What is plagiocephaly?
Plagiocephaly (pley-jee-oh-‘sef-uh-lee) is a term used to describe a malformation of the skull marked by an oblique slant to the head. More generally, the term applies to any condition in which there is a misshapen skull including a flat spot on the back or side of the head. It is important to distinguish between an abnormal head shape caused by positional changes or deformation vs. an abnormal head shape caused by premature closure of the cranial sutures, known as craniosynostosis.
What causes deformational or positional plagiocephaly?
An external force applied to the skull causes deformational or positional plagiocephaly. This external force can begin in utero and depends on the baby’s position. The external force can also occur after birth during infancy.
Sleep position and plagiocephaly
In 1992, the American Academy of Pediatrics recommended that infants sleep in a supine position. The so-called “back to sleep” program is promoted to reduce the incidence of sudden infant death syndrome (SIDS).
The incidence of SIDS has dramatically dropped since that time; however, the incidence of positional or deformational plagiocephaly has also dramatically increased during that same timeframe.
How flat spots develop
When an infant is placed in the same position day and night, the head contacts the mattress in the same spot and there is an external force applied which could then create a flat spot. The infant will then prefer to rest the head on that flat spot thereby worsening the problem.
How is plagiocephaly treated?
Early recognition and prevention
Early recognition of these conditions is important and further prevention can be initiated. The most important component is parent education.
Parent education and positioning
We stress “tummy time” and neck range of motion exercises if appropriate. This entails placement of the infant on the tummy as often as possible while awake. This will prevent further resting on the flat spot and further deformation of the skull.
Conservative treatment options
Typically, when caught early, plagiocephaly treatment can simply consist of physical therapy and position changes.
When additional evaluation is needed
Occasionally an infant’s skull is significantly misshapen and does not respond to these conservative measures. In this case the child will benefit from evaluation in our multidisciplinary Plagiocephaly Clinic at Children’s Minnesota to determine further plagiocephaly treatment options.
What to expect at the clinic evaluation
At this evaluation, the head is carefully measured and compared to established normal measurements. Our physical therapist also conducts a formal and thorough evaluation of the neck range of motion and neck strength.
We also have the availability to make a 3D-image of the head that can be used to fabricate a custom helmet if the family chooses that treatment plan.
Where to find plagiocephaly treatment
Plagiocephaly treatment is provided by our ENT and facial plastic surgery team at Children’s Minnesota. We offer a multidisciplinary plagiocephaly clinic to evaluate and treat infants when there is concern regarding head shape.
To schedule a consultation, please call: 612-874-1292.
Questions?
This information is not specific to your child and provides general information. If you have any questions, please call your nearest Children’s Minensota ENT and facial plastic surgery clinic.
