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Paediatrics & Child Health Jun 2017Many centres report receiving more referrals for deformational plagiocephaly since implementation of the Back to Sleep campaign. This commentary combines clinical...
Many centres report receiving more referrals for deformational plagiocephaly since implementation of the Back to Sleep campaign. This commentary combines clinical experience, local quality improvement data and existing literature to highlight three points to help prevent and manage plagiocephaly: (1) communicating 'Back to Sleep, Tummy to Play', (2) the importance of early detection and (3) plagiocephaly as a marker of developmental risk. We recommend: (1) equal emphasis on the messages of Back to Sleep and supervised Tummy to Play, to start this messaging early and reinforce at every opportunity; (2) examination of skull shape and neck range of motion as a routine component of the newborn assessment so that caregivers can implement positioning and handling suggestions immediately and (3) physiotherapy referral for babies who have torticollis, or who show persistent or worsening plagiocephaly despite positioning and handling interventions, for further assessment and management.
PubMed: 29479204
DOI: 10.1093/pch/pxx046 -
Journal of Clinical Medicine Apr 2023We assessed a method for screening the cranial shape of 1-month-old infants using a simple measuring instrument instead of a three-dimensional scanner. The Mimos...
We assessed a method for screening the cranial shape of 1-month-old infants using a simple measuring instrument instead of a three-dimensional scanner. The Mimos craniometer was used to measure cranial length, cranial width, and two diagonal lengths to calculate the cranial index (CI) and cranial asymmetry (CA). We defined a CI > 90% as brachycephaly and CA > 5 mm as deformational plagiocephaly (DP). Intra- and inter-examiner accuracy analyses were performed on a dummy doll and 1-month-old infants. The measurements of healthy 1-month-old infants were compared with previously reported three-dimensional scanner measurements. Intra- and inter-rater measurements showed good accuracy; diagnostic accuracy comparisons of brachycephaly and DP using a three-dimensional scanner showed kappa values of 1.0 and 0.8, respectively. Comparisons were made among 113 infants matched for day-age at the date of measurement; there were no significant differences in the CI (85.0% vs. 85.2%, = 0.98) and CA (5.9 mm vs. 6.0 mm, = 0.48) between the scanner and caliper measurements, nor in the prevalence of brachycephaly (12.4% vs. 17.7%, = 0.35) or DP (58.4% vs. 56.6%, = 0.89). This simple measurement method using calipers and bands was useful in screening for brachycephaly and DP in 1-month-old infants.
PubMed: 37109123
DOI: 10.3390/jcm12082787 -
Child's Nervous System : ChNS :... Feb 2017We test the hypothesis that ventriculoperitoneal (VP) shunt insertion significantly increases contralateral positional plagiocephaly.
PURPOSE
We test the hypothesis that ventriculoperitoneal (VP) shunt insertion significantly increases contralateral positional plagiocephaly.
METHODS
We reviewed 339 children who had a VP shunt inserted at Birmingham Children's Hospital between 2006 and 2013, noting laterality of shunt insertion and frontal or occipital position. We ascertained the presence of post-operative positional plagiocephaly using the cranial vault asymmetry index. Multinomial logistic regression modelling was used to examine relationships between plagiocephaly, shunt position, gender and age. Adjusted odds and risk ratios for effect of variables on plagiocephaly were calculated.
RESULTS
Children with occipital VP shunts are at significant risk of developing contralateral positional plagiocephaly, particularly in the first 12 months of life.
CONCLUSIONS
We recommend careful follow-up and advice regarding head positioning following surgery. There should be consideration for active monitoring to avoid plagiocephaly, including physiotherapy and health visitor interventions. Endoscopic third ventriculostomy in selected cases or anterior shunt placement could be considered. A larger national study would be of interest to evaluate the extent of an otherwise correctable problem.
Topics: Adolescent; Age Factors; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Logistic Models; Male; Plagiocephaly, Nonsynostotic; Retrospective Studies; Sex Factors; Treatment Outcome; Ventriculoperitoneal Shunt; Ventriculostomy
PubMed: 27848003
DOI: 10.1007/s00381-016-3275-z -
Scientific Reports Jan 2022Cranial deformation and deformational plagiocephaly (DP) in particular affect an important percentage of infants. The assessment and diagnosis of the deformation are...
