Related Experiment Video
Updated: May 21, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Clinical classification of infant nonsynostotic cranial deformity
Jan-Falco Wilbrand1, Kerstin Schmidtberg, Uta Bierther
1Department for Cranio-Maxillofacial Surgery, Plastic Surgery, University Hospital Giessen, Giessen, Germany. jan-falco.wilbrand@uniklinikum-giessen.de
Objective:
Based on a pilot study including >400 children and a comprehensive database analysis of >2500 children, we sought to define the craniofacial norm and to objectify the categorization of positional head deformity.
Study Design:
A database was created containing clinical information on children assessed for nonsynostotic cranial deformity. The findings of standardized anthropometric measurements were compared with data from a group of 401 healthy children with a normal head shape collected in terms of a prospective pilot study. Using a statistical analysis of all anthropometric craniofacial measurements, cut-off percentiles for discriminating different groups of deformation and severity classes were generated.
Results:
Normative percentiles for all dimensions in cranial vault anthropometric measurements during the first year of life were calculated. Children with definite nonsynostotic head deformity could be clearly allocated into 3 different groups: positional plagiocephaly (abnormal Cranial Vault Asymmetry Index), positional brachycephaly (abnormal Cranial Index), and combined positional plagiocephaly and brachycephaly (abnormal Cranial Vault Asymmetry Index and Cranial Index). Additionally, a reliable 3-level severity categorization (mild, moderate, and severe) for each group of cranial deformation could be obtained according to age and sex.
Conclusions:
Our results allow a meaningful and reliable classification of nonsynostotic early childhood cranial deformity.
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