Longitudinal, Three-Dimensional Analysis of Head Shape in Children with and without Deformational Plagiocephaly or Brachycephaly

Abstract

Objectives To assess three-dimensional (3D) changes in head shape ininfancy and at age 18 months in children with and without plagiocephaly or brachycephaly. Study design Using a longitudinal design, we evaluated head shape using 3D surface imaging. We compared the head shapes of children with (1) diagnosed deformational plagiocephaly or brachycephaly (cases; n=233); (2) unaffected controls, with no evidence of dysmorphology (n=167); and (3) affected controls, who despite having no previous diagnosis demonstrated skull dysmorphology on 3D surface imaging (n=70). Results Cases had greater skull flattening and asymmetry than unaffected controls at both time points, as did controls with skull dysmorphology. In all groups, head shapes became less flat and more symmetric over time. Among cases, symmetry improved slightly more for those who received orthotic treatment. Conclusions Although head shape improves over time for children with deformational plagiocephaly or brachycephaly, skull dysmorphology persists relative to unaffected controls. Further research is needed to clarify the extent to which thesedifferences are detectable to clinicians and lay observers.

A 3D Follow-Up Study of Cranial Asymmetry from Early Infancy to Toddler Age after Preterm versus Term Birth

“…Subsequently, the incidence of DP gradually diminished equally in both groups. The course of DP in full-term children follows a similar pattern worldwide, as our results are similar to other reports in various populations [5,28,29].…”

Accuracy of measurements used to quantify cranial asymmetry in deformational plagiocephaly

“…Although DP and deformational brachycephaly both result from prolonged external forces on the infant's cranium and they frequently co-occur, it is possible that the oftreported finding of infants with cranial asymmetry having higher CI values partly stems from different cranial proportions altering the visual perception of cranial symmetry. (Hutchison et al, 2004, McKinney et al, 2008, Collett et al, 2012 The subjectivity and inconsistency of visual assessment raises the question of whether measurable indices, such as the OCLR, should instead be considered the golden standard for the diagnostics and classification of DP. The potential sources for error with 3D stereophotogrammetry are restricted to the subjective identification of craniofacial landmarks, which seems to have a negligibly small effect as the measured parameters have previously shown excellent repeatability and reproducibility.…”

Clinical care in craniofacial microsomia: A review of current management recommendations and opportunities to advance research

“…In addition to outcomes studies designed to assess the potential benefits of specific interventions, there is a need to assess holistic short‐ and long‐term outcomes for patients with CFM. Few studies have assessed neurodevelopmental and psychological outcomes in CFM [Padwa et al, ; Maris et al, ; Du et al, ; Collett et al, ]. These types of studies provide valuable information that could be used to optimize psychological and cognitive outcomes in children with CFM.…”