The common term “sternocleidomastoid” refers to myotonic sternocleidomastoid contracture on one side of the body. There are also a few cases of bony sternocleidomastoid caused by spinal deformities, neurological sternocleidomastoid caused by compensatory postural and cervical muscle paralysis due to visual impairment, and head tilting to the side due to inflammation and swelling of the neck tissue. Sternocleidomastoid muscle The etiology of congenital myotonic squint is still unknown. However, most scholars believe that abnormal intrauterine pressure or malposition of the embryo is the main cause of congenital myotonic squamous neck. The fetal malposition in the uterus or abnormal pressure on the uterine wall may cause pressure on one side of the neck, and local blood circulation in the sternocleidomastoid muscle may be impaired, resulting in ischemic fibrous degeneration of the muscle and causing oblique neck. Difficult delivery and the use of forceps is one of the causes of myotonic squamous neck. This view has not been conclusively confirmed because it occurs more often in breech births, but examination of the local masses of the sternocleidomastoid muscle did not reveal signs of old bleeding. In addition, 1/5 of the children have a clear family history, so it is thought that its occurrence is genetically related and that such children are often combined with other parts of the body such as congenital acetabular dysplasia. Most congenital myotonic leptomeninges are congenital and there are no effective preventive measures. Early detection, early diagnosis and early treatment are the most important clinical aspects. Most children can be completely cured with correct and effective non-surgical treatment at an early stage. Therefore, young mothers and fathers must pay attention to their little one after birth and must look for any masses in his neck if his head is always tilted to one side. Once it is a tilted neck, don’t panic and go to the doctor as soon as possible. One day earlier treatment will increase the hope of successful treatment. If congenital myotonic squint is not effectively treated early, facial deformity will appear after 2 years of age. The main manifestation is facial asymmetry, the distance between the outer corner of the eye and the corner of the mouth is asymmetrical, the distance on the affected side is shortened, and the healthy side grows. The affected side of the eye position plane is reduced, because both eyes are not on the same level, easy to produce visual fatigue and vision loss. The healthy side of the face is round and full, while the affected side is narrow and flat. The cervical spine may develop compensatory scoliosis. In addition, the whole face, including the nose and ears, may be asymmetrically altered. The current treatment for congenital myotonic neck includes non-surgical treatment (such as local heat, massage, bed immobilization and traction) and surgical treatment. For children within half an age, non-surgical treatment can achieve satisfactory results. The specific method of manual traction is: lay the child down comfortably, make the child’s head slightly backward, the parents gently press the child’s thorax with the left hand, hold the head and neck with the right hand, rotate the child’s face to the affected side as far as possible, and the occiput to the shoulder peak of the healthy side, the operation should be gentle, the pulling action should be continuous and stable, so that the contracted sternocleidomastoid muscle gets a larger stretch. It is advisable to operate under the guidance of a specialist at the beginning. Each time 15-20 stretches, 4-6 times a day, the effect is satisfactory about 80-90%. When the child is in bed, he/she is placed in the supine position and the head is fixed with a small sandbag on the face towards the affected side and the occiput towards the healthy side. Surgery is mainly applied to: (1) those who are over half a year old and conservative treatment is ineffective; (2) those who are under 12 years old with obvious oblique neck deformity; (3) those who are over 12 years old with less serious facial deformity can also be considered for surgery. For a skilled pediatric surgeon, sternocleidomastoid surgery is a relatively simple procedure, which can be performed in about 20 to 30 minutes by cutting or partially removing the fibrotic sternocleidomastoid muscle, with little risk and few post-operative complications. Most babies have a good prognosis after surgery. Basically, children under one year of age recover quite quickly after surgery, with their heads turning around immediately and no longer requiring special treatment. If treatment is delayed until late, the head will still be habitually tilted after surgery, and physical therapy and four to five months of cervical collar correction will be needed before the head is fixed in the correct position: however, the deformation of the head and cheeks sometimes does not return to normal. In any case, it is very important to detect and start the treatment of the squint as early as possible, because the earlier the treatment, the easier and more effective it will be. Therefore, parents should not take it lightly to avoid delaying treatment for the rest of their lives.