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Plagiocephaly and brachycephaly treatment with cranial orthosis: a case report
Gerd Schreen1, Carolina Gomes Matarazzo
1Clínica Cranial Care, São Paulo, SP, Brasil.
Insights
Cranial deformities like plagiocephaly and brachycephaly increased due to recommended infant sleep positions. Cranial orthosis therapy effectively improved skull symmetry in a case study.
Area of Science:
- Pediatric Medicine
- Biomechanical Engineering
Background:
- The recommendation for supine infant sleep to reduce Sudden Infant Death Syndrome (SIDS) has inadvertently led to an increase in positional cranial deformities.
- Common deformities include plagiocephaly and brachycephaly, often exacerbated by prolonged infant positioning in devices.
Observation:
- A case report details a patient with associated brachycephaly and deformational plagiocephaly.
- Clinical evaluation involved photographic recording and laser scanning for precise asymmetry measurements before and after treatment.
Findings:
- Treatment with cranial orthosis resulted in significant improvement in cranial symmetry.
- Objective measurements showed a decreased cephalic index, reduced diagonal difference, and volume gain in flattened areas.
Implications:
- Orthotic therapy presents a safe and effective treatment option for positional cranial asymmetries in infants.
- This highlights the need for managing both SIDS prevention and the resulting orthopedic challenges.
Abstract:
The number of cranial deformities has increased considerably since international efforts of pediatricians to recommend parents putting their babies to sleep in the supine position as a strategy to reduce sudden death syndrome of the newborn. On the one hand, this program has demonstrated very efficient results at reducing deaths and, on the other hand, such recommendation has increased the incidence of cranial asymmetries. In addition, infants are kept too long in one position, much of this due to abusive use of strollers, baby carriers, car seats, swings and other devices. Among resulting asymmetries, the most frequently found are plagiocephaly (parallelogram shaped skull, with posterior unilateral flattening with the opposite frontal area also flattened) and brachycephaly (occipital bilateral flattening). The present study is a case report of a patient with brachycephaly associated with deformational plagiocephaly treated with cranial orthosis. The same physician clinically evaluated the patient before and after treatment using photographic recording and a laser scanning device, which allows the accurate measurement of variables determining asymmetries. It became clear during treatment that there was significant improvement in cranial symmetry documented by decrease in the cephalic index, diagonal difference and volume gain in the quadrant that was flattened. The authors conclude that orthotic therapy is a safe and effective therapeutic modality for position cranial asymmetries.
