Myotomy

Under myotomy ( from Greek mys muscle and τομή "cut" ) is generally understood operational transection of a muscle. The myotomy can even be willed ( primary) or as part of another operation carried out (secondary). However, if the tendon is severed, the muscle attaches to a bone, there is a tenotomy. In a transection in the muscle -tendon junction can be spoken by a Teno myotomy.

Clinical Significance

Usually the myotomy is transverse to the fiber orientation, it is in principle, however, even with a longitudinal split myotomy, for example, for transfer of a resection or muscle belly. Through a transverse cut through it often leads to increased bleeding, so that an accurate hemostasis eg by cauterization is necessary.

After completion of the myotomy, the muscle belly retracts by spontaneous contraction when it is not fixed by instruments. This marks the complete loss of function of the muscle. Even if the muscle belly is withdrawn from the severed muscle group so still forms a scar. This takes place together with further cure and results - in dependence on the distance of the muscle after the myotomy ends - a partial reattachment of the ends of muscle. Thus, a certain residual function of the muscle are preserved.

A secondary required myotomy may be temporary transection of a muscle to the creation of an operational access to deeper regions of the body, for example, with subsequent restoration (reconstruction ) or seam. Even with an amputation myotomies are necessary, the amount of which depends on the muscle group, the level of amputation and perfusion quality or contractility of the muscle. In amputations a myoplasty with connecting various muscle groups to cover the bone stump or a Myodese with attachment of the severed muscle connects directly to the bone.

In the primary sense, a myotomy is performed to solve, for example, a ( or fibrous spastic ) muscle contracture. There are different procedures: tenotomy, tendon lengthening or Teno myotomy. The latter method is used for example in pediatric orthopedics in infantile cerebral palsy. One of the most common reasons is a shortening of the triceps surae and Achilles tendon with resulting equinus. Even when muscular torticollis ( torticollis ) - in particular the innate form - often comes a myotomy or tenotomy of the sternocleidomastoid muscle into account.

A myotomy is also used in gastroenterology for the treatment of achalasia use, as well for the treatment of pyloric stenosis as pyloromyotomy, or rare in ophthalmology for the treatment of strabismus ( but there is often a tenotomy instead ).