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[Positional plagiocephaly]
Leif Christensen1, John R Østergaard, Sven Erik Nørholt
1Neurokirurgisk afdeling, Arhus Universitetshospital, Nørrebrogade 44, DK-8000 Arhus C.
Insights
Positional plagiocephaly in infants increased with back sleeping. Simple alternating head positioning can prevent it, or early physiotherapy or helmets may be needed.
Area of Science:
- Pediatric Health
- Craniofacial Development
Context:
- Public health recommendations for infant sleep position have shifted to promote safe sleep practices.
- This shift has correlated with an increased incidence of positional plagiocephaly.
Purpose:
- To describe the characteristics of positional plagiocephaly in infants.
- To recommend preventive and early treatment strategies for this condition.
Summary:
- A retrospective study analyzed 133 infants diagnosed with positional plagiocephaly between 1994 and 2000.
- The incidence rose significantly during this period. Physical causes for head turning were identified in a minority of cases, and no skull synostosis was detected via X-ray.
- Clinical diagnosis involves observing favored head turning, ipsilateral occipital flattening, frontal bossing, and anterior ear displacement.
Impact:
- Highlights the link between infant sleep positioning and craniofacial shape.
- Provides evidence-based recommendations for prevention and early intervention, potentially reducing the need for more invasive treatments.
- Informs healthcare providers and parents about managing and preventing positional plagiocephaly.
Introduction:
To prevent early sudden infant death syndrome, the health authorities recommend that newborn infants sleep on their back. This has led to an increase of positional plagiocephaly. The aim of this study was to describe this condition and to recommend a preventive treatment.
Material And Methods:
This is a retrospective registration of 133 children with positional plagiocephaly seen in the period from 1994 to 2000.
Results:
The number of children with positional plagiocephaly increased from two in 1994 to a maximum of 43 in 1999. 83 were males and 50 were females. 84 were dextral and 49 were sinistral. In seven (14%) of the sinistral and three (4%) of the dextral, we found a physical explanation of the head turning. In 51 children, X-rays of the skull were performed, but no synostosis was found.
Discussion:
The back-sleeping position of infants is a promotive factor to positional plagiocephaly which may be prevented by simple alternating head positioning. Otherwise early (< 6 months of age) corrective physiotherapy and positioning or an orthoplastic helmet must be considered. The diagnosis of positional plagiocephaly is based on clinical observations. There is a favourite head turning, an ipsilateral occipital flattening, an ipsilateral frontal bossing, and the ipsilateral ear is moved forward.
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