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Erschienen in: Child's Nervous System 9/2014

01.09.2014 | Original Paper

Cranial molding helmet therapy and establishment of practical criteria for management in Asian infant positional head deformity

verfasst von: Yasuo Aihara, Kana Komatsu, Hitoshi Dairoku, Osami Kubo, Tomokatsu Hori, Yoshikazu Okada

Erschienen in: Child's Nervous System | Ausgabe 9/2014

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Abstract

Background

The growing number of infants with deformational plagiocephaly (DP) has raised clinical questions about which children, at what age, and how molding helmet therapy (MHT) should be performed especially in Japan.

Methods

A total of 1,011 Japanese pediatric head deformity infants had undergone MHT after being diagnosed with non-synostotic DP. Three ratios of left to right comparison (anterior, posterior, and overall) were created and analyzed comparing age of starting treatment, helmet wearing period, and severity of skull deformity before with after MHT.

Results

The averages of head symmetry ratios after treatment in all groups (for the occipital region) showed apparent improvement; t(930) = −60.86, p = 0.000. (t(932) = −57.8, p = 0.000.) In the “severe” deformation group, the earlier the treatment was started, the higher symmetry ratio recovery was obtained. Treatment was especially effective when started in 4-month-old infants. In contrast to the “severe” group, the “mild” deformation group showed that MHT was most effective if treatment started before 6 months of age. Again, the earlier the treatment was started, the higher symmetry ratio was achieved, but compared to the “severe” group, it had a modest effect when treatment was started in infants older than 8 months.

