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Ear, nose and throat (Otolaryngology)

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Congenital muscular torticollis

Congenital muscular torticollis is a condition in which an infant's neck muscle is shortened causing the neck to twist. Congenital means present at birth and torticollis means twisted neck. The condition is sometimes called wryneck, fibromatosis colli of infancy, or pseudotumor of infancy.

What causes congenital muscular torticollis?

Congenital muscular torticollis may occur following a difficult birth, especially if the infant is very large or is delivered breech. During the delivery, if the sternocleidomastoid muscle, the neck muscle that extends from the jawbone (mastoid) to the clavicle (collarbone) and sternum (breastbone), is stretched or pulled, it may tear, causing bleeding and bruising within the muscle.

The injured muscle develops fibrosis (scar tissue) which causes the muscle to shorten and tighten, pulling the infant's head to one side. The fibrosis forms a mass or lump that sometimes can be felt on the side of the neck.

Occasionally, congenital muscular torticollis occurs because of a defect in the development of the sternocleidomastoid muscle, or because of an abnormal fetal position in the uterus.

The symptoms

Congenital muscular torticollis may be visible at birth or it may not become evident until several weeks later. The following are the most common symptoms of congenital muscular torticollis. However, each child may experience symptoms differently. Symptoms may include:

  • Tilting of the infant's head to one side
  • The infant's chin turns toward the opposite side
  • Firm, small, one to two centimeter mass in the middle of the sternocleidomastoid muscle

The symptoms of congenital muscular torticollis may resemble other neck masses or medical problems. Always consult your child's physician for a diagnosis.

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