Yoo Han-Su, Rah Dong Kyun, Kim Yong Oock
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Arch Plast Surg. 2012 Jul;39(4):338-44. doi: 10.5999/aps.2012.39.4.338. Epub 2012 Jul 13.
It is known that nonsynostotic plagiocephaly does not spontaneously improve, and the craniofacial deformities that result from it. This study was conducted to analyze the effectiveness of helmet therapy for the nonsynostotic plagiocephaly patient, and to suggest a new treatment strategy based on this analysis.
A total of 108 pediatric patients who had undergone helmet therapy after being diagnosed with nonsynostotic plagiocephaly were included in this study. The patients were classified according to the initiation age of the helmet therapy, severity, and helmet wearing time. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy.
The discrepancy of CVA and CVAI of all the patients significantly decreased after helmet therapy. According to the initiation time of helmet therapy, the treatment effect was best at 5 months old or less. The helmet wearing time per day was proportional to the treatment effect up to 20 hours. In addition, the rate of the successful treatment (final CVA ≤5 mm) significantly decreased when the initiation age was 9.1 months or older and the treatment period was less than 7.83 months.
This study showed the effectiveness of the helmet therapy for nonsynostotic plagiocephaly patients. Based on analysis of this study, helmet therapy should be started at the age of 9 months or younger for 7.83 months or more, and the helmet wearing time should be more than 20 hours a day.
已知非骨性融合斜头畸形不会自发改善,以及由此导致的颅面畸形。本研究旨在分析头盔疗法对非骨性融合斜头畸形患者的有效性,并基于该分析提出一种新的治疗策略。
本研究纳入了108例被诊断为非骨性融合斜头畸形后接受头盔疗法的儿科患者。根据头盔疗法的起始年龄、严重程度和佩戴头盔时间对患者进行分类。使用治疗前后对角测量获得的颅穹窿不对称(CVA)和颅穹窿不对称指数(CVAI)比较治疗效果。
头盔治疗后所有患者的CVA和CVAI差异均显著降低。根据头盔治疗的起始时间,治疗效果在5个月及以下时最佳。每天佩戴头盔的时间与治疗效果成正比,最长可达20小时。此外,当起始年龄为9.1个月或更大且治疗期小于7.83个月时,成功治疗率(最终CVA≤5mm)显著降低。
本研究表明头盔疗法对非骨性融合斜头畸形患者有效。基于本研究分析,头盔疗法应在9个月或更小年龄开始,持续7.83个月或更长时间,且每天佩戴头盔时间应超过20小时。