Diagnosis and Management of Posterior Plagiocephaly

Pollack, Ian F.; Losken, H. Wolfgang; Fasick, P

doi:10.1542/peds.99.2.180

Cited by 156 publications

(137 citation statements)

References 22 publications

(11 reference statements)

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“…Modern imaging resources as tomographies have been used in the diagnosis of those premature ossifications of the suture (Pollack et al, 1997;Perlyn et al, 2001;Smith et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Sagittal Suture of the Human Cranium and the Time of Closing

et al. 2009

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SUMMARY:The observation of the stage of ossification of the sagittal suture has been adopted as possible approach of age evaluation in anthropology and legal medicine, as area of cranial pathologies: craniosynostosis and scaphocephaly and as diagnosis resource in tomographies. Regarding it, we found many controversies in the specialized literature, thus we decided to accomplish this research with the following objectives: to examine the ossification of the external surface of the sagittal suture, observing eventual differences due to age, sex and ethnic group. Our material consists of 88 dry craniums of variable ages, both sexes belonging to the ethnic groups: white and black. In that material we observed that: with progression of age, the relation between age and stage of ossification of the sagittal suture stops existing. The statistical analysis didn't demonstrate significant differences between sexes and ethnic groups in the stages of ossification of the sagittal suture. The ossification of the sagittal suture starts developing from the posterior third.

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“…Modern imaging resources as tomographies have been used in the diagnosis of those premature ossifications of the suture (Pollack et al, 1997;Perlyn et al, 2001;Smith et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Sagittal Suture of the Human Cranium and the Time of Closing

et al. 2009

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“…Synostotic plagiocephaly usually requires surgical correction, whereas deformational plagiocephaly improves with crib positioning and, more predictably, with a molding helmet. [1][2][3][4][5] Earlier intervention results in improved outcome. 6 Plagiocephaly is either preponderantly anterior or posterior, or both.…”

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confidence: 99%

“…[25][26][27] Furthermore, clinical studies showed that deformational plagiocephaly could be corrected by positioning in the crib and use of a molding helmet. [3][4][5] In fact, the incidence of true lambdoid synostosis is very rare (Ͻ4% of craniosynostosis). 5,28 Usually, the parents and the pediatricians first notice deformational posterior plagiocephaly around 2 to 3 months.…”

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confidence: 99%

Incidence of Cranial Asymmetry in Healthy Newborns

Peitsch¹,

Keefer²,

et al. 2002

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ABSTRACT. Objective. During recent years, coincident with the recommendation to position infants supine, the incidence of posterior deformational plagiocephaly has increased dramatically. The purpose of our study was to determine whether early signs of cranial flattening could be detected in healthy neonates and to document incidence and potential risk factors.Design. A cross-sectional study was performed in healthy newborns. Physical findings, anthropometric cranial measurements, and data on pregnancy and birth were recorded.Results. The incidence of localized cranial flattening in singletons was 13%; other anomalous head shapes were found in 11% of single-born neonates. In twins, localized flat areas were much more frequent with an incidence of 56%. The following risk factors for cranial deformation were identified: assisted vaginal delivery, prolonged labor, unusual birth position, primiparity, and male gender. ABBREVIATIONS. SIDS, sudden infant death syndrome; TCD, transcranial difference. Conclusion. We propose that localized lateral or occipital cranial flattening at birth is a precursor to

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“…More commonly, deformational plagiocephaly occurs postnatally and is associated with congenital torticollis, vertebral anomalies, neurologic impairment, or forced sleeping position. [3][4][5] Few reports document any late effects of deformational plagiocephaly other than potential cosmetic concerns and the potential for strabismus, especially involving vertical eye movements. 6,7 Plagiocephaly may be morphometrically evident in as many as 14% of adults, but it is rarely recognized.…”

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confidence: 99%

Long-Term Developmental Outcomes in Patients With Deformational Plagiocephaly

2000

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ABSTRACT. Objectives. To determine whether there was an increased rate of later developmental delay in school-aged children who presented as infants with deformational plagiocephaly without obvious signs of delay at the time of initial evaluation.Methods. A retrospective medical record review of 254 patients evaluated at the Craniofacial Center of the Children's Hospital and Regional Medical Center in Seattle, Washington, from 1980 through 1991 was completed. Consenting patient families were interviewed via telelphone to determine what, if any, special medical or educational problems had occurred for the children who had had plagiocephaly in infancy or their siblings with normal head shapes.Results. A total of 181 families from the medical record review could be notified about the study and 63 families agreed to participate in a telephone interview. The sample of participants for the telephone interview was random to and representative of the group as a whole. The families reported that 25 of the 63 children (39.7%) with persistent deformational plagiocephaly had received special help in primary school including: special education assistance, physical therapy, occupational therapy, speech therapy generally through an Individual Education Plan. Only 7 of 91 siblings (7.7%), serving as controls, required similar services ( 2 ‫؍‬ 21.24). Delays could not be specifically anticipated at the time of the diagnosis of deformational plagiocephaly from any simple set of factors including treatment with helmet therapy, although effected males with reported uterine constraint were at the highest risk for subsequent school problems.Conclusions. Infants with deformational plagiocephaly comprise a high-risk group for developmental difficulties presenting as subtle problems of cerebral dysfunction during the school-age years. There is a need for additional research on the long-term developmental problems in infants with deformational plagiocephaly. Pediatrics 2000;105(2). URL: http://www.pediatrics.org/ cgi/content/full/105/2/e26; plagiocephaly, facial asymmetry, torticollis, developmental delay.

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Diagnosis and Management of Posterior Plagiocephaly

Abstract: The vast majority of children with posterior plagiocephaly do not have true synostosis and can be effectively managed by nonsurgical means. The impact of positional preference on the development of this process is discussed.

Cited by 156 publications

References 22 publications

Sagittal Suture of the Human Cranium and the Time of Closing

Sagittal Suture of the Human Cranium and the Time of Closing

Incidence of Cranial Asymmetry in Healthy Newborns

Long-Term Developmental Outcomes in Patients With Deformational Plagiocephaly

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