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Positional Plagiocephaly and Brachycephaly: Is There a Correlation Between Subjective and Objective Assessment of Cranial Shape?

Feijen, Michelle MD; Schuckman, Marjoes MD; Habets, Edith; van der Hulst, Rene MD, PhD

Journal of Craniofacial Surgery: July 2012 - Volume 23 - Issue 4 - p 998–1001
doi: 10.1097/SCS.0b013e31824e642e
Original Articles

Introduction: During the last 2 decades, the incidence of positional plagiocephaly and brachycephaly has increased. Treatment options are conservative and can include physiotherapy and molding helmet therapy. The decision to start helmet therapy is based on patient history and subjective assessment of cranial shape by the physician and the parents. Recently, a noninvasive, objective, reliable, and valid measurement instrument became available: the plagiocephalometry (PCM). Because there are no data available comparing the result of PCM with subjective assessment of cranial shape, we performed the current study.

Methods: All consecutive children with positional plagiocephaly and brachycephaly admitted to the craniofacial outpatient clinic between October 2008 and July 2009 were included. Physician and parents assessed the cranial shape of the child, using a numeric scale from 1 to 10. In consultation with the parents, the physician decided whether helmet therapy was indicated. Plagiocephalometry was performed after visit to the physician.

Results: We included 75 patients in our study. There was a significant correlation between the numeric score from the physician and both the oblique diameter difference index (P < 0.001) and the cranial proportional index (P = 0.023). There was no significant correlation between the numeric score from the parents and both the oblique diameter difference index (P = 0.427) and the cranial proportional index (P = 0.155).

Conclusions: There is a significant correlation between the subjective assessment of cranial shape by the physician and PCM results. Plagiocephalometry can be a useful additive tool to assess cranial shape.

From the Maastricht University Medical Center, Maastricht, the Netherlands.

Received June 8, 2011.

Accepted for publication January 2, 2012.

Address correspondence and reprint requests to Michelle Feijen, MD, Department of Plastic Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; E-mail: michellefeijen@gmail.com

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD