Hussein Mohammed Ahmed, Woo Taeyong, Yun In Sik, Park Hanna, Kim Yong Oock
Department of Plastic and Reconstructive Surgery, Cairo University, Cairo, Egypt.
Plastic and Reconstructive Surgery Department, Institute of Human Tissue Restoration, Yonsei University, Seoul, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2018 Jan;71(1):112-117. doi: 10.1016/j.bjps.2017.08.015. Epub 2017 Aug 16.
Deformational plagiocephaly (DP) refers to cranial asymmetry resulting from uneven external forces. A strong association exists between DP and developmental delay. We investigated the effect of DP severity on developmental delay.
Between 2010 and 2016, data from 155 patients with DP were reviewed retrospectively. Two indices were used to evaluate the deformation quantitatively: cranial index (CI) and cranial vault asymmetry index (CVAI). The Bayley Scales of Infant Development-II was used to evaluate the neurodevelopment of patients.
According to the CI of the study population, 2 patients showed scaphocephaly, 12 showed mesocephaly, and 141 showed brachycephaly. For CVAI, 10 patients showed values of <3.5, 10 patients showed mild deformity (3.5-6.25), 27 patients showed moderate deformity (6.25-8.75), and 108 patients showed severe deformity. The means of the mental development index (MDI) and psychomotor development index (PDI) were 91.69 ± 16.8 and 92.28 ± 17.59, respectively; after the exclusion of patients with confounding factors, the values were 96.26 and 92.9, respectively. The Spearman correlation coefficients between MDI and CI and CVAI were -0.019662 and 0.118916, respectively, whereas for PDI, the values were -0.195428 and -0.012386, respectively.
There was a statistically significant neurodevelopmental delay in patients with DP. However, accelerated neurodevelopment was also encountered in many patients. MDI was found to be more affected by multiple confounding factors than PDI, whereas PDI was only affected by congenital anomalies. There was no definitive relationship between the severity of DP and the degree of developmental delay in our study group.
变形性斜头畸形(DP)是指由不均衡外力导致的颅骨不对称。DP与发育迟缓之间存在密切关联。我们研究了DP严重程度对发育迟缓的影响。
回顾性分析2010年至2016年间155例DP患者的数据。使用两个指标对变形进行定量评估:颅骨指数(CI)和颅穹不对称指数(CVAI)。采用贝利婴儿发育量表第二版评估患者的神经发育情况。
根据研究人群的CI,2例为舟状头畸形,12例为中头畸形,141例为短头畸形。对于CVAI,10例患者的值<3.5,10例患者为轻度畸形(3.5 - 6.25),27例患者为中度畸形(6.25 - 8.75),108例患者为重度畸形。智力发育指数(MDI)和精神运动发育指数(PDI)的均值分别为91.69 ± 16.8和92.28 ± 17.59;排除有混杂因素的患者后,值分别为96.26和92.9。MDI与CI和CVAI的Spearman相关系数分别为 -0.019662和0.118916,而对于PDI,值分别为 -0.195428和 -0.012386。
DP患者存在具有统计学意义的神经发育迟缓。然而,许多患者也出现了神经发育加速的情况。发现MDI比PDI更容易受到多种混杂因素的影响,而PDI仅受先天性异常的影响。在我们的研究组中,DP的严重程度与发育迟缓程度之间没有明确的关系。