on the recorded factors. Sonography and physical examination were repeated at one to three months after birth in the abnormal group. The P＜0.05 was considered to be statistically significant.
Results: The incidence of CMT was found to be 3.92% by ultrasonography, but only 1.08% by traditional diagnosis. The associated factors are longer body length, larger body weight and longer shoulder width, nulliparturition, birth trauma, difficult labor, and craniofacial asymmetry (p＜0.05). But the head circumference, birth by caesarian section, difficult labor and cord around neck didn’t have been found significant correlation with CMT.
Conclusion: Portable ultrasonograpy is an important tool on screening for congenital muscular torticollis. Newborns with craniofacial asymmetry were the high risk group for CMT.

並列關鍵字

congenital muscular torticollis ； sternocleidomastoid muscle ； soft tissue ultrasonography ； fibrosis