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Helmet Therapy In Infants With Positional Plagiocephaly:do Helmets Work
Nathan Eberle, DDS,MD1, Brian Boland, MD1, Eric Stelnicki, MD2.
1Cleveland Clinic Florida, Weston, FL, USA, 2Private Practice, Fort Lauderdale, FL, USA.

PURPOSE:
Positional plagiocephaly is a common condition with controversy regarding optimal treatment modality. Treatment options include repositioning exercises, watchful waiting, and cranial molding orthotics. Recently an article in The British Journal of Medicine featured in The Wall Street Journal stated watchful waiting is as effective as helmet therapy. Our aim was to determine the effectiveness of helmet therapy for positional skull deformation in a single provider practice.
METHODS:
A retrospective chart review was performed for all patients that were seen from 2008-2013 for deformational skull deformity by a single provider and treated with an orthotic cranial molding device by a single orthotist. Objective data was obtained from each patient via a 3-D surface scanner.
RESULTS:
2820 patients between the ages of 4-12 months were seen and evaluated for deformational skull deformity. 307 patients underwent helmet therapy. Average treatment duration was 5 months with 99% having complete correction of deformity with a single helmet. 4 patients required a second helmet for additional correction, and all patients achieved full recovery of head shape. There were no serious complications from treatment.
CONCLUSION:
This is the largest series to date by a single provider showing the efficacy of cranial molding for treatment of deformational skull deformities. A single helmet fabricated by a skilled orthotist and followed by a craniofacial surgeon can correct deformational skull deformities in nearly all infants. This conflicts the data of the BJM article, which has been a source of insurance denials for infants who could benefit from cranial molding orthotics.


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