Infants with positional deformities may present with a number of different head
shapes. They may have unilateral flattening of their posterior skull, which is
plagiocephaly, and/or forehead bulging along with bilateral flattening, which is
brachycephaly. When they have increased skull height and/or a long, narrow skull
it is scaphocephaly. Deformities result from positioning during pregnancy,
sleeping position, or from neck tightness. An asymmetrical skull can result in
asymmetries of the face causing various functional problems that affect chewing,
speech, breathing, and vision. Some of these infants can be managed with just
positioning, such as changing their sleeping position. If the deformity
persists, however, treatment may be necessary.
Infant treatment of
positional deformities is with a molding helmet. Ideally, the treatment is begun
during the first six months of life. The helmet is worn 23 hours a day and
requires 3-4 months of wear. Severe cases in older children require longer
periods of correction. The result of wearing the helmet is typically a 70 percent rate
of improvement, but the correction rate correlates with the severity of the
deformity and the age that treatment commenced. Long-term follow up in these
children reveals that the correction does not relapse with continued growth. |
