Congenital Muscular Torticollis-Long-Term Consequences

Background: Congenital muscular torticollis is the most common type of congenital torticollis. A good prognosis is expected, especially if treated early. However the occurrence of musculoskeletal and psychomotor development sequelae, in the medium to long term, has been reported in the literature. Purpose: To review the current scientific knowledge on the subject and to characterize the late term consequences of congenital muscular torticollis in the population followed in a paediatric tertiary Hospital. Methods: A bibliographic research was carried out and it was performed a review of the electronic records of the patients evaluated in 2009. Additionally, a telephone questionnaire was conducted, aiming to characterize musculoskeletal and developmental changes occurring during the last eleven years. Findings: There is a scarcity of studies addressing congenital muscular torticollis sequelae in the medium/long term, and the studies present very low levels of evidence. Sequelae describedare in the musculoskeletal, visuospatial, cognitive-behavioral and psychomotor spectrum. We identified 41 patients with congenital muscular torticollis newly diagnosed in our outpatient clinic in 2009, of which 26 answered the telephone query. Age at the time of the query ranged from 11,5 and 14 years. At the present time, 65% of patients had visual and/or dentition/chewing changes. Conclusions: In the series of patients studied, vision and oromandibular problems, followed by neurodevelopmental changes, were the most reported by the parents. The bibliographic references converge in the need for periodic reassessments in children with severe / difficult to resolve congenital muscular torticollis or severe skull deformities, in order to detect long term spinal and psychomotor development sequelae.