CAJ | 학술논문

目的探讨局麻关节镜下胸锁乳突肌松解治疗先天性肌性斜颈的疗效.方法局麻关节镜下射频胸锁乳突肌松解术治疗先天性肌性斜颈26例.右侧14例,左侧12例.男11例,女15例,年龄平均22岁.术前标记胸锁乳突肌、锁骨和手术切口.局部浸润麻醉后,在胸锁关节以远10cm,分别作2个5 mm的皮肤切口,沿锁骨中1/3的表面钝性分离出3 cm×5 cm的工作腔隙.置入关节镜和双极射频,紧贴锁骨表面气化切割胸锁乳突肌的胸骨头和锁骨头附着部分.结果术后随访平均25个月(15～71个月)根据术后颈部活动度、颜面部畸形改善情况、头颈倾斜度和主观感觉满意度评分,优19例,良7例.患者颜面畸形均明显矫正,无瘢痕、复发、复视、血肿及血管神经损伤,疗效满意.结论局麻关节镜下胸锁乳突肌松解术治疗成人肌性斜颈方法可行,创伤小、操作简便、疗效好、有利于美容.
목적 탐토국마관절경하흉쇄유돌기송해치료선천성기성사경적료효.방법 국마관절경하사빈흉쇄유돌기송해술치료선천성기성사경26례.우측14례,좌측12례.남11례,녀15례,년령평균22세.술전표기흉쇄유돌기、쇄골화수술절구.국부침윤마취후,재흉쇄관절이원10cm,분별작2개5 mm적피부절구,연쇄골중1/3적표면둔성분리출3 cm×5 cm적공작강극.치입관절경화쌍겁사빈,긴첩쇄골표면기화절할흉쇄유돌기적흉골두화쇄골두부착부분.결과 술후수방평균25개월(15～71개월)근거술후경부활동도、안면부기형개선정황、두경경사도화주관감각만의도평분,우19례,량7례.환자안면기형균명현교정,무반흔、복발、복시、혈종급혈관신경손상,료효만의.결론 국마관절경하흉쇄유돌기송해술치료성인기성사경방법가행,창상소、조작간편、료효호、유리우미용.
Objective To evaluate the efficacy of sternoclidomastoideus radiofrequency carburation with local anesthesia under arthroscope for the treatment of congenital muscular torticollis in adults. Methods Twenty-six cases of congenital muscular torticollis were treated by radiofrequency carburetion with local anesthesia under arthroscope. The right side was in 14 patients and left in 12. There were 11 males and 15 females with an average age of 22 years old. Sternoclidomastoideus and clavicula were pre-operatively marked. Through an artificial lacouna, arthroscope and radiofrequency probe were inserted. Results The mean follow-up period was 25 months (range: 15-71 ). According to the motion deficits, craniofacial asymmetry, head tilt and subjective assessment,there were 19 excellent and 7 fair outcomes. Most patients showed a marked improvement in neck motion and head tilt with satisfactory functional and cosmetic outcomes. There was no nerve or vascular injury, no recurrence, infection and scar. The overall efficacy was satisfactory. Conclusion The radiofrequncy therapy for torticollis with local anesthesia under arthroscopy has a satisfactory efficacy. The advantages are minimal trauma, simple procedure, less pain and better cosmetics.