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A Spectrum of Disease

James K. Bredenkamp, MD; Larry A. Hoover, MD; Gerald S. Berke, MD; Anthony Shaw, MD

Arch Otolaryngol Head Neck Surg. 1990;116(2):212-216.

Abstract
• Sternocleidomastoid muscle fibrosis has been recognized for centuries, but its pathogenesis and treatment remains controversial. Pseudotumor of infancy is a firm fibrous mass in the sternocleidomastoid muscle appearing at 2 to 3 weeks of age. Congenital muscular torticollis is less common and appears later in life. Pseudotumor and congenital muscular torticollis probably represent different manifestations of sternocleidomastoid muscle fibrosis. Pseudotumor will usually resolve with conservative therapy; however, some patients will subsequently develop torticollis. Congenital muscular torticollis usually requires surgical release of the sternocleidomastoid muscle to achieve a good cosmetic result and to prevent plagiocephaly, facial asymmetry, and scoliosis. This report provides guidelines for the management of congenital muscular torticollis and pseudotumor of infancy based on the authors' experience and review of the medical literature. Representative case histories from the neonate through the adult are presented, and the pathogenesis, diagnosis, treatment, and prognosis are discussed.

(Arch Otolaryngol Head Neck Surg. 1990;116:212-216)

Author Affiliations
From the Divisions of Head and Neck Surgery (Otolaryngology) (Drs Bredenkamp, Hoover, and Berke) and Pediatric Surgery (Dr Shaw), UCLA School of Medicine, Los Angeles, Calif, and the Divisions of Head and Neck Surgery (Otolaryngology) (Dr Hoover) and Pediatric Surgery (Dr Shaw), Olive View Medical Center, Sylmar, Calif.

Footnotes
Accepted for publication March 3, 1989.

Read before the Paul H. Ward, MD, Society, Los Angeles, Calif, April 16, 1988.

Reprint requests to Division of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, CA 90024 (Dr Hoover).

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