ヘルメット療法を受けた位置的斜頭症患者における頭蓋骨成長の低下
Maximilian Lindemann1, Donjetë Januzi1, Sabine Borowski2
1Department of Neurosurgery, University Hospital Jena, Friedrich Schiller University, Jena, Germany.
Introduction:
Helmet treatment is a worldwide acknowledged method to improve motor function, quality of life and aesthetics in patients with plagiocephaly.
Research Question:
The objective of this study is to assess percentile escape in head circumference in newborns receiving helmet therapy (HMT) for plagiocephaly.
Material And Methods:
All patients underwent HMT over 124.32 days on average (SD = 72.56), with 3D scans (Rodin4D neo) taken of their heads before, during and after the treatment. Eight participants were excluded due to insufficient data. Ten patients were excluded for either craniosynostosis or discontinuation of helmet therapy."German Health Interview and Examination Survey for Children and Adolescents" (KiGGS study) served as reference for the assessment of head circumference growth. Percentiles were calculated using the LMS-method.
Results:
Out of 272 patients (94 females, 178 males), 238 had suitable parameters for the LMS-method. The average age at the onset of therapy was 5.99 (SD = 2.23) months, concluding at 10.06 months (SD = 3.01). The median percentile before HMT was 50.00 (SD = 39.5), which decreased significantly to 25.00 (SD = 33.84) after HMT (p < 0.001). Only 59 patients showed percentile adherence during the treatment. The mean difference in head circumference was 21.51 mm (SD = 14.81), ranging from -44.4 mm to 69.1 mm. Clinical examination revealed that the patients exhibit developmental progress consistent with respective ages.
Discussion And Conclusion:
Significant decrease in head circumferential growth was observed following HMT. Even though patients did not show clinical signs of raised ICP, to ascertain the clinical relevance of this percentile escape, conducting longer follow-ups involving a larger cohort of patients is crucial.
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