An infant delivered by cesarean section shows facial asymmetry and head rotation. What condition is this most likely indicative of?

The presentation of facial asymmetry and head rotation in an infant, particularly following a cesarean delivery, is most indicative of congenital torticollis. This condition occurs when the sternocleidomastoid muscle, which connects the sternum and clavicle to the mastoid process of the skull, is tight or shortened. Such tightness can lead to a characteristic posture where the head may tilt to one side and rotate toward the opposite side, resulting in facial asymmetry.

Congenital torticollis is not just associated with physical constraints during delivery but may also arise during the third trimester when the fetus is positioned in a way that can stress the neck muscles. In infants, this muscle tightness can manifest shortly after birth and is often noted by caregivers or healthcare providers due to the visible head tilt and facial differences.

The other conditions listed do not typically present with the same combination of symptoms. Plagiocephaly refers to an asymmetrical shape of the skull due to positioning rather than muscular tightness. Facial dystrophy relates to structural or functional issues of the facial muscles and typically does not result in the described head positioning. Microcephaly involves a smaller than average head size and does not correlate with facial asymmetry or head rotation