Etiology: There are still many different opinions on the etiology of congenital oblique neck. Most of them think that the fetal malposition or abnormal pressure of the uterine wall makes the abnormal posture of the head and neck and obstructs the blood circulation of one side of the sternocleidomastoid muscle, causing ischemia, atrophy, dysplasia and contracture of the muscle, resulting in oblique neck. It is also believed that the sternocleidomastoid muscle is injured and bleeding due to extrusion or traction by the birth canal or forceps during childbirth, and the hematoma is caused by mechanized contracture. It is also believed that the sternocleidomastoid muscle has degenerative changes due to embolism of the nutrient artery or obstruction of the venous return, resulting in the formation of a squint. In adults, congenital squint is a series of symptoms caused by the lack of timely or thorough treatment of the muscularity in children. Clinical manifestations: Newborns are often found to have a hard oval mass in the lower part of the sternocleidomastoid muscle 7-14 days after birth, which may gradually increase in size. After two months, the mass begins to shrink and finally disappears completely, and the muscle becomes an inelastic fibrous cord. It is also common for the muscle at the mastoid process to be cord-like. The head is gradually pulled to the affected side, the neck is twisted, the face is tilted, and the jaw is tilted to the healthy side. If left uncorrected, the affected side develops more slowly, resulting in gradual deformation of the face and skull and asymmetry on both sides, which can be known by measuring the distance from the outer canthus of both eyes to the corner of the mouth; the occipital, cervical and upper thoracic vertebrae are visible in the posterior view, showing scoliosis deformity. In patients who have not been treated for a long time, other muscles on the affected side of the neck also develop corresponding contractures, and the cervical vertebrae gradually undergo morphological and structural changes. In this kind of advanced myotonic squint, even if the contracture of the sternocleidomastoid muscle is corrected, it is difficult to restore the normal shape of the face. After surgery, the child sleeps in a supine position with the chin to the affected side and the occiput to the healthy side, and the head is fixed in the above position with a cotton pad and a small clean sand bag. Only when awake, alternate with brace fixation and manual correction, when the manual correction must turn the chin to the affected side and gradually raise it, while tilting the head to the healthy side; 3 to 4 groups per day, each group of 30 for half an hour, each group interval 1.5 to 2 hours, for 3 weeks. Adult rehabilitation Suitable for adults and adolescents with self-control ability 1. Use brace to fix when sleeping. Functional exercises should be performed when waking up. Functional exercises should be performed by turning the lower chin to the affected side and gradually raising it, while tilting the head to the healthy side and turning the face to the healthy side as much as possible; 3 to 4 groups per day, each group of 30 for half an hour, with an interval of 1.5 to 2 hours between each group for 3 weeks. 2, adults should also carry out lumbar back muscle exercise and cervical spine exercise: (1) lumbar back muscle exercise (purpose: to make the lumbar back muscle strong and powerful to correct the hunchback)
Lie on the bed (prone position) head and limbs all slowly up out of bed, limbs straight out of bed the higher the better only the stomach (abdomen) contact bed, and then slowly back to bed flat; each time the back stretching force lifting the higher the better; exercise from the first day after surgery, no less than 3 groups per day, each group practice until the muscles slightly sore, interval of at least 2 hours, so that muscle recovery. Continue for at least 3 months, if you insist on lifelong spinal stability is better. (2) cervical spine exercise: after tilting the head back as hard as possible, keep the head tilted backward once (1), to the left once (2), backward once again (3), to the right once (4); so repeat until the muscles are slightly sore for a group of not less than 3 groups per day, each group interval of at least 2 hours, so that the muscles recover. Continue for at least 3 months, if you insist on lifelong to prevent cervical spondylosis better.