Wang Fei,Zhang Jing,Ni Lei,et al.Sonographic outcomes of sternomastoid tumor after manual stretching for congenital muscular torticollis in children[J].Journal of Clinical Pediatric Surgery,,():958-964.[doi:10.3760/cma.j.cn101785-202101026-011]
Sonographic outcomes of sternomastoid tumor after manual stretching for congenital muscular torticollis in children
- Keywords:
- Congenital Muscular Torticollis; Sternomastoid Tumor; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the impact of manual stretching on the size changes of sternomastoid (SCM) tumor in congenital muscular torticollis (CMT). Methods Between May 2017 and May 2019, retrospective review was conducted for 209 CMT children with SCM tumor. There were 132 males and 77 females, respectively. The side of involvement, the first visiting age and the initial long diameter, short diameter and cross section area of the SCM tumor were compared between sexes. Three visits were recorded in 209 patients, of whom 71 had four visits. The long diameter, short diameter and cross section area of the SCM tumor were compared between different visits. According to the age at visiting, 141 cases were 1 month old, 67 cases were 2 months old, 91 cases were 3 months old, 51 cases were 4 months old, 49 cases were 5 months old, 58 cases were 6 months old, 32 cases were 7 months old, 39 cases were 8 months old, 22 cases were 9 months old, 16 cases were 10 months old, 11 cases were 11 months old, 118 cases were 12 months old, and 15 cases were older than 12 months old. The long diameter, short diameter and cross section area of the SCM tumor were compared between different age. The patients were divided into three groups according to the age when ultrasound demonstrated the tumor disappeared. Group Ⅰ:≤ 6 months; Group Ⅱ:>6 months; Group Ⅲ:Still not disappeared at the final follow up. The demographic information, the initial long diameter, short diameter and cross section area of the SCM tumor and the total follow up time were compared within three groups. Results Initial long diameter, short diameter and cross-section area were (28.8±5.6)mm, (12.5±2.4)mm and (288.5±94.9)mm2 respectively.No gender differences existed in initial visiting age [(37.2±19.1) vs.(37.7±20.2) day, P=0.669], initial long diameter [(29.0±5.6) vs.(28.6±5.6)mm, P=0.818], short diameter [(12.6±2.4) vs.(12.2±2.3)mm, P=0.640] or cross-section area [(293.5±96.8) vs.(280.0±91.0) mm2, P=0.458].Long diameter [first time (28.9±5.6), second time (17.1±14.0), third time (5.9±11.4), fourth time (1.0±5.2)mm, P<0.001], short diameter [first time (12.4±2.4) second time (7.1±5.8), third time (2.4±4.7), fourth time (0.4±2.3)mm, P<0.001] and cross section area [first time (288.1±94.4), second time (157.6±146.4), third time (52.1±109.1), fourth time (9.4±53.7)mm2, P<0.001] decreased gradually with elapsing visiting time and age.And 40.3% of tumors disappeared until an age of 6 months and this ratio spiked to 94.3% at Month 12.No differences existed in initial visiting age [((36.0±18.9) vs.(38.4±20.6) vs.(37.1±14.0)day, P=0.701], left/right involved side [36 ∶46, 49 ∶56, 10 ∶11, P=0.918] or initial long diameter [(28.5±5.4) vs.(28.7±5.8) vs.(30.7±5.0)mm, P=0.286] among three groups.Meanwhile, short diameter [(11.9±2.3) vs.(12.6±2.3) vs.(13.6±2.4)mm, P=0.007] and cross-section area [(273.5±90.6) vs.(291.3±94.4) vs.(335.0±98.5)mm2, P=0.027] differed statistically among three groups.Gender ratio (male:female) increased from group Ⅰ to group Ⅲ (48 ∶35, 68 ∶37, 16 ∶5).However, the difference was insignificant (P=0.277).Group Ⅲ had greater initial short diameter [(13.6±2.4) vs.(11.9±2.3)mm, P<0.05] and cross section area [(335.0±98.5) vs.(273.5±90.6)mm2, P<0.05] than Group Ⅰand yet shorter follow-up time [(6.9±2.3) vs.(10.7±3.1)m, P<0.05] than Group Ⅱ.Average age of disappearing tumor was greater in boys and that in girls [(8.7±4.4) vs.(7.5±3.3)m, P<0.05]. Conclusions More than 90% of SCM tumors in CMT children may disappear within an age of 1 year if manual stretching is initiated within 3 months.Tumors disappear later in boys than girls.The dynamic process of SCM tumor may be evaluated more accurately after improving health tutoring and boosting follow-up compliance.
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Memo
收稿日期:2021-1-11。
基金项目:南京市卫生科技发展专项资金项目(YKK20123)
通讯作者:唐凯,Email:tk603@sina.com