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Published on: September 21, 2017
Natural Progression of Cranial Shape Following Helmet Therapy for Deformational Plagiocephaly
Risa Kato1, Nobuhiko Nagano1, Mari Sasano2
1Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan.
Insights
Deformational plagiocephaly often shows minimal cranial shape changes after helmet therapy until age one. Most infants maintain their improved cranial symmetry, with slight worsening in a few cases.
Area of Science:
- Pediatric orthopedics
- Craniofacial development
Background:
- Deformational plagiocephaly is a common condition in infants.
- Helmet therapy is a standard treatment for moderate to severe cases.
- Understanding long-term cranial shape changes post-treatment is crucial.
Purpose of the Study:
- To evaluate the natural progression of cranial shape after helmet therapy for deformational plagiocephaly.
- To assess changes in cranial asymmetry from treatment cessation to one year of age.
Main Methods:
- Infants with moderate to severe deformational plagiocephaly were included.
- Cranial shape was measured using 3D scanning at treatment end and 12 months.
- Cranial Vault Asymmetry Index (CVAI) changes were analyzed.
Main Results:
- 32 infants were studied; 88% showed no significant change in cranial deformity severity post-treatment.
- A small percentage experienced minor improvement (3%) or worsening (9%).
- The average CVAI change from end of treatment to 12 months was minimal (0.3 ± 0.8%).
Conclusions:
- Cranial deformity severity remains largely stable from the end of helmet therapy to one year of age.
- Natural progression suggests minimal detrimental changes in most cases.
- Further monitoring may be beneficial for a small subset of infants.
Abstract:
Objectives: This study aimed to examine the natural progression of the cranial shape from the end of helmet therapy for deformational plagiocephaly to 1 year of age. Methods: This study included infants with moderate to severe deformational plagiocephaly who began treatment at our department between December 2022 and July 2023. The cranial shape was assessed using a 3D scanner (VECTRA®H2) at the start of treatment, end of treatment, and 12 months of age. Changes in the Cranial Vault Asymmetry Index (ΔCVAI), an indicator of cranial deformity, and the severity of deformity (normal, mild, moderate, severe, very severe) were assessed between the end of treatment and 12 months. Results: The study included 32 infants: 30 were full-term and 2 were preterm (gestational ages: 34 and 36 weeks). The median age at the start of treatment was 4 months (range: 2-7 months), with a mean CVAI of 10.5 ± 2.2%. At the end of treatment, the median age was 9 months (range: 5-11 months), with a mean CVAI of 4.2 ± 1.8%. The ΔCVAI from the end of treatment to 12 months of age was 0.3 ± 0.8%. Regarding severity, an improvement was observed in one infant (3%) (from moderate to mild), no change in 28 infants (88%) (23 classified as normal, three as mild, and two as moderate), and worsening in three infants (9%) (one from mild to moderate and two from normal to mild). Conclusions: The severity of cranial deformity showed minimal worsening during the natural progression from the end of helmet therapy to 1 year of age.
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