Objective To evaluate the efficacy and influencing factors of cranial remolding orthoses (CRO) in the treatment of infant positional brachycephaly (PB),in order to provide scientific basis for optimizing the treatment strategy of CRO. Methods A total of 63 infants with PB who received CRO treatment at the Beijing United Family Hospital from September 2018 to February 2022 were collected.Three-dimensional laser scanning technology was used to measure the Cephalic Ratio (CR),calculate the rate of head shape change.The efficacy and influencing factors of CRO treatment were analyzed. Results After CRO treatment,the CR value of infants with PB improved significantly (t=16.97,P<0.001).There was a significant difference in the treatment time among different groups of CRO onset months,with the 4- to 5-month-old age group being significantly shorter than the 8-month-old and above group (H=9.611,P<0.05).There was a negative correlation between the age of initial treatment and the rate of head shape change (r=-0.592,P<0.001).The severity of PB at the beginning of treatment was positively correlated with the rate of head shape change (r=0.498,P＜0.001).Comorbidity with plagiocephaly was correlated with the rate of head shape change (Z=-2.115,P＜0.05).Prematurity was not significantly correlated with the rate of head shape change (Z=-1.424,P>0.05). Conclusions CRO has a significant effect on the treatment of infant PB.The younger the age,the shorter the treatment time,and the more severe the PB,the higher the treatment efficiency.The treatment efficiency of infants with concurrent plagiocephaly is affected.It is recommended that pediatricians diagnose the PB as early as possible and recommend wearing CRO for treatment,especially for severe PB,to achieve better treatment outcomes.
Key words
positional brachycephaly /
cranial remolding orthoses /
orthopedic helmet
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Marshall JM,Shahzad F.Safe sleep,plagiocephaly,and brachycephaly: Assessment,risks,treatment,and when to refer[J].Pediatr Ann,2020,49(10):e440-e447.
[2] Ahluwalia R,Foster J,Sherburn MM,et al.Deformational brachycephaly: The clinical utility of the cranial index[J].J Neurosurg Pediatr,2020,26(2):122-126.
[3] Yang W,Hu B,Chen J,et al.Analysis of cranial type characteristics in term infants: A multi-center study[J].BMC Pediatr,2021,21(1):20.
[4] Kelly KM,Joganic EF,Beals SP,et al.Helmet treatment of infants with deformational brachycephaly[J].Glob PediatrHealth,2018,5:2333794X18805618.doi:10.1177/2333794×18805618.
[5] Holowaka MA,Reisner A,Giavedoni B,et al.Plagiocephaly Severity Scale toaid in clinical treatment recommendations[J].J Craniofac Surg,2017,28(3):717-722.
[6] Wilbrand JF,Wilbrand M,Malik CY,et al.Complications in helmet therapy [J].J Craniomaxillofac Surg,2012,40(4):341-346.
[7] Linz C,Kunz F,Böhm H,et al.Positional skull deformities[J].Dtsch Arztebl Int,2017,114(31-32):535-542.
[8] 马良,董荣芝,裴连平,等.扁头综合征的危险因素[J].中国康复理论与实践,2015,21(3):326-329.
Ma L,Dong RZ,Pei LZ,et al.Risk factors for plagiocephaly and brachycephaly[J].Chin J Rehabilitation Theory and Practice,2015,21(3):326-329.(in Chinese)
[9] Hallac RR,Ajiwe T,Effendi M,et al.Molding helmet therapy for deformational brachycephaly[J].J Craniofac Surg,2019,30(6):1756-1759.
[10] Teichgraeber JF,Seymour-Dempsey K,Baumgartner JE,et al.Molding helmet therapy in the treatment of brachycephaly and plagiocephaly[J].J Craniofac Surg,2004,15(1):118-123.
[11] Hinken L,Willenborg H,Dávila LA,et al.Outcome analysis of molding helmet therapy using a classification for differentiation between plagiocephaly,brachycephaly and combination of both[J].J Craniomaxillofac Surg,2019,47(5):720-725.
[12] van Cruchten C,Feijen MMW,van der Hulst RRWJ.Helmet therapy for positional cranial deformations:A 5-year follow-up study[J].J Craniomaxillofac Surg,2022,50(6):499-503.
[13] Çevik S,Işιk S,Özkιlιç A.The role of age on helmet therapy in deformational plagiocephaly and asymmetric brachycephaly[J].Childs Nerv Syst,2020,36(4):803-810.
[14] Hinken L,Willenborg H,Davila LA,et al.Outcome analysis of molding helmet therapy using a classification for differentiation between plagiocephaly,brachycephaly and combination of both[J].J Craniomaxillofac Surg,2019,47(5):720-725.
[15] Choi H,Lim SH,Kim JS,et al.Outcome analysis of the effects of helmet therapy in infants with brachycephaly[J].J Clin Med,2020,9(4):1171.
PDF(664 KB)
