Prognosis

The majority of children with CMT have complete resolution with conservative management including physiotherapy and a home programme.[2][10][16] Younger age at diagnosis and less severe rotation or lateral flexion deformities have been shown to positively influence outcome and treatment duration in most studies. Results vary in studies comparing the outcomes of children with a sternocleidomastoid mass and those without.[10][16]

Even if a child requires surgery, most studies have shown a good outcome with long-term follow-up. One study of patients (age range 2 to 13 years) with CMT treated surgically showed excellent results in 88%.[40] The most important factor affecting the overall result and outcome was age at the time of operation: excellent results were obtained in all children under the age of 3 years. Endoscopic release has been shown to have a favourable long-term outcome.[40][41]

Long-term development is not affected; however, children who do not experience frequent prone positioning while awake may have delayed acquisition of prone skills such as crawling.[43] Plagiocephaly alone is not a predictor of developmental delay in infants with plagiocephaly and torticollis. In very young infants (i.e., average age 22 weeks), developmental delay appears to be related to sleep position, muscle tone, activity level, male sex, and neck dysfunction.[44]

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