Cranial deformation and deformational plagiocephaly (DP) in particular affect an important percentage of infants. The assessment and diagnosis of the deformation are commonly carried by manual measurements that provide low interuser accuracy. Another approach is the use of three-dimensional (3D) models. Nevertheless, in most cases, deformation measurements are carried out manually on the 3D model. It is necessary to develop methodologies for the detection of DP that are automatic, accurate and take profit on the high quantity of information of the 3D models. Spherical harmonics are proposed as a new methodology to identify DP from head 3D models. The ideal fitted ellipsoid for each head is computed and the orthogonal distances between head and ellipsoid are obtained. Finally, the distances are modelled using spherical harmonics. Spherical harmonic coefficients of degree 2 and order - 2 are identified as the correct ones to represent the asymmetry characteristic of DP. The obtained coefficient is compared to other anthropometric deformation indexes, such as Asymmetry Index, Oblique Cranial Length Ratio, Posterior Asymmetry Index and Anterior Asymmetry Index. The coefficient of degree 2 and order - 2 with a maximum degree of 4 is found to provide better results than the commonly computed anthropometric indexes in the detection of DP.
Topics: Algorithms; Case-Control Studies; Cephalometry; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Models, Anatomic; Patient-Specific Modeling; Photogrammetry; Plagiocephaly, Nonsynostotic; Predictive Value of Tests; Skull
PubMed: 34997100
DOI: 10.1038/s41598-021-04181-z -
Frontiers in Neuroscience 2017Deformational plagiocephaly and craniosynostosis are two of the most common neonatal cranial head shape anomalies. Traditionally, both entities were thought to cause... (Review)
Review
Deformational plagiocephaly and craniosynostosis are two of the most common neonatal cranial head shape anomalies. Traditionally, both entities were thought to cause aesthetic concerns solely. Recently, many groups have demonstrated that both conditions are strongly associated with developmental delays. The relationship between the abnormal neonatal cranial shape and early developmental delays manifested in both conditions remains poorly understood.
PubMed: 29311788
DOI: 10.3389/fnins.2017.00708 -
BMC Pediatrics Feb 2019The aim was to evaluate the intervention's effect on prevention and reversal of nonsynostotic plagiocephaly.
BACKGROUND
The aim was to evaluate the intervention's effect on prevention and reversal of nonsynostotic plagiocephaly.
METHODS
Thirty-eight intervention group nurses were educated about nonsynostotic plagiocephaly and asked to follow guidelines; 18 control group nurses were not. In a longitudinal single-blinded clinical intervention, parents brought infants to well-child visits according to the national schedule. Cranial shape was assessed in 176 intervention and 92 control group infants at 2-, 4-, and 12-month visits.
RESULTS
Asymmetry at two months reversed by four months four times more often in intervention than control subgroup infants (OR = 4.07, p = 0.02) when adjusted for parent awareness of written information from their nurse. Asymmetry at two months reversed by 12 months fivefold when parents were aware of written information (OR = 0.19, p = 0.04). The risk for persistent asymmetry at 12 months was lower for intervention than control group infants (RR = 0.35, p = 0.03). Of infants with no asymmetry at two months, 25% in intervention and 22% in control group developed brachycephaly.
CONCLUSIONS
The intervention contributed to early reversal and reducing infants' risk for persistent asymmetry. Parents' awareness of written information contributed to reversal. Preventing brachycephaly was difficult. Further research is needed.
Topics: Child Health Services; Female; Humans; Infant; Infant, Newborn; Longitudinal Studies; Male; Parents; Pediatric Nursing; Plagiocephaly, Nonsynostotic; Single-Blind Method; Sweden
PubMed: 30727985
DOI: 10.1186/s12887-019-1405-y -
Surgical Neurology International 2018Surgical methods to treat craniosynostosis have evolved from a simple strip craniectomy to a diverse spectrum of partial or complete cranial vault remodeling with...
BACKGROUND
Surgical methods to treat craniosynostosis have evolved from a simple strip craniectomy to a diverse spectrum of partial or complete cranial vault remodeling with excellent results but often with high comorbidity. Therefore, minimal invasive craniosynostosis surgery has been explored in the last few decades. The main goal of minimal invasive craniosynostosis surgery is to reduce the morbidity and invasiveness of classical surgical procedures, with equal long-term results, both functional as well as cosmetic.
METHODS
To reach these goals, we adopted endoscopy-assisted craniosynostosis surgery (EACS) supplemented with helmet molding therapy in 2005.
RESULTS
We present in detail our surgical technique used for scaphocephaly, trigonocephaly, plagiocephaly, complex multisutural, and syndromic cases of craniosynostosis.
CONCLUSIONS
We conclude that EACS with helmet therapy is a safe and suitable treatment option for any type of craniosynostosis, if performed at an early age, preferably around 3 months of age.
