A 39-week-gestation male infant appears to be looking over his left shoulder with facial asymmetry. What condition is likely present?

The presence of facial asymmetry in a 39-week-gestation male infant who is looking over his left shoulder is indicative of congenital torticollis. This condition results from a shortening or fibrosis of the sternocleidomastoid muscle, leading to a head tilt towards the affected side and a rotation towards the opposite side. The infant's posture of looking over the left shoulder suggests that the right sternocleidomastoid muscle could be affected.

Congenital torticollis typically presents during infancy and may be associated with positional issues in utero or tightness in the muscle due to birth trauma or other factors. The asymmetry in the face can occur as the infant consistently positions their head to one side, which alters the developmental aspects of the skull and facial features.

In contrast, plagiocephaly refers specifically to a flat spot on the head and is not characterized by the developmental posture being observed. Spina bifida is a neural tube defect that affects the spine and typically does not present with facial asymmetry or specific head turning behavior. A cleft palate involves a structural defect in the mouth and does not relate to the postural and muscle tone characteristics observed in this infant. Therefore, the details provided clearly align with