The role of age on helmet therapy in deformational plagiocephaly and asymmetric brachycephaly

Area of Science:

• Pediatric orthopedics
• Craniofacial abnormalities
• Biomechanical engineering

Background:

• Deformational plagiocephaly (DP) and asymmetrical brachycephaly (AB) are common infant skull conditions.
• Helmet therapy is a primary treatment, but optimal timing remains a key consideration.
• Understanding the impact of age at treatment initiation is crucial for maximizing efficacy.

Purpose of the Study:

• To evaluate the influence of age at the start of helmet therapy on treatment success in infants with moderate-to-severe DP and AB.
• To compare treatment outcomes between infants treated before and after six months of age.

Main Methods:

• Retrospective review of 98 infants treated with helmet therapy between 2014 and 2018.
• Inclusion criteria: DP (CVAI > 7%, DD > 10 mm) and AB (CVAI > 7%, CR ≥ 94%).
• 3D screening systems measured pre- and post-treatment cranial asymmetries; infants grouped by age (<6 months vs. ≥6 months).

Main Results:

• Statistically significant improvements in cranial vault asymmetry index (CVAI) were observed in all treatment groups.
• Infants treated before six months showed significantly greater CVAI reduction compared to those treated later (p < 0.0013).
• Achieving normal cranial shape (CVAI < 3.5%, CR ≤ 89) was more frequent in the younger treatment group.

Conclusions:

• Helmet therapy is highly effective for treating DP and AB, especially in severe cases.
• Early intervention, initiating helmet therapy before six months of age, is strongly recommended for optimal outcomes.
• Age at treatment onset is a critical factor influencing the success of helmet therapy for positional plagiocephaly.