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    Deformational Plagiocephaly

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    fsdafa
    Deformational plagiocephaly is a misshapen head caused by external pressure on an infant's skull from prolonged positioning, such as time spent in a crib or car seat. It results in a flattened area on the back of the head and potential asymmetry of the forehead, ears, and face. The condition is usually treated by changing the infant's positioning through techniques like tummy time and helmet therapy for more severe cases. Craniosynostosis, which involves premature fusion of skull bones, causes a more severe asymmetry and requires surgical treatment.

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    Deformational Plagiocephaly

    Uploaded by

    fsdafa
    109 views2 pages
    Deformational plagiocephaly is a misshapen head caused by external pressure on an infant's skull from prolonged positioning, such as time spent in a crib or car seat. It results in a flattened area on the back of the head and potential asymmetry of the forehead, ears, and face. The condition is usually treated by changing the infant's positioning through techniques like tummy time and helmet therapy for more severe cases. Craniosynostosis, which involves premature fusion of skull bones, causes a more severe asymmetry and requires surgical treatment.

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    Deformational_Plagiocephaly

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    Deformational plagiocephaly is a misshapen head caused by external pressure on an infant's skull from prolonged positioning, such as time spent in a crib or car seat. It results in a flattened area on the back of the head and potential asymmetry of the forehead, ears, and face. The condition is usually treated by changing the infant's positioning through techniques like tummy time and helmet therapy for more severe cases. Craniosynostosis, which involves premature fusion of skull bones, causes a more severe asymmetry and requires surgical treatment.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    109 views2 pages

    Deformational Plagiocephaly

    Uploaded by

    fsdafa
    Deformational plagiocephaly is a misshapen head caused by external pressure on an infant's skull from prolonged positioning, such as time spent in a crib or car seat. It results in a flattened area on the back of the head and potential asymmetry of the forehead, ears, and face. The condition is usually treated by changing the infant's positioning through techniques like tummy time and helmet therapy for more severe cases. Craniosynostosis, which involves premature fusion of skull bones, causes a more severe asymmetry and requires surgical treatment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    What is deformational plagiocephaly?

    The most common craniofacial problem today is


    called plagiocephaly, literally meaning oblique
    head. Deformational plagiocephaly, also known as
    positional plagiocephaly, refers to a misshapen
    (asymmetrical) head shape.

    Information for
    healthcare professionals

    Deformational
    Plagiocephaly

    What causes deformational


    plagiocephaly?
    This skull deformity results from repeated external
    pressure to an infants skull due to the head being in
    one position for extended periods (e.g. in a cot or car
    seat). In these positional deformities, the occiput
    (back part of the head) is most often flattened. When
    viewed from above, the head will take on a
    parallelogram shape and the forehead on the
    affected side is typically prominent. The ear on the
    affected side may be pushed forward compared with
    the other side. There may also be facial asymmetry,
    with the affected side having a fuller cheek.

    How is deformational plagiocephaly


    different from craniosynostosis?

    Department of Plastic and Maxillofacial Surgery


    Royal Childrens Hospital
    Flemington Road
    Parkville Victoria 3052
    www.rch.org.au/plastic
    Telephone: (03) 9345 5391
    Facsimile:
    (03) 9345 6585
    Email:
    [email protected]

    Infants with craniosynostosis also present with


    asymmetrical skull shapes. In craniosynostosis,
    however, the skull deformity results from premature
    fusion of one or more of the skull sutures. There is
    no premature sutural fusion in deformational
    plagiocephaly. The skull and facial asymmetry in
    craniosynostosis is typically more severe than that of
    deformational plagiocephaly.
    Craniosynostosis and deformational plagiocephaly
    can usually be distinguished by physical
    examination. Skull X-rays and CT scans may
    sometimes be required to differentiate synostotic
    from deformational plagiocephaly.

    Key differences
    Deformational
    plagiocephaly
    Craniofacial
    features

    Parallelogram
    head shape
    Nose generally
    straight
    Ear more
    anterior

    Craniosynostosis
    Rhomboid head
    shape
    Nose root
    deviates towards
    fused suture
    Orbit on affected
    side enlarged
    Eyebrow
    elevated
    Ear posterior

    Head
    circumference

    Normal rate of
    head growth

    Progressive
    slowing in head
    growth

    Causal factors

    External
    pressure, e.g.
    back sleeping,
    restricted
    intrauterine
    environment,
    muscular
    torticollis,
    prematurity

    Internal
    mechanisms

    Diagnosis

    Clinical
    examination

    Clinical
    examination
    Imaging scans

    Treating
    practitioner

    GP and/or
    paediatrician.
    If concerns,
    refer to a
    craniofacial
    surgeon

    Craniofacial
    surgeon

    Treatment

    Counter
    positioning
    and/or helmet
    therapy

    Cranial
    expansion
    surgery

    Common causes of deformational


    plagiocephaly

    The most common forms of treatment are counter


    positioning and/or helmet therapy.

    Back sleeping
    Infants who sleep on their backs and/or in car seats
    without alternating their position are at increased risk
    of deformational plagiocephaly.

    Counter positioning
    Counter positioning is recommended where a helmet
    is not warranted and is most effective between birth
    and 4 months of age. This involves consistently
    repositioning the infants head so that they do not
    rest on the flat spot. Increased tummy time and side
    lying play when the infant is awake is also
    encouraged. Positioning with rolled up towels can
    sometimes be of assistance. Counter positioning
    techniques can be taught by health professionals,
    including maternal and child health nurses and
    paediatric physiotherapists.

    Muscular torticollis
    This is a congenital condition caused by shortening
    or tightening of one or more of the neck muscles.
    This causes the infants head to tilt and/or turn to
    favour one particular direction.
    Prematurity
    The cranial bones of premature infants are very soft
    and malleable following birth, and therefore more
    susceptible to external pressures.
    In utero constraint
    Less frequently, a baby is born with a flattened skull
    due to a restricted intrauterine environment or
    crowding (i.e. multiple births, breech position, small
    maternal pelvis).

    Treatment options
    Treatment will vary depending on the nature and
    severity of the deformity. Many mild cases do not
    require any treatment and the condition will improve
    spontaneously when the infant begins to sit. Early
    diagnosis of co-existing torticollis is important as this
    does require treatment by a paediatric
    physiotherapist.
    More severe deformity may warrant treatment. In
    these cases early referral is advised (between 4-8
    months of age) as the majority of cranial growth is
    achieved during the first 12 months of life, and the
    greatest amount of correction will be achieved during
    this time.

    Helmet therapy
    In moderate to severe cases of deformational
    plagiocephaly, and/or where a trial of counter
    positioning has failed, a cranial remodelling helmet
    may be recommended. The helmet assists the skull
    moulding process by removing the pressure over the
    flat area, allowing the skull to grow into the space
    provided. Helmets are most effective between 4-8
    months of age. The helmet is made of an outer hard
    shell and is lightweight with a foam lining. They are
    custom-made to fit the infants head by an
    experienced orthotist. This requires the orthotist to
    make a casting of the infants head. The average
    duration of helmet therapy is usually 2-6 months,
    depending on the age of the infant and the severity
    of the deformational plagiocephaly.
    The helmet is required to be worn for 23 out of 24
    hours every day. Frequent adjustments are also
    required on a fortnightly, sometimes weekly, basis to
    ensure proper head growth and optimal correction of
    the deformity.

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