Zuyderland MC, Geleen.
MUMC, Maastricht, The Netherlands.
J Craniofac Surg. 2021;32(8):2736-2740. doi: 10.1097/SCS.0000000000007811.
In the last 3 decades, the incidence of positional cranial deformations in infants, such as positional plagiocephaly and positional brachycephaly, has increased. The deviating shape often causes parental concern for the later psychosocial wellbeing of the child. Treatment options are nonoperative, varying from positional change to helmet therapy, of which the effect has often been debated. Multiple risk factors have been associated with an increased risk on the development of these deformations. The goal of this study was to assess the impact of known risk factors on the type and severity of resulting positional cranial deformation.Parents were asked to fill out a questionnaire regarding the presence of risk factors, such as gender, age, pregnancy duration, method of delivery and reasons for atypical deliveries, breech position, birth weight, developmental status, positional preference, family history, number of siblings, and torticollis presence. Treatment methods were documented and plagiocephalometry was used to measure the cranial proportions. All children were invited to participate in short-term follow-up. The significance of the risk factors and the effect of different kinds of therapy are discussed. Although no significant correlation was found between severity and risk factors, some risk factors could be correlated with the kind of positional cranial deformation. Of the different therapies, helmet therapy had a significant impact on the reduction of positional plagiocephaly.
在过去的 30 年中,婴儿的位置性颅面畸形(如位置性斜头畸形和位置性扁头畸形)的发病率有所增加。这种畸形的形状常常引起父母对孩子以后的社会心理福利的担忧。治疗方法是非手术的,从改变姿势到头盔治疗,其中效果经常存在争议。多个危险因素与这些畸形的发展风险增加有关。本研究的目的是评估已知危险因素对位置性颅面畸形类型和严重程度的影响。
家长被要求填写一份关于危险因素的问卷,例如性别、年龄、妊娠持续时间、分娩方式和非典型分娩的原因、臀位、出生体重、发育状况、姿势偏好、家族史、兄弟姐妹数量和斜颈的存在。记录治疗方法,并使用头形测量法来测量颅骨比例。所有儿童都被邀请参加短期随访。讨论了危险因素的意义和不同治疗方法的效果。虽然没有发现严重程度和危险因素之间存在显著相关性,但一些危险因素可能与位置性颅面畸形的类型有关。在不同的治疗方法中,头盔治疗对减少位置性斜头畸形有显著影响。