Clinical classification of infant nonsynostotic cranial deformity

J Pediatr. 2012 Dec;161(6):1120-5. doi: 10.1016/j.jpeds.2012.05.023. Epub 2012 Jun 23.

Abstract

Objective: Based on a pilot study including >400 children and a comprehensive database analysis of >2500 children, we sought to define the craniofacial norm and to objectify the categorization of positional head deformity.

Study design: A database was created containing clinical information on children assessed for nonsynostotic cranial deformity. The findings of standardized anthropometric measurements were compared with data from a group of 401 healthy children with a normal head shape collected in terms of a prospective pilot study. Using a statistical analysis of all anthropometric craniofacial measurements, cut-off percentiles for discriminating different groups of deformation and severity classes were generated.

Results: Normative percentiles for all dimensions in cranial vault anthropometric measurements during the first year of life were calculated. Children with definite nonsynostotic head deformity could be clearly allocated into 3 different groups: positional plagiocephaly (abnormal Cranial Vault Asymmetry Index), positional brachycephaly (abnormal Cranial Index), and combined positional plagiocephaly and brachycephaly (abnormal Cranial Vault Asymmetry Index and Cranial Index). Additionally, a reliable 3-level severity categorization (mild, moderate, and severe) for each group of cranial deformation could be obtained according to age and sex.

Conclusions: Our results allow a meaningful and reliable classification of nonsynostotic early childhood cranial deformity.

MeSH terms

  • Age Distribution
  • Cephalometry*
  • Cluster Analysis
  • Cohort Studies
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Orthotic Devices
  • Pilot Projects
  • Plagiocephaly, Nonsynostotic / classification*
  • Plagiocephaly, Nonsynostotic / diagnosis
  • Plagiocephaly, Nonsynostotic / therapy
  • Prospective Studies
  • Reference Values
  • Severity of Illness Index
  • Sex Distribution