Nonsynostotic Occipital Plagiocephaly: Factors Impacting Onset, Treatment, and Outcomes

Losee, Joseph E.; Mason, Aaron; Dudas, Jason R.; Hua, Lan; Mooney, Mark P.

doi:10.1097/01.prs.0000259190.56177.ca

Cited by 69 publications

(77 citation statements)

References 21 publications

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“…Most often, the vertex of the head lies within the birth canal with a left occipital anterior presentation. 20 In this position, the infant' s right occiput is compressed against the maternal pelvis and the left forehead against the lumbosacral spine. 20,28 This position may initiate a process that may be perpetuated by postnatal supine sleep positioning, resulting in the preference to rightsided head turning and allowing for a position of comfort to be established.…”

Section: Discussionmentioning

confidence: 99%

“…The helmet approach to treating positional plagiocephaly has been proven effective and is well documented. [12][13][14][15][16][17][18][19][20][21][22][23][24] However, little research has been undertaken to determine the incidence of positional plagiocephaly. Clinicians working at Head Shape Clinics in Canada have reported anecdotally more infants attending these specialty clinics.…”

mentioning

confidence: 99%

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The Incidence of Positional Plagiocephaly: A Cohort Study

Mawji

Vollman²,

Hatfield³

et al. 2013

Pediatrics

120

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WHAT'S KNOWN ON THIS SUBJECT: The incidence of plagiocephaly varies widely and is based on anecdotal evidence of increase in the number of referrals to specialty clinics. Five studies have produced varying results, indicating that the incidence of plagiocephaly ranges from 3.1% to 61.0%. WHAT THIS STUDY ADDS:This is the first study to estimate the incidence of positional plagiocephaly using 4 community-based data collection sites in infants ranging from 7 to 12 weeks of age. The estimated incidence of positional plagiocephaly was found to be 46.6%. abstract OBJECTIVE: The objective of this study was to estimate the incidence of positional plagiocephaly in infants 7 to 12 weeks of age who attend the 2-month well-child clinic in Calgary, Alberta, Canada.METHODS: A prospective cohort design was used to recruit 440 healthy full-term infants (born at $37 weeks of gestation) who presented at 2-month well-child clinics for public health nursing services (eg, immunization) in the city of Calgary, Alberta. The study was completed in 4 community health centers (CHCs) from July to September 2010. The CHCs were selected based on their location, each CHC representing 1 quadrant of the city. Argenta' s (2004) plagiocephaly assessment tool was used to identify the presence or absence of plagiocephaly. RESULTS:Of the 440 infants assessed, 205 were observed to have some form of plagiocephaly. The incidence of plagiocephaly in infants at 7 to 12 weeks of age was estimated to be 46.6%. Of all infants with plagiocephaly, 63.2% were affected on the right side and 78.3% had a mild form.CONCLUSIONS: To our knowledge, this is the first population-based study to investigate the incidence of positional plagiocephaly using 4 community-based data collection sites. Future studies are required to corroborate the findings of our study. Research is required to assess the incidence of plagiocephaly using Argenta' s plagiocephaly assessment tool across more CHCs and to assess prevalence at different infant age groups. The utility of using Argenta' s plagiocephaly assessment tool by public health nurses and/or family physicians needs to be established. Pediatrics 2013;132:298-304

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Incidence of Positional Plagiocephaly: A Cohort Study

Mawji

Vollman²,

Hatfield³

et al. 2013

Pediatrics

120

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…These cranial orthotic devices cost anywhere from $1000 to $3500. 23 Part of the high cost is secondary to the fact that the companies that make most devices pride themselves on custom-making the orthosis for the baby. However, Thompson et al reported positive results in 2009 while using a generic-sized soft foam helmet that was fitted to patients by applying extra foam padding.…”

Section: Helmet Therapy In Comparison With Conservative Treatmentsmentioning

confidence: 99%

“…7,22,32 Nevertheless, the general consensus is that cranial orthoses are indeed as efficacious, if not more efficacious, in treating deformational plagiocephaly as compared with other more conservative treatments. 22,23,32 Studies of helmet therapy often target patients who have already undergone unsuccessful osteopathy and/or physiotherapy as conservative measures. 5 This experience consequently introduces a selection bias whereby patients who have more severe deformational plagiocephaly are selected to take part in orthotic trials.…”

Section: Helmet Therapy In Comparison With Conservative Treatmentsmentioning

confidence: 99%

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Orthotic (helmet) therapy in the treatment of plagiocephaly

Goh

Bauer²,

Durham³

et al. 2013

FOC

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Object The goal of this study was to review the current literature on orthotic (helmet) therapy use in the treatment of deformational plagiocephaly. Methods PubMed was used to search English articles using the medical subject headings “deformational plagiocephaly” and “orthosis,” and “deformational plagiocephaly” and “helmet.” Results Forty-two articles were found. There were no Class I studies, 7 Class II studies, 1 Class III study, and 13 Class IV studies. Cranial orthoses have been shown to be effective in treating deformational plagiocephaly. It continues to be debated as to whether the statistical significance of treatment with cranial orthoses compared with conservative therapies is clinically significant. Children older than 12 months of age with deformational plagiocephaly may still benefit from orthotic therapy. The long-term effects of orthotic therapy are controversial. Conclusions There is a lack of Class I literature evidence supporting the use of helmet therapy in deformational plagiocephaly. There are controversies surrounding the use of orthotic therapy such as appropriate use, cost, use in older children, and long-term outcomes. Clinical indications for orthotic therapy need to be better defined with further research studies.

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Investigation Into an Increase in Plagiocephaly in Texas From 1999 to 2007

Sheu

Ethen

Scheuerle

et al. 2011

Arch Pediatr Adolesc Med

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Design: Descriptive epidemiologic study of time trends and a nested case-control study. Setting: Texas. Participants: Cases in the Texas Birth Defects Registry. Outcome Measures: Time trends in the birth prevalence of plagiocephaly overall and by region, demographic group, and clinical subgroup. Trends in percentage of cases using specific facilities or procedures. Results: From 1999 to 2007, the prevalence of plagiocephaly in Texas increased from 3.0 cases per 10 000 live births to 28.8, an average increase of 21.2% per year. This was highly statistically significant. The time trend was most pronounced in the Dallas/Fort Worth region and in certain health care facilities. It was observed in all demographic and clinical subgroups. Cases born in 2004 and 2005 were not more likely to be postnatally acquired when compared with cases born in 1999 and 2000. There was no commensurate decrease in other birth defects of the face or skull. Conclusions: A small part of the trend might have been due to delayed compliance with the infant supine sleeping recommendation and a slight increase in preterm births. It was not due to changes in birth defect coding practice or trends in multiple births, torticollis, or oligohydramnios. Because the plagiocephaly trend was observed mainly in patients visiting certain health care facilities, among mild cases, and among cases with minimally invasive procedures, we suspect it may be due mainly to changes in available therapies and insurance reimbursement practices.

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Nonsynostotic Occipital Plagiocephaly: Factors Impacting Onset, Treatment, and Outcomes

Cited by 69 publications

References 21 publications

The Incidence of Positional Plagiocephaly: A Cohort Study

The Incidence of Positional Plagiocephaly: A Cohort Study

Orthotic (helmet) therapy in the treatment of plagiocephaly

Investigation Into an Increase in Plagiocephaly in Texas From 1999 to 2007

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