Relationship between starting age of cranial-remolding-orthosis therapy and effectiveness of treatment in children with deformational plagiocephaly

Childs Nerv Syst. 2017 Aug;33(8):1349-1356. doi: 10.1007/s00381-017-3427-9. Epub 2017 May 8.


Purpose: The aim of this study was to investigate the optimal age for starting cranial-remolding-orthosis therapy in children with deformational plagiocephaly.

Methods: Medical records of 310 patients with deformational plagiocephaly were retrospectively reviewed and the initial and final cranial vault asymmetry index (CVAI), age when starting therapy, duration of therapy, mean change of CVAI, improvement rate, and treatment success were analyzed. We compared outcomes according to the groups divided by ages starting therapy.

Results: There were no significant differences in improvement rate and duration of cranial-remolding-orthosis therapy among patients starting therapy at the age of 3, 4, and 5 months. However, when starting therapy after the age of 6 months, the rates of CVAI improvement were significantly lower and the duration of therapy was significantly increased.

Conclusion: Considering the spontaneous resolution effect according to the head growth nature, the age 5 month is the optimal period to start cranial-remolding-orthosis therapy for deformational plagiocephaly.

Keywords: Craniofacial abnormalities; Craniosynostoses; Nonsynostotic plagiocephaly; Treatment outcome.

MeSH terms

  • Bone Remodeling
  • Craniotomy / methods*
  • Female
  • Head Protective Devices
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Orthotic Devices*
  • Plagiocephaly, Nonsynostotic / surgery*
  • Skull / growth & development*
  • Skull / surgery*
  • Treatment Outcome