Assessing and Treating Torticollis and Facial Asymmetry

Q: Dr. Eppley, The untreated torticollis has left me with a head tilt as I mentioned before, but when I force my head to the right I can line up my eyes and my ears. I would like to model the surgery around my head in this position, not the tilted one, if that makes sense? I was wondering if that was possible, and if there are any treatments to fix the shortened muscle in adults? If there isn’t however I still ultimately rather fix my asymmetric features based on the position in which I tilt my head lining up my eyes and ears. Let me know if you need any clarity on that.

Lastly, would it be possible to do a CT scan, figure out surgeries I need and the cost of the surgeries then come back at a later date to have them performed? I would like to know what the total cost would be and then I could start saving with a direct goal in mind, instead of just guessing.

A: As I mentioned earlier you can not change the head tilt regardless of what is done to the muscle. Besides the fact that the muscle can not be lengthened, even if it were possible the head tilt would remain the same. There are many more anatomic derangements than just the shortened sternocleidomastoid muscle that accounts for the head tilt.

I would agree that any craniofacial changes should be based on a more neutral head position even if that is not your ‘natural’ head position.

It would be essential that a 3D craniofacial CT scan is done for treatment planning purposes. You can not do any facial asymmetry surgery without it.

Dr. Barry Eppley

Indianapolis, Indiana