OMT Minute: Condylar Decompression Technique for Infants
eVideo. Stacey Pierce-Talsma, DO, demonstrates the use of the osteopathic manipulative treatment (OMT) technique condylar decompression on infants. This technique can help manage various symptoms, including colic, reflux, feeding dysfunction, torticollis, plagiocephaly, and constipation.
Osteopathic manipulative treatment may be safely and easily applied to the pediatric population, including infants. In the video, we review the condylar decompression technique, a common technique that may be of benefit when treating an infant.
Condylar decompression is the release of the occipital condyles at the base of the skull. In a newborn and infant the condyle is in 2 parts and is surrounded by cartilage. Distortions of these parts along with numerous muscular, ligamentous, or fascial connections near this area may cause compression or irritation of the hypoglossal nerve as it exits the hypoglossal canal.
Other cranial nerves in this region include those that exit the jugular foramen, which comprises the articulation of the occiput and temporal bone. These nerves include cranial nerves IX (glossopharyngeal), X (vagus), and XI (accessory). Irritation or compression in these cranial nerves may contribute to a myriad of symptoms, including colic, reflux, feeding disfunction, torticollis, plagiocephaly, and constipation. Although condylar decompression is demonstrated on a pediatric patient in the video, this technique can also be used on adults.
When performing this technique, the infant or newborn should be placed in a supine position, and the physician should sit at the baby's head and cradle it in his or her hands. The physician's fingers should curl around the craniocervical space so that the ring fingers lie on the approximate plane of the occipital condyles. The index fingers may monitor at the mastoid region of the temporal bone, and the middle fingers may be used to stabilize and balance the atlas from the occiput.
The physician should use his or her ring fingers to induce a gentle but firm lateral and posterior spreading motion to spread the tissues away from the atlas and help decompress the condyles. This position should be maintained until the tissues soften or the range of motion improves between the occiput and the atlas. One side may release before the other. (doi:10.7556/jaoa.2017.139)
We thank Jeffery Reedy for filming and video editing and Garrick Higgins and Mia Higgins for contributions to the video.
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