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Turning the Tie: The Impact of OMT on infant torticollis and tongue tie

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 17. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p13.xml)

Keywords:

ankyloglossia [4]
case report [723]
infants [202]
OMT [3776]
osteopathic manipulative treatment [3796]
pediatrics [546]
tongue tie [2]
torticollis [23]

Abstract:

Introduction/Background: Infant torticollis, characterized by the abnormal tilt and rotation of the head due to muscle contracture in the neck, often affects the sternocleidomastoid muscle, leading to restricted cervical motion and facial asymmetry. Approximately 1 in 250 infants are affected, with untreated cases potentially delaying motor milestones. Ankyloglossia (tongue tie) complicates some cases by affecting cranial and cervical muscle balance, often through increased digastric muscle tension. Osteopathic Manipulative Treatment (OMT) has been explored as a conservative method to alleviate muscle tension and improve range of motion. Case: An otherwise healthy 2-week-old male presented with right-sided head tilt and left neck rotation restriction. His parents, familiar with torticollis from a previous child, noticed early signs of abnormal posture. The osteopathic exam revealed limited cervical rotation, hypertonicity in the sternocleidomastoid and digastric muscles, and a restrictive tongue tie. These factors contributed to muscle strain, worsening the torticollis. Results: The infant underwent five OMT sessions over several weeks, including indirect myofascial release, cranial techniques, and balanced ligamentous tension. Oral-motor exercises were also introduced to improve tongue mobility. After treatment, the infant showed improved neck range of motion, reduced head tilt, and better midline head control per physical exam and parental report. Daily home stretches and side-lying holds were advised to maintain post-OMT improvement. Discussion: This case highlights the importance of early diagnosis and OMT for torticollis, particularly in infants with ankyloglossia. Parental awareness enabled early intervention, improving outcomes. It also underscores how ankyloglossia can exacerbate muscular asymmetry. Limitations include the small sample size and reliance on parental reports of improvement. Further studies are needed to explore the role of ankyloglossia in torticollis and compare OMT with surgical options like frenotomy.


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