Explaining the major problems related to the oblique neck

  The slanting neck can be divided into congenital muscular slanting neck and congenital bony slanting neck. The former is a congenital neck deformity caused by the contracture of the sternocleidomastoid muscle on one side, which is quite common; the latter is due to the developmental malformation of the cervical vertebrae, which is less common. Slanting neck is characterized by head tilt to the affected side, forward tilt and facial deformation. A few are bony squint caused by spinal deformity, compensatory postural of visual impairment and neurological squint caused by cervical muscle paralysis, and mostly refers to muscular squint caused by contracture of sternocleidomastoid muscle on one side.?  Most scholars believe that sternocleidomastoid is related to injury, such as breech birth and fetal malposition, compression of the sternocleidomastoid muscle in the neck, vascular compression and ischemia, embolization of the arterial lumen of the sternocleidomastoid muscle on the affected side, resulting in muscle dysplasia, or muscle edema, inflammation degenerates the muscle cells and produces fibrous degeneration, which is eventually replaced by connective tissue, resulting in contracture.  The diagnosis of a typical squint is not difficult. After birth, a pyknotic swelling is found on one side of the neck, which is oriented in the same direction as the sternocleidomastoid muscle. Head and face deformities are first noticed a few months later with a tense striated mass in the neck.  For children with oblique neck, passive pulling can be started two weeks after birth to correct the deformity by tilting the child’s head to the healthy side so that the healthy side of the earlobe approaches the shoulder and performing movements in the opposite direction of the deformity. The child’s head should be inclined to the healthy side so that the healthy side of the earlobe moves closer to the shoulder, and the movement is performed in the opposite direction of the deformity. The technique should be gentle, and the swelling should be massaged at the same time. Feeding, sleeping on pillows and using toys to attract the child’s attention in daily life can correct the posture, and physical therapy can be used if possible.  For children over 1 year old, surgery is required to cut off the sternal and clavicular heads of the contracted sternocleidomastoid muscle. After the surgery, we still need to continue to correct and maintain the normal posture of the head and neck in order to achieve good results.