PubMed: 29629226
DOI: 10.4103/sni.sni_17_18 -
Neurologia Medico-chirurgica May 2024This study aimed to assess the prevalence, severity, and natural history of positional posterior plagiocephaly (PPP) and positional posterior brachycephaly in Japan. We...
This study aimed to assess the prevalence, severity, and natural history of positional posterior plagiocephaly (PPP) and positional posterior brachycephaly in Japan. We conducted a cross-sectional study of pediatric patients, ranging from 0 to 15 years old, evaluated for head trauma with negative computed tomography (CT) findings. The cranial vault asymmetry index (CVAI) was calculated using CT images at the superior orbital rim. Asymmetry according to CVAI values was subcategorized as follows: mild (3.5%-7%), moderate (7%-12%), and severe (>12%). The results were analyzed according to different age groups: group 1, 2-23 months (54 patients); group 2, 2-6 years (123 patients); and group 3, 7-15 years (123 patients). Overall, 300 patients were included (109 [36.3%] girls and 191 [63.7%] boys). The overall prevalence of PPP in the 300 patients was 46.7% (140 patients). PPP prevalence decreased consistently with age group: group 1, 57.4%; group 2, 47.2%; and group 3, 41.5%. Severe asymmetry was seen in all age groups. The overall mean cephalic index (CI) was 85.2. Cephalic index scores decreased consistently with age: group 1, 87.4; group 2, 85.1; and group 3, 84.3. The prevalence of PPP in Japan was higher than that reported in other countries. Although there was an overall decrease in the prevalence and severity of PPP with increasing patient age, PPP does not necessarily resolve spontaneously in all children. Furthermore, severe asymmetry was seen across all age groups.
Topics: Humans; Female; Male; Japan; Adolescent; Child; Infant; Prevalence; Cross-Sectional Studies; Child, Preschool; Plagiocephaly, Nonsynostotic; Craniosynostoses; Severity of Illness Index; Tomography, X-Ray Computed; Infant, Newborn
PubMed: 38432945
DOI: 10.2176/jns-nmc.2023-0216 -
The Cleft Palate-craniofacial Journal :... Oct 2023Objective differentiation between unilateral coronal synostosis (UCS) and positional posterior plagiocephaly (PPP) based on 3D photogrammetry according to Utrecht...
OBJECTIVE
Objective differentiation between unilateral coronal synostosis (UCS) and positional posterior plagiocephaly (PPP) based on 3D photogrammetry according to Utrecht Cranial Shape Quantificator (UCSQ).
DESIGN
Retrospective study.
SETTING
Primary craniofacial center.
PATIENTS, PARTICIPANTS
Thirty-two unoperated patients (17 UCS; 15 PPP) (age < 1 year).
INTERVENTIONS
Extraction of variables from sinusoid curves derived using UCSQ: asymmetry ratio forehead and occiput peak, ratio of gradient forehead and occiput peak, location forehead and occiput peak.
MAIN OUTCOME MEASURE(S)
Variables, derived using 3D photogrammetry, were analyzed for differentiation between UCS and PPP.
RESULTS
Frontal peak was shifted to the right side of the head in left-sided UCS (mean -value 207 [192-220]), and right-sided PPP (mean -value 210 [200-216]), and to the left in right-sided UCS (mean -value 161 [156-166]), and left-sided PPP (mean -value 150 [144-154]). Occipital peak was significantly shifted to the right side of the head in left-sided PPP (mean -value 338 [336-340]) and to the left in right-sided PPP (mean -value 23 [14-32]). Mean -value of occipital peak was 9 (354-30) in left- and 2 (350-12) in right-sided UCS. Calculated ratio of gradient of the frontal peak is, in combination with the calculated asymmetry ratio of the frontal peak, a distinctive finding.
CONCLUSIONS
UCSQ objectively captures shape of synostotic and positional plagiocephaly using 3D photogrammetry, we therefore developed a suitable method to objectively differentiate UCS from PPP using radiation-free methods.
Topics: Humans; Infant; Plagiocephaly, Nonsynostotic; Retrospective Studies; Skull; Craniosynostoses; Plagiocephaly; Photogrammetry
PubMed: 35538856
DOI: 10.1177/10556656221100679 -
Journal of Medical Imaging (Bellingham,... Jul 2023[This corrects the article DOI: 10.1117/1.JMI.8.2.024504.].
[This corrects the article DOI: 10.1117/1.JMI.8.2.024504.].
PubMed: 37581170
DOI: 10.1117/1.JMI.10.4.049801