Management of positional plagiocephaly

Long-term outcomes in treatment of deformational plagiocephaly and brachycephaly using helmet therapy and repositioning: a longitudinal cohort study

“…Some providers still see the use of cranial molding helmets as controversial, but those that use them state that the outcomes are superior to repositioning alone. This controversy has been well documented in the literature [9,11]. In a review performed by Saeed et al [11], it was found that many providers believe that DPB is self-limiting and helmeting is not necessary.…”

“…Helmeting and repositioning are the only two treatment choices for DPB [9,19,25,26]. The helmet applies slight pressure over the prominent areas, limiting further growth in those areas while redirecting the growth to the flatter areas of the skull [11,13]. Cranial molding helmets work well during the first year of life because the skull bones are very malleable and the cranium is expanding rapidly [12,13,26,28].…”

“…There are disagreements among pediatric health care providers as to whether head shape will normalize on its own over time and whether molding helmet treatment is even indicated [7,11,27]. In studies comparing helmet versus repositioning treatment for DPB, primarily short-term outcomes have been addressed [13,19,25,28,29].…”

“…DPB is diagnosed at birth or shortly thereafter in children with an abnormal head shape caused by extrinsic forces on an infant's malleable cranium [16,17]. DPB presents with varying degrees of unilateral or bilateral occipital flattening and often ventral displacement of the ear, forehead, and cheek on the affected side [11,[18][19][20]. In addition to sleep position, there are many other risk factors that may contribute to the development of DPB.…”

Orthotic (helmet) therapy in the treatment of plagiocephaly

“…Six articles were excluded because they were not directly related to cranial orthoses therapy in deformational plagiocephaly (n = 5), or involved nonhuman subjects (n = 1). Of the remaining 36 papers, 21 were primary research literature articles, 5,6,[9][10][11][12][13][14][15][16][17]20,25,26,31,33,[35][36][37]39,41 12 were reviews, 7,8,[22][23][24]29,30,32,34,38,40,42 2 were letters, 3,18 and 1 described the methodology of an ongoing randomized controlled trial. 43 Of the 21 primary research articles, there were 7 Class II studies, 10,11,13,17,25,31,36 1 Class III study, 33 and 13 Class IV studies.…”