Susanne Kluba1, Wiebke Kraut2, Benjamin Calgeer2, Siegmar Reinert2, Michael Krimmel2. 1. Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany. Electronic address: susanne.kluba@med.uni-tuebingen.de. 2. Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Siegmar Reinert, M.D., D.M.D., Ph.D.), University Hospital Tuebingen, Germany.
Abstract
INTRODUCTION: Positional plagiocephaly has attained widespread attention. There is a lot of data on helmet therapy available, but the natural course of the deformity has not been investigated in depth. The decision for or against helmet therapy can be controversial. This study examined the outcome of both options. METHODS: 128 infants were enrolled in this prospective, non-randomized, longitudinal study. 62 were treated with and 66 without a helmet. The initial cranial vault asymmetry index (modified CVAI) was determined at 6.3 and 6.2 months of age (SD 1.44/2.14). Follow-up took place at the end of helmet therapy (age: 10.2 months, SD 1.77) or after 1 year (age: 18.5 months, SD 2.28) respectively. The outcome and the correlation of the changes to the initial asymmetry were compared. RESULTS: All infants showed a significant reduction of their plagiocephaly. Although children with helmet had more severe asymmetry initially, they showed significantly better improvement (68% vs. 31%). Only a weak correlation was found between the initial asymmetry and the amount of improvement in both groups. CONCLUSION: Despite concerns against helmet therapy (comfort, finances), it should be the treatment of choice for moderate to severe cases. Only mild cases (modified CVAI ≤ 6.5%) can be adequately treated by conservative, i.e. non-helmet, management.
INTRODUCTION: Positional plagiocephaly has attained widespread attention. There is a lot of data on helmet therapy available, but the natural course of the deformity has not been investigated in depth. The decision for or against helmet therapy can be controversial. This study examined the outcome of both options. METHODS: 128 infants were enrolled in this prospective, non-randomized, longitudinal study. 62 were treated with and 66 without a helmet. The initial cranial vault asymmetry index (modified CVAI) was determined at 6.3 and 6.2 months of age (SD 1.44/2.14). Follow-up took place at the end of helmet therapy (age: 10.2 months, SD 1.77) or after 1 year (age: 18.5 months, SD 2.28) respectively. The outcome and the correlation of the changes to the initial asymmetry were compared. RESULTS: All infants showed a significant reduction of their plagiocephaly. Although children with helmet had more severe asymmetry initially, they showed significantly better improvement (68% vs. 31%). Only a weak correlation was found between the initial asymmetry and the amount of improvement in both groups. CONCLUSION: Despite concerns against helmet therapy (comfort, finances), it should be the treatment of choice for moderate to severe cases. Only mild cases (modified CVAI ≤ 6.5%) can be adequately treated by conservative, i.e. non-helmet, management.
Authors: Renske M van Wijk; Janine A van Til; Catharina G M Groothuis-Oudshoorn; Monique P L'Hoir; Magda M Boere-Boonekamp; Maarten J IJzerman Journal: Childs Nerv Syst Date: 2014-03-19 Impact factor: 1.475
Authors: Renske M van Wijk; Leo A van Vlimmeren; Catharina G M Groothuis-Oudshoorn; Catharina P B Van der Ploeg; Maarten J Ijzerman; Magda M Boere-Boonekamp Journal: BMJ Date: 2014-05-01
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Authors: Josefa González-Santos; Jerónimo J González-Bernal; Raquel De-la-Fuente Anuncibay; Raúl Soto-Cámara; Esther Cubo; José M Aguilar-Parra; Rubén Trigueros; Remedios López-Liria Journal: Int J Environ Res Public Health Date: 2020-04-10 Impact factor: 3.390