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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Positional plagiocephaly – outcome of helmet treatment compared to conservative management

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  • Susanne Kluba - Universitätsklinikum Tübingen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland
  • Wiebke Kraut - Universitätsklinikum Tübingen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland
  • Benjamin Calgéer - Universitätsklinikum Tübingen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland
  • Karin Haas-Lude - Universitätsklinikum Tübingen, Kinder- und Jugendmedizin Tübingen, Tübingen, Deutschland
  • Siegmar Reinert - Universitätsklinikum Tübingen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland
  • Michael Krimmel - Universitätsklinikum Tübingen, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch021

doi: 10.3205/16dgch021, urn:nbn:de:0183-16dgch0217

Published: April 21, 2016

© 2016 Kluba et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Positional plagiocephaly has attained widespread attention. There are a lot of data on helmet therapy available, but the natural course of the deformity has not been investigated in depth. The decision for or against helmet therapy can be controversial. This study examined the outcome of both options.

Materials and methods: 128 infants were enrolled in this prospective, non-randomized, longitudinal study. 62 were treated with and 66 without a helmet. The initial cranial vault asymmetry index (CVAI) was determined at 6.3 and 6.2 months of age (SD 1.44/ 2.14). Follow-up took place at the end of helmet therapy (age: 10.2 months, SD 1.77) or after 1 year (age: 18.5 months, SD 2.28) respectively. The outcome and the correlation of the changes to the initially existing asymmetry were compared.

Results: All infants showed a significant reduction of their plagiocephaly. Although children with helmet had a more severe initial asymmetry, they showed significantly better improvement (68% vs. 31%). Only a weak correlation was found between the initial asymmetry and the amount of improvement in both groups.

Conclusion: Despite concerns against helmet therapy (comfort, finances), it should be the treatment of choice for moderate to severe cases. Only slight cases (CVAI ≤ 6.5%) might be sufficiently treated by the natural course.