Conclusion

This is the first large-scale molding helmet study reporting the method and efficacy in Japanese infants. It demonstrated that despite the structural and physiological differences from infants of other races, molding helmet therapy is effective in Asian-born infants, provided that intervention timing and recognition conditions are met.
Literatur
1.
Zurück zum Zitat Kluba S, Kraut W, Reinert S, Krimmel M (2011) What is the optimal time to start helmet therapy in positional plagiocephaly? Plast Reconstr Surg 128:492–498PubMedCrossRef Kluba S, Kraut W, Reinert S, Krimmel M (2011) What is the optimal time to start helmet therapy in positional plagiocephaly? Plast Reconstr Surg 128:492–498PubMedCrossRef
2.
Zurück zum Zitat Lipira AB, Gordon S, Darvann TA, Hermann NV, Van Pelt AE, Naidoo SD, Govier D, Kane AA (2010) Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis. Pediatrics 126:e936–e945PubMedCrossRef Lipira AB, Gordon S, Darvann TA, Hermann NV, Van Pelt AE, Naidoo SD, Govier D, Kane AA (2010) Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis. Pediatrics 126:e936–e945PubMedCrossRef
3.
Zurück zum Zitat Biggs WS (2003) Diagnosis and management of positional head deformity. Am Fam Physician 67:1953–1956PubMed Biggs WS (2003) Diagnosis and management of positional head deformity. Am Fam Physician 67:1953–1956PubMed
4.
Zurück zum Zitat Mortenson P, Steinbok P, Smith D (2012) Deformational plagiocephaly and orthotic treatment: indications and limitations. Childs Nerv Syst 28:1407–1412PubMedCrossRef Mortenson P, Steinbok P, Smith D (2012) Deformational plagiocephaly and orthotic treatment: indications and limitations. Childs Nerv Syst 28:1407–1412PubMedCrossRef
6.
Zurück zum Zitat Plank LH, Giavedoni B, Lombardo JR, Geil MD, Reisner A (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091PubMedCrossRef Plank LH, Giavedoni B, Lombardo JR, Geil MD, Reisner A (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091PubMedCrossRef
7.
Zurück zum Zitat Wilbrand JF, Seidl M, Wilbrand M, Streckbein P, Bottger S, Pons-Kuehnemann J, Hahn A, Howaldt HP (2013) A prospective randomized trial on preventative methods for positional head deformity: physiotherapy versus a positioning pillow. J Pediatr 162:1216–1221, 1221 e1211PubMedCrossRef Wilbrand JF, Seidl M, Wilbrand M, Streckbein P, Bottger S, Pons-Kuehnemann J, Hahn A, Howaldt HP (2013) A prospective randomized trial on preventative methods for positional head deformity: physiotherapy versus a positioning pillow. J Pediatr 162:1216–1221, 1221 e1211PubMedCrossRef
8.
Zurück zum Zitat Paquereau J (2013) Non-surgical management of posterior positional plagiocephaly: orthotics versus repositioning. Ann Phys Rehabil Med 56:231–249PubMedCrossRef Paquereau J (2013) Non-surgical management of posterior positional plagiocephaly: orthotics versus repositioning. Ann Phys Rehabil Med 56:231–249PubMedCrossRef
9.
Zurück zum Zitat Pogliani L, Mameli C, Fabiano V, Zuccotti GV (2011) Positional plagiocephaly: what the pediatrician needs to know. A review. Childs Nerv Syst 27:1867–1876PubMedCrossRef Pogliani L, Mameli C, Fabiano V, Zuccotti GV (2011) Positional plagiocephaly: what the pediatrician needs to know. A review. Childs Nerv Syst 27:1867–1876PubMedCrossRef
10.
Zurück zum Zitat Kluba S, Schreiber R, Kraut W, Meisner C, Reinert S, Krimmel M (2012) Does helmet therapy influence the ear shift in positional plagiocephaly? J Craniofac Surg 23:1301–1305PubMedCrossRef Kluba S, Schreiber R, Kraut W, Meisner C, Reinert S, Krimmel M (2012) Does helmet therapy influence the ear shift in positional plagiocephaly? J Craniofac Surg 23:1301–1305PubMedCrossRef
11.
Zurück zum Zitat Shamji MF, Fric-Shamji EC, Merchant P, Vassilyadi M (2012) Cosmetic and cognitive outcomes of positional plagiocephaly treatment. Clin Investig Med 35:E266 Shamji MF, Fric-Shamji EC, Merchant P, Vassilyadi M (2012) Cosmetic and cognitive outcomes of positional plagiocephaly treatment. Clin Investig Med 35:E266
12.
Zurück zum Zitat Rekate HL (1998) Occipital plagiocephaly: a critical review of the literature. J Neurosurg 89:24–30PubMedCrossRef Rekate HL (1998) Occipital plagiocephaly: a critical review of the literature. J Neurosurg 89:24–30PubMedCrossRef
13.
Zurück zum Zitat Davis BE, Moon RY, Sachs HC, Ottolini MC (1998) Effects of sleep position on infant motor development. Pediatrics 102:1135–1140PubMedCrossRef Davis BE, Moon RY, Sachs HC, Ottolini MC (1998) Effects of sleep position on infant motor development. Pediatrics 102:1135–1140PubMedCrossRef
14.
Zurück zum Zitat Binder H, Eng GD, Gaiser JF, Koch B (1987) Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil 68:222–225PubMed Binder H, Eng GD, Gaiser JF, Koch B (1987) Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil 68:222–225PubMed
15.
Zurück zum Zitat Seruya M, Oh AK, Taylor JH, Sauerhammer TM, Rogers GF (2013) Helmet treatment of deformational plagiocephaly: the relationship between age at initiation and rate of correction. Plast Reconstr Surg 131:55e–61ePubMedCrossRef Seruya M, Oh AK, Taylor JH, Sauerhammer TM, Rogers GF (2013) Helmet treatment of deformational plagiocephaly: the relationship between age at initiation and rate of correction. Plast Reconstr Surg 131:55e–61ePubMedCrossRef
