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Definition

In recent years, there has been an increase in the number of infants with skull deformities as a consequence of prenatal in utero positioning and/or postnatal prolonged supine positioning. This condition called positional plagiocephaly is characterized by unusual flattening of the head and often a prominent or flattened forehead is visible. Plagiocephaly exhibits a variety of different head shapes. Positional brachycephaly is characterized by a generalized flattening of the posterior occipital area. Infants with positional scaphocephaly have a long, narrow head shape As many as 85% of the infants with positional plagiocephaly also have congenital muscular tightness, torticollis, that limits head and neck movement. This condition can contribute to associated asymmetry and malalignment of the ears, eye orbits, cheeks and mandible. Other factors that may influence the development of positional plagiocephaly include: premature births, restrictive intrauterine positioning, cervical spine abnormalities and/or birth trauma. Positional plagiocephaly is commonly seen in multiple births, affecting one or more siblings.

Treatment

Early treatment of positional plagiocephaly includes aggressive repositioning and stretching exercises. Stretching exercises are recommended if the infant does not have full neck and head range of motion in all directions. If repositioning and stretching exercises are unsuccessful in promoting symmetrical head growth by 4 months, a cranial remolding orthosis is considered. The orthotic treatment program focuses on redirecting cranial growth toward greater symmetry. This is accomplished by maintaining contact over the areas of bossing or high spots and allowing room for growth in the areas of depression or flattening. Progressive adjustments over the course of the treatment program accommodate growth and ensure optimum outcomes.

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Cranial Remolding Guidelines

Cranial Asymmetries Program - A Medical Professional's Guide to...
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Cranial Remolding Guidelines


Cranial Remolding Guidelines
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