多数先天性肌斜颈患儿经过包括理疗和家庭康复在内的保守治疗可以完全康复。[2]Cheng JC, Wong MW, Tang SP, et al. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. A prospective study of eight hundred and twenty-one cases. J Bone Joint Surg Am. 2001;83-A:679-687.http://www.ncbi.nlm.nih.gov/pubmed/11379737?tool=bestpractice.com[9]Binder H, Eng GD, Gaiser JF, et al. Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil. 1987;68:222-225.http://www.ncbi.nlm.nih.gov/pubmed/3566514?tool=bestpractice.com[14]Emery C. The determinants of treatment duration for congenital muscular torticollis. Phys Ther. 1994;74:921-929.http://ptjournal.apta.org/content/74/10/921.full.pdf+htmlhttp://www.ncbi.nlm.nih.gov/pubmed/8090843?tool=bestpractice.com 多数研究表明,诊断时年龄较小、转向程度或侧曲变形较轻在大多数研究中对于预后和治疗过程有较积极的影响。比较患儿胸锁乳突肌内是否有包块对预后的影响在不同的研究中结果各不相同。[9]Binder H, Eng GD, Gaiser JF, et al. Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil. 1987;68:222-225.http://www.ncbi.nlm.nih.gov/pubmed/3566514?tool=bestpractice.com[14]Emery C. The determinants of treatment duration for congenital muscular torticollis. Phys Ther. 1994;74:921-929.http://ptjournal.apta.org/content/74/10/921.full.pdf+htmlhttp://www.ncbi.nlm.nih.gov/pubmed/8090843?tool=bestpractice.com 即使对于需要手术干预的患儿,多数研究表明长期随访预后较好。有项先天性肌斜颈患者(年龄分布在2~13岁)的研究表明88%的病例经过手术治疗获得满意疗效。[37]Cheng JC, Tang SP. Outcome of surgical treatment of congenital muscular torticollis. Clin Orthop Relat Res. 1999 May;(362):190-200.http://www.ncbi.nlm.nih.gov/pubmed/10335298?tool=bestpractice.com手术结果:中等质量证据表明,88%的先天性肌斜颈病例手术后得到改善。[37]Cheng JC, Tang SP. Outcome of surgical treatment of congenital muscular torticollis. Clin Orthop Relat Res. 1999 May;(362):190-200.http://www.ncbi.nlm.nih.gov/pubmed/10335298?tool=bestpractice.com受试者<200名的随机对照临床试验(RCT)、受试者>200名且方法学存在缺陷的随机对照临床试验(RCT)、方法学存在缺陷的系统评价或者高质量的观察性(队列)研究。 影响整体结果和结局的最重要的因素是手术时的年龄:所有 3 岁以下的患儿均获得了极佳的结果。内窥镜下松解术已显示长期结局良好。[37]Cheng JC, Tang SP. Outcome of surgical treatment of congenital muscular torticollis. Clin Orthop Relat Res. 1999 May;(362):190-200.http://www.ncbi.nlm.nih.gov/pubmed/10335298?tool=bestpractice.com[38]Burstein FD. Long-term experience with endoscopic surgical treatment for congenital muscular torticollis in infants and children: a review of 85 cases. Plast Reconstr Surg. 2004 Aug;114(2):491-3.http://www.ncbi.nlm.nih.gov/pubmed/15277820?tool=bestpractice.com长期预后:中等质量证据显示内窥镜下松解术治疗先天性肌斜颈患儿有更好的长期预后。[38]Burstein FD. Long-term experience with endoscopic surgical treatment for congenital muscular torticollis in infants and children: a review of 85 cases. Plast Reconstr Surg. 2004 Aug;114(2):491-3.http://www.ncbi.nlm.nih.gov/pubmed/15277820?tool=bestpractice.com受试者<200名的随机对照临床试验(RCT)、受试者>200名且方法学存在缺陷的随机对照临床试验(RCT)、方法学存在缺陷的系统评价或者高质量的观察性(队列)研究。 长期发育不受影响,然而,没经过清醒期俯卧位训练的患儿可能会推迟获得俯卧位技能如爬行。[40]Tessmer A, Mooney P, Pelland L. A developmental perspective on congenital muscular torticollis: a critical appraisal of the evidence. Pediatr Phys Ther. 2010;22:378-383.http://www.ncbi.nlm.nih.gov/pubmed/21068637?tool=bestpractice.com 在斜颈和斜头畸形患儿中,斜头畸形并不能作为发育迟缓的预测因素。在小月龄婴儿中(比如平均年龄22周),发育延迟可能与睡眠姿势、肌肉张力、活动水平、男性以及颈部功能障碍有关。[41]Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). Prognosis of infant development with plagiocephaly, torticollis. June 2011. http://www.cincinnatichildrens.org/ (last accessed 28 August 2017).http://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/recommendations/topic/