16.
Zurück zum Zitat Wilbrand JF, Wilbrand M, Malik CY, Howaldt HP, Streckbein P, Schaaf H, Kerkmann H (2012) Complications in helmet therapy. J Craniomaxillofac Surg 40:341–346PubMedCrossRef Wilbrand JF, Wilbrand M, Malik CY, Howaldt HP, Streckbein P, Schaaf H, Kerkmann H (2012) Complications in helmet therapy. J Craniomaxillofac Surg 40:341–346PubMedCrossRef
17.
Zurück zum Zitat Ifflaender S, Rudiger M, Konstantelos D, Wahls K, Burkhardt W (2013) Prevalence of head deformities in preterm infants at term equivalent age. Early Hum Dev 89:1041–1047PubMedCrossRef Ifflaender S, Rudiger M, Konstantelos D, Wahls K, Burkhardt W (2013) Prevalence of head deformities in preterm infants at term equivalent age. Early Hum Dev 89:1041–1047PubMedCrossRef
18.
Zurück zum Zitat Mawji A, Vollman AR, Hatfield J, McNeil DA, Sauve R (2013) The incidence of positional plagiocephaly: a cohort study. Pediatrics 132:298–304PubMedCrossRef Mawji A, Vollman AR, Hatfield J, McNeil DA, Sauve R (2013) The incidence of positional plagiocephaly: a cohort study. Pediatrics 132:298–304PubMedCrossRef
19.
Zurück zum Zitat van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CG, Van der Ploeg CP, Ijzerman MJ, Boere-Boonekamp MM (2014) Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 348:g2741PubMedCentralPubMedCrossRef van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CG, Van der Ploeg CP, Ijzerman MJ, Boere-Boonekamp MM (2014) Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 348:g2741PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Roby BB, Finkelstein M, Tibesar RJ, Sidman JD (2012) Prevalence of positional plagiocephaly in teens born after the “Back to Sleep” campaign. Otolaryngol Head Neck Surg 146:823–828PubMedCrossRef Roby BB, Finkelstein M, Tibesar RJ, Sidman JD (2012) Prevalence of positional plagiocephaly in teens born after the “Back to Sleep” campaign. Otolaryngol Head Neck Surg 146:823–828PubMedCrossRef
21.
Zurück zum Zitat Meyer-Marcotty P, Bohm H, Linz C, Kunz F, Keil N, Stellzig-Eisenhauer A, Schweitzer T (2012) Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment. J Orofac Orthop 73:151–165PubMedCrossRef Meyer-Marcotty P, Bohm H, Linz C, Kunz F, Keil N, Stellzig-Eisenhauer A, Schweitzer T (2012) Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment. J Orofac Orthop 73:151–165PubMedCrossRef
22.
Zurück zum Zitat Schweitzer T, Bohm H, Linz C, Jager B, Gerstl L, Kunz F, Stellzig-Eisenhauer A, Ernestus RI, Krauss J, Meyer-Marcotty P (2013) Three-dimensional analysis of positional plagiocephaly before and after molding helmet therapy in comparison to normal head growth. Childs Nerv Syst Schweitzer T, Bohm H, Linz C, Jager B, Gerstl L, Kunz F, Stellzig-Eisenhauer A, Ernestus RI, Krauss J, Meyer-Marcotty P (2013) Three-dimensional analysis of positional plagiocephaly before and after molding helmet therapy in comparison to normal head growth. Childs Nerv Syst
23.
Zurück zum Zitat Schaaf H, Wilbrand JF, Boedeker RH, Howaldt HP (2010) Accuracy of photographic assessment compared with standard anthropometric measurements in nonsynostotic cranial deformities. Cleft Palate Craniofac J 47:447–453PubMedCrossRef Schaaf H, Wilbrand JF, Boedeker RH, Howaldt HP (2010) Accuracy of photographic assessment compared with standard anthropometric measurements in nonsynostotic cranial deformities. Cleft Palate Craniofac J 47:447–453PubMedCrossRef
24.
Zurück zum Zitat Schaaf H, Malik CY, Streckbein P, Pons-Kuehnemann J, Howaldt HP, Wilbrand JF (2010) Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity. J Craniofac Surg 21:1677–1682PubMedCrossRef Schaaf H, Malik CY, Streckbein P, Pons-Kuehnemann J, Howaldt HP, Wilbrand JF (2010) Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity. J Craniofac Surg 21:1677–1682PubMedCrossRef
25.
Zurück zum Zitat Wilbrand JF, Wilbrand M, Pons-Kuehnemann J, Blecher JC, Christophis P, Howaldt HP, Schaaf H (2011) Value and reliability of anthropometric measurements of cranial deformity in early childhood. J Craniomaxillofac Surg 39:24–29PubMedCrossRef Wilbrand JF, Wilbrand M, Pons-Kuehnemann J, Blecher JC, Christophis P, Howaldt HP, Schaaf H (2011) Value and reliability of anthropometric measurements of cranial deformity in early childhood. J Craniomaxillofac Surg 39:24–29PubMedCrossRef
26.
Zurück zum Zitat Wilbrand JF, Schmidtberg K, Bierther U, Streckbein P, Pons-Kuehnemann J, Christophis P, Hahn A, Schaaf H, Howaldt HP (2012) Clinical classification of infant nonsynostotic cranial deformity. J Pediatr 161:1120–1125PubMedCrossRef Wilbrand JF, Schmidtberg K, Bierther U, Streckbein P, Pons-Kuehnemann J, Christophis P, Hahn A, Schaaf H, Howaldt HP (2012) Clinical classification of infant nonsynostotic cranial deformity. J Pediatr 161:1120–1125PubMedCrossRef
Metadaten
Titel
Cranial molding helmet therapy and establishment of practical criteria for management in Asian infant positional head deformity
verfasst von
Yasuo Aihara
Kana Komatsu
Hitoshi Dairoku
Osami Kubo
Tomokatsu Hori
Yoshikazu Okada
Publikationsdatum
01.09.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 9/2014
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-014-2471-y

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