Intramuscular fibromatosis of stermocleidomastoid muscle causes muscular torticollis, i.e. wry neck. The etiology is not well established, but related to multiple factors such as abnormal intrauterine position, birth trauma, vascular accidents
like
venous obstruction or arterial occlusion, infection, heredity, etc. Facial asymmetry usually developes with flattening of the occipital portion of the skull on the contralateral side, depression of the zygoma, and inferior positioning of the
orbit,
ear,
and corner of the mouth on the ipsilateral side. The cause of this asymmetry is supposed to be multifactorial. One suggested cause is the imbalance of muscle forces on the head in the rotated and tilted position, and another is sleep position.
In this paper, we report a case of facial asymmetry secondary to congenital muscular torticollis which had been treated in three stages-bipolar sternocleidomastoid muscle release followed by use of a cervical splint and physical therapy ;
bimaxillary
osteotomy to bring the jaw midline toward the true mid-facial line ; septorhinoplasty.
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