Treatment of positional plagiocephaly - Helmet or no helmet?
What is the optimal time to start helmet therapy in positional plagiocephaly? Plastic and Reconstructive Surgery, 128(2), 492-498.
While treatment for positional plagiocephaly
exists, it is costly.
A multidisciplinary task force complied of clinical experts was assigned to perform a comprehensive review and analysis of the research on diagnosis and treatment of positional plagiocephaly. Developed by the Congress of Neurological Surgeons, these guidelines are also endorsed by the Joint Guidelines Committee of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, and the American Academy of Pediatrics.
In most cases, positional plagiocephaly can be diagnosed by clinical examination.
Present in up to 30% of infants, usually within the first 4 months of life, positional plagiocephaly
presents in a way that is unique and distinguishable from deformities caused by early suture fusion.
Although some researchers suggest that this problem may contribute to developmental delays, it's just as likely that the developmental delays may cause the positional plagiocephaly
. Children with developmental delays, especially in motor function, may move less, thus causing the skull-shape changes.
"The rest develop positional plagiocephaly
from spending a lot of time in one position, usually on their backs.
Despite a lack of evidence of any difference in outcomes between treated and untreated positional plagiocephaly
, early treatment is thought to have the best chance of correction.
n Reports estimate that positional plagiocephaly
affects around half of all babies under a year old.
Since the recommendation in the early 1990s to place infants on their backs in order to reduce the risk of sudden infant death syndrome, there has been an increase in the incidence of positional plagiocephaly
(a right- or left-sided occipital flattening) as indicated by referrals to paediatricians, neurosurgeons and craniofacial surgeons for advice and management.
It may be found that torticollis has aggravated potential positional plagiocephaly
by preventing the head from turning 180[degrees].