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Published on: February 5, 2019
Diagnostic and treatment possibilities in the management of positional plagiocephaly
Robert Chrenko1,2, Andrej Plž3, Barbora Nedomová4,5
1Department of Pediatric Neurosurgery, National Institute of Children´s Diseases, Limbova 1, 83340, Bratislava, Slovakia.
Insights
Positional plagiocephaly, a common infant skull deformity, is diagnosed clinically and treated with repositioning or helmet therapy. Early intervention, especially cranial orthotics between 4-7 months, yields favorable outcomes.
Area of Science:
- Pediatric Medicine
- Craniofacial Surgery
- Developmental Pediatrics
Background:
- Positional plagiocephaly is the most common infant craniofacial malformation.
- Risk factors include supine positioning, assisted delivery, prematurity, and torticollis.
- Increasing prevalence drives innovation in diagnosis and treatment.
Purpose of the Study:
- To review diagnostic and therapeutic strategies for positional plagiocephaly.
- To highlight the effectiveness of cranial orthotic therapy.
- To discuss the management of this common infant condition.
Main Methods:
- Clinical and anthropometric examinations for diagnosis.
- Three-dimensional optical scanning for moderate to severe deformities.
- Review of repositioning and orthotic therapy approaches.
Main Results:
- Diagnosis relies on clinical assessment and anthropometry.
- 3D scanning offers detailed, noninvasive follow-up.
- Repositioning is primary; orthotics are for severe cases, most effective at 4-7 months.
Conclusions:
- Positional plagiocephaly management involves clinical evaluation and targeted therapies.
- Cranial orthotics are a key treatment for severe deformities.
- The condition has a generally benign course with a favorable prognosis.
Abstract:
Positional plagiocephaly, characterized by an asymmetric skull shape, is the most common craniofacial malformation in infancy. Associated risk factors include a preference for the supine position, first and assisted delivery, multiple pregnancy, prematurity, and congenital muscular torticollis. The diagnosis is established by clinical and anthropometric examinations. In the case of moderate or severe deformity, three-dimensional optical scanning enables a detailed depiction of the deformity and provides a safe and noninvasive tool for follow-up. Treatment mainly includes repositioning of the infant, while orthotic therapy is considered in cases of severe deformity. Cranial orthotic therapy is most effective when started between 4 and 7 months of age. The total duration of orthotic treatment ranges from 2 to 6 months. Although the clinical course of positional plagiocephaly is generally benign and the prognosis favorable, its increasing prevalence has prompted the development of novel diagnostic and therapeutic strategies over the past decade.
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