In the area of pediatric myotonic neck, we use the “Five Part Zen Rubbing Method”, which has the characteristics of “unique Zen rubbing technique, safe and quick to disperse the knots, localized and overall, and adaptable to different ages”. In response to the current situation that the treatment of pediatric myelomenorrhea takes a long time and has poor efficacy at higher ages, we have developed the “Five Parts Zen Rubbing Method” after years of clinical exploration and innovation, which is based on the developmental pattern of infant neck muscles and the scientific connotation of Chinese medicine meridians. Compared with the traditional Tui-Na method, the “Five Parts Zen Rubbing Method” greatly reduces the cure time of myxomatous squint at low months of age, at the same time, most of the children with high months of age are free from the pain of surgery and avoid the occurrence of deformities of the face, neck and shoulders.
1.What is pediatric myotonic neck?
There are two types of clinical cases, mainly based on the presence or absence of hard knots in the neck muscles, which are divided into mass type and non-mass type. The cause is the deviation of the head to the affected side due to the fibrotic contracture of the sternocleidomastoid muscle on one side. Nowadays, the incidence of pediatric squamous neck is very high and can reach the level of five thousandths or even one hundredth of the newborns.
2.What are the causes of pediatric oblique neck?
1, excessive pressure in the uterine cavity during pregnancy, and there are many reasons for high pressure in the uterine cavity, like fetal malposition, huge baby, etc., especially fetal malposition.
2, habits during pregnancy, from foreign papers and other information suggests that lying on the left side may be a risk factor, in my treatment summary of more than 1,000 cases of children with myelomeningocele, about 70% of the mother during pregnancy is lying on the left side.
3. Injuries occurring during childbirth, but nowadays, with the advanced technology of childbirth, such causes are actually rare.
In fact, the real reason for the formation of pediatric myelomeningocele is still not very clear. But pregnancy habits are important, and moderate activity is advocated during pregnancy. The common feature of myotonic squamous neck is the compression of the sternocleidomastoid blood vessels and the lack of blood supply, resulting in muscle dysplasia and fibrotic changes of different degrees. Just like a muscle that has been traumatized, it gradually hardens and undergoes fibrotic changes, which is not normal muscle tissue. Only there is no trauma during pregnancy. The blood circulation of the lump is not good, so it will be especially hard to touch.
3. Can pediatric oblique neck be prevented?
Because it happens during pregnancy, it is not a good idea to intervene in advance. The focus should be on timely observation and detection after birth. In clinical practice, many cases are discovered by the sister-in-law, who finds a lump on the neck when caring for the newborn, including when doing touch. So it is very necessary for parents to be able to master the method of detecting myotonic squint.
4. Can parents check whether their child has myotonic neck at home? What are the external signs?
Parents can actually check at home by themselves, and it is not complicated, as long as they observe carefully, it is easy to tell. There are three main methods as follows.
1, touch both sides of the neck muscles whether there are bumps. You can directly feel both sides of the child’s neck, you should mainly feel the sternocleidomastoid muscle, along the beginning of the sternocleidomastoid muscle at the mastoid behind the ear diagonally touch the sternum and clavicle stop, if there are bumps, then it may be a pediatric myotonic neck. Also, if there are small hard nodes around the sternocleidomastoid muscle, they may be enlarged lymph nodes, which are not related to the sternocleidomastoid. It can be easily distinguished in newborns by palpation about one or two days after birth. The bumps on the muscle are usually not painful when pressed, unless they are caused by injury during birth. Most children with a squint get the disease during the mother’s pregnancy, so it is at least a month or two before birth.
2. Observe whether the head is often tilted to one side. If you don’t know how to feel, it is possible to observe. The head often tilted to one side should be given great attention. Even if you do not feel the bumps, you should go to the hospital at the latest after the full moon. At the same time children who are often crooked to one side, their cervical vertebrae on both sides of the head turn at different angles and the range of motion on the crooked side of the head is significantly reduced compared to the other side.
3. Look at whether the two sides of the face are symmetrical. Children with squint often have a large face on one side and a small face on the other side, i.e. a small or large face with asymmetry on both sides.
5.What are the treatment options for pediatric squint?
There are generally two ways to treat pediatric squint, one is physical therapy and the other is surgery.
Physiotherapy is mainly based on tui-na, assisted by traction, hot compress, physical spectrum and acupuncture. The principle of Tui Na is to relax the tendons and blood, reduce swelling and disperse knots. The technique requires kneading, twisting, twisting and lifting, and so on, which is highly skilled. In fact, foreign countries also advocate the operation of massage method to treat myotonic squint, and their massage method is similar to the principle of Tui Na in Chinese medicine. Traction is to pull the neck in the opposite direction of the skewed head, this technique can be operated by parents at home, we recommend at least five groups per day, 20 times per group, and so the child is used to each pull can stay for 20 seconds, step by step. There are also hot compresses, hot compresses are divided into pure temperature and external compresses with medicine, which can promote blood circulation and can also be operated by parents, but pay attention to the grasp of the temperature. I would like to emphasize here that it is very unlikely that children with squamous neck will recover by themselves without treatment, and if they are not treated, the muscle bumps will become harder and harder as time passes, and the fibrosis will increase, and finally they can only be solved by surgery. After surgery, some children with squint still have problems such as asymmetrical movements on both sides of the head and neck and cervicothoracic scoliosis.
6.What degree of squint can be treated with massage? Can Tui Na completely cure?
Tui Na is the main treatment method for pediatric squint, and it is the most effective treatment among all physical therapies. The cure rate of Tui Na can reach over 90%, but the earlier the treatment, the better the result. However, pediatric tui na is not very useful for cases like osseous and oculogenic squint.
7.What is the best age for treating pediatric squints?
The earlier the better, if the problem is found at birth, the latest you can come for treatment is at full term. I have treated a child who was born 16 days ago. The bumps were hard and big at that time, and the size of the bumps was 37mm X 10mm according to the ultrasound, but the bumps were almost gone after about 20 days of treatment. It is best not to start the massage treatment more than three months old.
8.What do parents need to pay attention to in their daily care after the diagnosis of pediatric squamous neck?
The posture of nursing is also important, for example, if the child has a right-sided squint, put the child on the left side when nursing. At the same time, daily pulling techniques on the head.
9.What sequelae will be left if it does not heal?
The main sequelae are crooked neck, asymmetry between the two sides of the face, a large and a small. The cervical and thoracic vertebrae will be deformed by scoliosis. Overall, it will affect the normal development of the muscles and bones of the child’s neck. In addition, it will affect the child’s mental health in the long run.
10.What are the criteria for healing pediatric squint?
There are three main criteria.
1.No lump in the sternocleidomastoid muscle of the neck. This can be confirmed by ultrasound and hand feeling, which means that the softness and shape of the muscles on both sides are completely normal.
2, no head tilt.
3.The angle of cervical spine activity is symmetrical, and there are six directions of cervical spine activity such as forward and backward flexion and extension, lateral flexion and rotation. The angles of activities in the above directions should be the same. In the clinic, we often meet such children, that is, the lump in the neck can hardly be felt, but the angle of neck turning to the affected side is significantly less than that of the healthy side, which means that the stretching function of the sternocleidomastoid muscle on the affected side has not been fully recovered, and it is still necessary to continue the massage consolidation treatment.
11.Is there a possibility of recurrence after the cure?
In general, there is almost no recurrence after complete cure. However, the standard of cure should be judged by the doctor, not the parents’ own subjective opinion.