Cranial orthoses for deformational plagiocephaly

Institute for Clinical Systems Improvement
Record ID 32004000183
Authors' objectives:

This review aims to assess the available evidence on cranial orthoses for deformational plagiocephaly. Deformational plagiocephaly refers to cranial asymmetries without synostosis. The infant is typically born without a flattened region of the skull but develops one within a few weeks or months. Deformational plagiocephaly is purely an aesthetic issue; brain function is not affected.

Authors' recommendations: With regard to cranial orthoses for deformational plagiocephaly, the ICSI Technology Assessment Committee finds: Deformational plagiocephaly is largely preventable by alternating right and left head positioning when sleeping, minimizing prolonged periods in seating devices that maintain a supine position, and appropriately using prone positioning during awake time. Prevention is most likely to be effective in children under 6 months of age. Cranial orthoses should only be used for infants with moderate to severe deformational plagiocephaly after failure of a 6 to 8 week trial of repositioning therapy. At present, there is no objective definition of moderate to severe plagiocephaly. Cranial orthoses are safe when prescribed by experienced, qualified individuals and used as directed. In case series and non-randomized trials, cranial orthoses have been found to be effective in reducing cranial asymmetries. Although the evidence is limited, the balance of the literature supports the use of cranial orthoses before 12 months of age. There is evidence that positional therapy, a more conservative treatment, is only effective when employed early (i.e., at 2 to 4 months of age). Randomized, controlled trials with objective outcome measures are needed to clarify the potential benefits of positional therapy and cranial orthoses. (Conclusion Grade II)
Authors' methods: Review
Project Status: Completed
Year Published: 2004
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Craniosynostoses
  • Facial Asymmetry
  • Infant
  • Orthotic Devices
  • Skull
Organisation Name: Institute for Clinical Systems Improvement
Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
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Copyright: Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.