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Three-dimensional analysis of positional plagiocephaly before and after molding helmet therapy in comparison to normal head growth

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Abstract

Objective

Stereophotogrammetry enables a simple and radiation free longitudinal analysis of skull asymmetries: in a three-dimensional coordinate system various distances (length, breadth, cephalic index, oblique diameters, ear shift, head circumference) can be analyzed. We also defined separate volume sections in order to further quantify the degree of asymmetry in the posterior and anterior components of both sides of the head.

Patients and methods

In 51 infants (mean age, 6 months; SD 0.97) with positional plagiocephaly, we determined these parameters at the beginning as well as at the end of molding helmet therapy (mean therapy time 4.9 months). Thirty-seven infants without positional deformity (mean age, 6.4 months; SD 0.3) served as control group and provided data about what appears to be normal and how these parameters change during growth over a comparable period of time.

Results

Compared with the control group, the plagiocephalic heads were more brachycephalic, but closely approximated the normal shape under molding therapy. The striking volume difference between the left and right posterior sections in the plagiocephalic children (the mean volume of the flattened side being 21 % smaller than the one on the contralateral side) improved as well (to a residual difference of mean 8 %) and ended up with a value close to the control group (mean 6 %).

Conclusion

There is a broad clinical application area for stereophotogrammetry analyzing skull morphology: In plagiocephalic infants we demonstrate impressive changes of head shape under molding therapy; in normal-looking infants we describe the extent of unperceived asymmetry.

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Acknowledgments

This investigation was supported by grants from the Interdisciplinary Center for Clinical Research at the Medical Faculty of the University of Würzburg, Germany.

Funding source

This investigation was supported by grants from the Interdisciplinary Center for Clinical Research at the Medical Faculty of the University of Würzburg, Germany.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflict of Interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Craniofacial Center, University of Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany

    Tilmann Schweitzer

  2. Department of Maxillo-Facial-Surgery and Plastic Surgery, Craniofacial Center, University of Würzburg, Würzburg, Germany

    Hartmut Böhm & Christian Linz

  3. Department of Pediatric Neurosurgery, University of Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany

    Beatrice Jager & Jürgen Krauß

  4. Department of Neurosurgery, University of Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany

    Ralf-Ingo Ernestus

  5. Department of Pediatric Neurology, University Childrens Hospital, Würzburg, Germany

    Lucia Gerstl

  6. Department of Orthodontics, Craniofacial Center, University of Würzburg, Würzburg, Germany

    Felix Kunz & Philipp Meyer-Marcotty

  7. Department of Orthodontics, University of Würzburg, Würzburg, Germany

    Angelika Stellzig-Eisenhauer

Authors
  1. Tilmann Schweitzer
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  2. Hartmut Böhm
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  3. Christian Linz
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  4. Beatrice Jager
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  5. Lucia Gerstl
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  7. Angelika Stellzig-Eisenhauer
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  8. Ralf-Ingo Ernestus
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Corresponding author

Correspondence to Tilmann Schweitzer.

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Schweitzer, T., Böhm, H., Linz, C. et al. Three-dimensional analysis of positional plagiocephaly before and after molding helmet therapy in comparison to normal head growth. Childs Nerv Syst 29, 1155–1161 (2013). https://doi.org/10.1007/s00381-013-2030-y

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  • DOI: https://doi.org/10.1007/s00381-013-2030-y

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