Torticollis was first noted at a median age of 2 months with the median age of presentation being 6 months. At presentation, a sternomastoid tumour was noted in 33 patients and 62 patients had facial asymmetry. Thirteen of 22 patients with neonatal records available had mandibular hypoplasia at birth on the side where the sternomastoid was affected. 20 underwent surgery and the median age of presentation of 19.5 months in this group was significantly later than that of 4 months in the group which responded to physiotherapy alone. Birth trauma appears to be the main aetiological factor in congenital muscular torticollis.
Patients generally respond well to physiotherapy.
More studies, however, are required to confirm these findings. A sternomastoid mass or tumour may or may not be clinically apparent. Untreated, cervical function and facial cosmesis may be severely compromised. Popular theories include birth trauma, fetal malposition in-utero, infection and ischaemia. The exact aetiology, however, remains unclear at present.