Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years

Objective This study evaluates the safety and parent satisfaction of a new cranial orthosis designed to treat deformational plagiocephaly. Design A retrospective phone survey of parental satisfaction of a new cranial orthosis that has Food and Drug Administration (FDA) clearance for treatment of deformational plagiocephaly. Setting A tertiary referral center for children with craniofacial anomalies. Patients The first 232 consecutive infants enrolled in this program were retrospectively reviewed. Interventions Infants were entered in the cranial orthosis program if they had been diagnosed with deformational plagiocephaly and were less than 1 year of age, and if the infant's parents were interested in enrolling in a monitored cranial orthosis program. Main Outcome Measure After completing therapy, a random sample of 81 parents (half completing treatment) was surveyed. Parents rated the improvement in their infant's head shape from 1 (least) to 5 (most). They were asked if they would repeat the program with a subsequent child. To date, 70% (162/ 232) have completed treatment. Results The orthosis was worn an average of 89 days. On average, parents rated head shape improvement 4.06 out of 5 (range, 3 to 5). Of parents surveyed, 81 (100%) would repeat the program with a subsequent child. There were three (3/232 or 1.3%) minor complications: one child with a persistent rash that resolved with termination of orthosis use, one child with a skin irritation that resolved with orthosis recontouring, and one child who could not be successfully fit. Conclusions The CranioCap, a new cranial orthosis with clearance for treatment of deformational plagiocephaly, appears to be safe, well tolerated, and has excellent parent satisfaction.

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Three-Dimensional Head Shape Quantification for Infants with and without Deformational Plagiocephaly

The Cleft Palate-Craniofacial Journal ◽

10.1597/09-059.1 ◽

2010 ◽

Vol 47 (4) ◽

pp. 368-377 ◽

Cited By ~ 20

Author(s):

I. Atmosukarto ◽

L.G. Shapiro ◽

J.R. Starr ◽

C.L. Heike ◽

B. Collett ◽

...

Keyword(s):

Three Dimensional ◽

Head Shape ◽

Deformational Plagiocephaly ◽

Shape Quantification

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Differential Diagnosis of the Trapezoid-Shaped Head

The Cleft Palate-Craniofacial Journal ◽

10.1597/02-053 ◽

2004 ◽

Vol 41 (1) ◽

pp. 13-19 ◽

Cited By ~ 22

Author(s):

Frederick W. Ehret ◽

Michael F. Whelan ◽

Richard G. Ellenbogen ◽

Michael L. Cunningham ◽

Joseph S. Gruss

Keyword(s):

Medical Center ◽

Systematic Evaluation ◽

Head Shape ◽

Deformational Plagiocephaly ◽

Appropriate Treatment ◽

Lambdoid Synostosis ◽

Regional Medical ◽

Regional Medical Center ◽

Coronal Synostosis ◽

Physical Findings

Objective To recognize several conditions that result in a trapezoid head shape and review and contrast their various physical findings. Methods A detailed review of all patients seen in the Craniofacial Clinic at the Children's Hospital and Regional Medical Center in Seattle, Washington, over a 10-year period from 1991 to 2001, with the diagnosis of craniosynostosis and plagiocephaly was performed. During this period, 690 patients had a surgical correction of craniosynostosis, and 1537 patients had posterior plagiocephaly. Results and Conclusions The shape of the head when viewed from the vertex position in an axial plane can be a significant diagnostic aid when evaluating a patient with plagiocephaly. Positional molding causes the vast majority of plagiocephaly. This deformational change results in a parallelogram-shaped head. A much more rare cause of plagiocephaly is lambdoid synostosis. With premature fusion of one of the lambdoid sutures, the head takes on a very characteristic trapezoid shape when viewed from the vertex. Unilateral coronal synostosis that occurs on the same side as either posterior positional molding or unilateral lambdoid synostosis will also result in the trapezoid head shape. Furthermore, on the rare occasion when anterior and posterior deformational plagiocephaly occurs on the same side, the trapezoid head shape may be the consequence. The choice of appropriate treatment modality requires systematic evaluation of the patient with a trapezoid-shaped head to determine the etiology of the deformation.

