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Published on: February 5, 2019
Demographics of Positional Plagiocephaly and Brachycephaly; Risk Factors and Treatment
Cas van Cruchten1, Michelle Marlena Wilhelmina Feijen1, Rene Remmelt Willie Johan van der Hulst2
1Zuyderland MC, Geleen.
Insights
Positional cranial deformations in infants are rising. While risk factors don't predict severity, helmet therapy significantly reduces positional plagiocephaly.
Area of Science:
- Pediatrics
- Developmental Biology
- Public Health
Background:
- Infant positional cranial deformations, including positional plagiocephaly and positional brachycephaly, have seen increased incidence over the past 30 years.
- These conditions can cause parental anxiety regarding potential long-term psychosocial effects on the child.
- Current non-operative treatments range from repositioning techniques to helmet therapy, with debated efficacy.
Purpose of the Study:
- To investigate the impact of identified risk factors on the type and severity of positional cranial deformations.
- To evaluate the effectiveness of different non-operative treatment modalities.
Main Methods:
- A questionnaire was administered to parents to collect data on risk factors (e.g., gender, birth details, torticollis, developmental status).
- Plagiocephalometry was employed to quantitatively measure cranial proportions.
- Treatment methods were documented, and short-term follow-up was conducted.
Main Results:
- No significant correlation was observed between the severity of positional cranial deformation and the studied risk factors.
- Certain risk factors showed a correlation with the specific type of cranial deformation.
- Helmet therapy demonstrated a significant positive effect in reducing positional plagiocephaly.
Conclusions:
- While risk factors may influence the type of positional cranial deformation, they do not appear to correlate with its severity.
- Helmet therapy is an effective treatment for reducing positional plagiocephaly.
Abstract:
In the last 3 decades, the incidence of positional cranial deformations in infants, such as positional plagiocephaly and positional brachycephaly, has increased. The deviating shape often causes parental concern for the later psychosocial wellbeing of the child. Treatment options are nonoperative, varying from positional change to helmet therapy, of which the effect has often been debated. Multiple risk factors have been associated with an increased risk on the development of these deformations. The goal of this study was to assess the impact of known risk factors on the type and severity of resulting positional cranial deformation.Parents were asked to fill out a questionnaire regarding the presence of risk factors, such as gender, age, pregnancy duration, method of delivery and reasons for atypical deliveries, breech position, birth weight, developmental status, positional preference, family history, number of siblings, and torticollis presence. Treatment methods were documented and plagiocephalometry was used to measure the cranial proportions. All children were invited to participate in short-term follow-up. The significance of the risk factors and the effect of different kinds of therapy are discussed. Although no significant correlation was found between severity and risk factors, some risk factors could be correlated with the kind of positional cranial deformation. Of the different therapies, helmet therapy had a significant impact on the reduction of positional plagiocephaly.
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