Helmet Treatment Improves Deformational Brachycephaly

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Treating infants who have isolated deformational brachycephaly with a cranial orthosis appears to be successful in most cases. Nearly 90 percent of infants with isolated deformational brachycephaly demonstrated improvement in cephalic index following treatment with a cranial orthosis, according to a study published October 16 in the Global Pediatric Health journal. More than half of the infants were returned to a "normal-to-mild" cephalic index classification, and nearly half of infants with severe deformities were classified with "normal-to-mild" condition after treatment.

The study was designed to examine the effects of helmet treatment for isolated deformational brachycephaly and to investigate the role of three treatment factors—entrance age, treatment time, and initial severity—on treatment outcome. Researchers found that entrance age influences treatment results, with younger infants demonstrating improved outcomes and shorter treatment times.

After reviewing the data of 128,014 patients with abnormal head shape diagnoses from January 2013 through December 2017, researchers reported on 4,205 infants with isolated deformational brachycephaly treated with a cranial orthosis. Study subjects had complete records at entry into and exit from treatment, moderate to severe brachycephaly, normal or minimal asymmetry, and had entered into treatment between three and 12 months of age. All infants began treatment within three weeks of their initial treatment consultation for a cranial remodeling orthosis. Patients with confounding medical conditions were excluded.

Of the 4,205 infants included in the study, 69.5 percent (2,921) began treatment initially classified as having severe brachycephaly. Of those, 17.4 percent (509) finished treatment in the normal category; 27.3 percent (799) finished as mild; 39.6 percent (1,156) were moderate. Only 15.6 percent (457) remained in the severe category.

The results demonstrated that of the 2,921 infants initially classified as having a severe deformity at the initiation of treatment, 84.4 percent (2,464) were no longer in that category at the end of treatment, with nearly half, 44.8 percent (1,308), having been returned to a "normal-to-mild" classification. In total, 60.3 percent (2,537/4,205) ended treatment with a "normal-to-mild" classification, the study found. With the exception of a low incidence (0.91 percent) of skin irritation, no significant issues were reported.