Abstract
Torticollis, or wry neck, has a wide variety of causes in infants and children, including sternomastoid fibrosis, strabismus, cervical hemivertebrae, intracranial malignancy, trauma, and inflammation of the soft tissues of the neck. When it presents at about 3 weeks of age, it is usually due to a sternomastoid tumor, with tightness and shortness of the sternomastoid muscle – demonstration of the tight and shortened sternomastoid muscle is the key clinical feature that distinguishes this condition from all other causes of torticollis. Sternomastoid tumor/fibrosis is a benign condition that resolves spontaneously in the first year of life in about 90% of cases, but sometimes produces secondary plagiocephaly and hemifacial hypoplasia. If it fails to resolve by 1 year of age, or where the shortened sternomastoid muscle presents later in childhood, surgical division of the lower end of the muscle is indicated.