Dynamic orthotic cranioplasty: treatment of the older infant. Report of four cases.

The Dynamic Orthotic Cranioplasty Band is a cranial orthotic device used to treat deformational plagiocephaly in infants. The device works by applying a mild holding pressure to the most anterior and posterior prominences, where growth is not desired, while encouraging growth in adjacent flattened regions. Although this technique has been successfully used to treat infants as young as 3 months of age, it is often assumed that decreasing cranial growth and increasing cranial rigidity prohibit treatment in infants older than 1 year of age. The authors' experience with older infants suggests the contrary. Through a series of case reports, they present evidence that this treatment remains viable during the 2nd year of life and that improvement has been observed in infants in whom treatment has been initiated as late as 18 months. These examples certainly suggest that additional prospective studies are warranted.