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Posterior plagiocephaly: proactive conservative management.

E S O'Broin1, D Allcutt, M J Earley

  • 1Temple Street Craniofacial Unit, Children's Hospital, Dublin, Republic of Ireland.

British Journal of Plastic Surgery
|May 27, 1999
PubMed
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Conservative management, including sleep posture modification and physiotherapy, significantly improved most posterior plagiocephaly cases. Many non-synostotic deformities resolved to mild, acceptable levels without surgery.

Area of Science:

  • Pediatric Neurosurgery
  • Craniofacial Surgery
  • Developmental Pediatrics

Background:

  • Posterior plagiocephaly diagnosis and management are controversial, especially for non-synostotic cases.
  • Surgical intervention is standard for true lambdoid synostosis, but non-surgical approaches for severe, persistent cases lack consensus.
  • Standard imaging often fails to definitively diagnose or assess the severity of posterior plagiocephaly.

Purpose of the Study:

  • To review the outcomes of conservative management for posterior plagiocephaly.
  • To evaluate the effectiveness of sleep posture modification and physiotherapy in treating non-synostotic posterior plagiocephaly.
  • To assess the role of imaging versus clinical follow-up in managing these conditions.

Main Methods:

  • Retrospective review of 39 posterior plagiocephaly cases.

Related Experiment Videos

  • Analysis of conservative treatments including sleep posture modification and physiotherapy.
  • Clinical assessment of deformity severity and patient/parental satisfaction.

    • Main Results:

    • 37 out of 39 patients were treated conservatively.
    • 34 patients showed significant improvement within one year with conservative treatment.
    • Most remaining deformities were mild and did not require surgery; complete normalization occurred in 8 cases.

    Conclusions:

    • Conservative management is effective for many posterior plagiocephaly cases, leading to significant improvement.
    • Clinical follow-up is currently the most reliable method for assessing progress and determining the need for surgery.
    • Defining recalcitrant cases remains challenging, and 3-D CT, while accurate, poses radiation concerns.