Pediatric squint is a common deformity in infants and children, most of which are physiological and many children will slowly improve by the age of 1 year. However, there are also cases of pathological squint. In physiological squint, the crooked neck is often not fixed to one side, meaning that the child can tilt his or her head to both sides, just to one side most of the time. This condition is most common in young infants and is related to the lack of strength in the neck muscles to control the head and neck posture and the fixed position in which the child is held at this stage of development. As the child develops and changes its holding habits, most of the cases can be cured. The common symptoms of pathological squint in infancy include neck lumps, facial asymmetry, large face on one side and small face on the other; head fixed to one side; and in severe cases, crooked mouth and eyes and high and low ears. These symptoms can persist and worsen progressively. If they are not treated in time, they can lead to high and low shoulders, curvature of the spine, and visual fatigue caused by secondary strabismus at school age. The most common type of pathological squint is myelomeningocele. However, there are also some other causes of squint, so it is necessary to go to a specialized hospital for examination and differential diagnosis by a doctor: 1, strabismus Patients with strabismus coordinate their vision with a skewed neck, which can also be manifested as a squint. 2, bony squint Cervical spine skeletal abnormalities such as atlantoaxial subluxation, cervical hemivertebrae, scoliosis, etc. can also be manifested as crooked neck, and X-ray examination can confirm the diagnosis. 3.Inflammation of the neck Inflammation of the neck can lead to crooked neck, usually with enlarged lymph nodes in the neck and local pressure pain in the neck. 4. Hearing asymmetry in both ears Hearing asymmetry in both ears caused by congenital factors, the child is used to using the ear with good hearing, which can also be manifested as a crooked neck. 5.Other intracranial tumors and gastroesophageal reflux can also cause a crooked neck. Special examinations such as MRI and gastroscopy are needed to confirm the diagnosis. So, how to target the treatment of squint neck? If the diagnosis is physiological squint, then just pay attention to change the feeding habits and adopt postural therapy, i.e. parents should adjust their position in relation to the child when feeding or holding the child to sleep, for example, if the child is right-sided myotonic squint, the child should be placed on the left side of the parents when feeding and sleeping, and vice versa. Most cases of physiological myelomeningocele will heal as the child develops. For children diagnosed with myelomeningocele, early detection and early treatment are effective, and more than half of them can be cured conservatively, eliminating the need for surgery. More than half of them can be cured conservatively and can be exempted from surgery. Late detection and serious cases can be treated surgically. 1.Manipulation correction treatment After the newborn is diagnosed with myotonic squint, passive pulling is used every day, moderate pulling of the head to the healthy side, several times a day, 10-15 times each time. A sand pillow is applied to fix the head during sleep. As the child grows up, the strength of manual pulling increases, the occipital part is rotated to the healthy side, and the lower jaw is pulled to the affected side several times a day, and most of them can get satisfactory results. 2.Surgical treatment Suitable for children around 2 years old with severe neck deviation and sternocleidomastoid muscle contracture after conservative treatment. Generally, a transverse incision is made at the proximal end of the clavicle. For children aged 2-4 years old with mild disease, only the clavicular and sternal heads of the sternocleidomastoid muscles are cut off, and a neck brace is applied to keep the child in the overcorrected position after surgery, and the child is often helped to rotate the lower jaw to the affected side and the occiput to the healthy side. For those who are over 4 years old and have severe oblique neck, upper and lower sternocleidomastoid muscles can be cut and released, and postoperative brace is applied to correct the deformity. However, the combined facial asymmetry deformity still cannot be completely restored to normal after surgery.