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An increase in infant cranial deformity with supine sleeping position
L C Argenta1, L R David, J A Wilson
1Department of Plastic and Reconstructive Surgery, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1075, USA.
The Journal of Craniofacial Surgery
|January 1, 1996
Summary
Positional occipital plagiocephaly in infants has increased due to safe sleep recommendations. Most cases resolve with conservative treatment like positioning or helmets, avoiding surgery.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Pediatrics
Background:
- Occipital cranial suture abnormalities in infants can lead to significant posterior cranial asymmetry and facial deformities.
- A notable increase in occipital skull deformation has been observed, correlating with the adoption of supine/side sleeping positions to prevent sudden infant death syndrome (SIDS).
Purpose of the Study:
- To evaluate the incidence and outcomes of occipital plagiocephaly in infants.
- To determine the efficacy of conservative management versus surgical intervention for positional cranial deformities.
Main Methods:
- A cohort of 51 infants with occipital cranial deformity was treated over 16 months.
- Treatment strategies included continuous parental positioning for older infants and soft-shell helmets for younger infants or those with poor head control.
- Follow-up ranged from 8 to 24 months.
Main Results:
- The mean age at diagnosis and treatment initiation was 5.5 months.
- Mean helmet treatment duration was 3.8 months.
- Only 3 out of 51 patients required surgical intervention; most showed spontaneous improvement with conservative care.
Conclusions:
- Most occipital plagiocephaly deformities are positional deformations, not true craniosynostoses.
- Conservative management is highly effective, with surgery reserved for progressive cases.
- The trend of back-sleeping for SIDS prevention may continue to increase the incidence of these deformities.