[Treatment of non-synostotic head deformity in infants with dynamic orthosis]

In all craniofacial deformities the differential diagnosis between synostotic and non-synostotic conditions must be made. While the first group is usually subject to intracranial surgical intervention, the treatment of non-synostotic deformities is the subject of controversial discussion. Often associated with premature birth, restrictive intrauterine environment or torticollis, these conditions, also defined as positional deformations, can lead to severe plagiocephalic head shapes. Dynamic orthotic cranioplasty is a conservative method of treating these deformities in early childhood by means of an individually fabricated orthotic head band. The principle is that dynamic pressure is applied to prominent parts while leaving space for growth in depressed areas. In accordance with this principle, various deformities can be addressed. Through clinical, anthropometric and radiographic evaluation it has been shown that dynamic orthotic cranioplasty can correct positional deformation of the cranial vault, skull base and upper face with no relapse following treatment. It must be emphasised that the method is simple, easy to handle and very effective when treatment starts within the first 6 months of life. Therefore, its potential should be recognised by paediatricians and craniofacial surgeons.