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Deformational Plagiocephaly Follow-up at 3 & 4 Years

AAP Grand Rounds ◽

10.1542/gr.26-1-6 ◽

2011 ◽

Vol 26 (1) ◽

pp. 6-6

Author(s):

J. Corcoran

Keyword(s):

Deformational Plagiocephaly

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Parental Judgement of Hearing Loss in Infants With Cleft Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619899743 ◽

2020 ◽

Vol 57 (7) ◽

pp. 886-894 ◽

Cited By ~ 1

Author(s):

Lucy McAndrew

Keyword(s):

Hearing Loss ◽

Cleft Palate ◽

Middle Ear ◽

Objective Assessment ◽

Speech And Language ◽

Language Therapy ◽

Parental Concern ◽

Hearing Assessment ◽

Specialist Center

Objective: To investigate whether reported parental concern is supported by hearing assessment findings in children with cleft palate. To describe this population by examining the relationship between cleft type, middle ear status, and hearing loss. Design: Retrospective consecutive case note review. Setting: Tertiary institutional regional cleft center. Patients: Consecutive cases of 194 babies born with cleft palate and referred to the specialist center from January 2009 and December 2013. Following exclusions, data from 155 infants were included for analysis. Interventions: Documented parental concern in ear, nose and throat (ENT) and speech and language therapy case notes were compared to hearing assessment findings. Findings from otoscopic examination, tympanometry, and hearing assessment were analyzed with respect to cleft type. Results: Parental concern is not always accurately reflected by objective assessment particularly when no concern is reported. Analysis of the cohort examined suggests that cleft type is not related to middle ear findings or hearing. Conclusions: It is helpful to be aware of parental concern and clinicians should consider that parental reports may not be accurately reflected by test results. As cleft type was not found to substantially influence middle ear status or hearing it is not recommended to adapt speech and language advice offered to families according to cleft type. Follow-up studies to increase participant numbers would support a statistical analysis.

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3D Head Shape Quantification for Infants with and without Deformational Plagiocephaly

The Cleft Palate-Craniofacial Journal ◽

10.1597/09-059 ◽

2009 ◽

pp. 100611121139056 ◽

Cited By ~ 2

Author(s):

Indriyati Atmosukarto ◽

Linda Shapiro ◽

Jacqueline Starr ◽

Carrie Heike ◽

Brent Collett ◽

...

Keyword(s):

Head Shape ◽

Deformational Plagiocephaly ◽

Shape Quantification

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Effect of molding helmet on head shape in nonsurgically treated sagittal craniosynostosis

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.4.peds116 ◽

2011 ◽

Vol 7 (6) ◽

pp. 627-632 ◽

Cited By ~ 21

Author(s):

Sandeep Sood ◽

Arlene Rozzelle ◽

Blerina Shaqiri ◽

Natasha Sood ◽

Steven D. Ham

Keyword(s):

Head Circumference ◽

Ct Scanning ◽

3D Ct ◽

Head Shape ◽

Sagittal Craniosynostosis ◽

Index Measurement ◽

Cranial Index ◽

Surgical Condition ◽

Improved Outcome

Object Sagittal craniosynostosis is traditionally considered to be a surgical condition. Poor results of simple suturectomy follow from early reclosure of the suture. A wider craniectomy or use of interposing materials has not improved the outcome. However, endoscopic suturectomy supplemented with postoperative use of a molding helmet has shown good results. Because suturectomy reunites within 8–12 weeks of surgery, the authors questioned if the improved outcome was primarily related to use of the helmet. Methods In 4 patients whose families opted for calvarial reconstruction when the infant was 4–6 months old, instead of endoscopic suturectomy, a molding helmet was used to minimize compensatory changes in the interim. Patients underwent 3D CT scanning to confirm craniosynostosis. Follow-up visits were made at intervals of 4 weeks for adjustment of the helmet, head circumference measurements, clinical photographs, and cranial index measurement. Results There was significant improvement in the head shape within 6 weeks of use of the molding helmet. The cranial index score improved from a mean (± SD) of 67% ± 3% to 75% ± 2%. Conclusions These cases demonstrate that molding helmets improve head shape even without a suturectomy in patients with sagittal craniosynostosis, challenging the traditional view.

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