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Open AccessArticle

The Effects of Helmet Therapy Relative to the Size of the Anterior Fontanelle in Nonsynostotic Plagiocephaly: A Retrospective Study

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu 702701, Korea
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J. Clin. Med. 2019, 8(11), 1977; https://doi.org/10.3390/jcm8111977
Received: 24 October 2019 / Revised: 8 November 2019 / Accepted: 10 November 2019 / Published: 14 November 2019
Helmet therapy is an important nonsurgical approach for patients with nonsynostotic plagiocephaly, but its effectiveness may depend on certain anatomical features. We retrospectively examined the effects of helmet therapy according to the size of the anterior fontanelle. Two hundred patients with nonsynostotic plagiocephaly who underwent helmet therapy between 2016 and 2018 were included. Data regarding age at treatment onset and treatment duration were collected. Patients were divided into two groups depending on the age at treatment initiation: the 12–23 weeks group and the >23 weeks group. Patients were also divided based on the anterior fontanelle size to analyze the effects of helmet therapy according to the severity of plagiocephaly in each group as the change in the cranial vault asymmetry index (CVAI). Therapeutic effects were evaluated using the cranial vault asymmetry (CVA), CVAI, anterior symmetry ratio, posterior symmetry ratio (PSR), and overall symmetry ratio at baseline and treatment completion. Treatment initiation at age 12–23 weeks resulted in better effects than that after age 24 weeks. There were no sex-dependent differences in therapeutic effects. Greater changes in the CVA, CVAI, and PSR were associated with larger anterior fontanelles. Therefore, the anterior fontanelle size could be a prognostic factor for estimating helmet therapy outcomes. View Full-Text
Keywords: plagiocephaly; helmet therapy; anterior fontanelle; cranial vault asymmetry; posterior symmetry ratio; overall symmetry ratio plagiocephaly; helmet therapy; anterior fontanelle; cranial vault asymmetry; posterior symmetry ratio; overall symmetry ratio
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Kim, D.G.; Lee, J.S.; Lee, J.W.; Yang, J.D.; Chung, H.Y.; Cho, B.C.; Choi, K.Y. The Effects of Helmet Therapy Relative to the Size of the Anterior Fontanelle in Nonsynostotic Plagiocephaly: A Retrospective Study. J. Clin. Med. 2019, 8, 1977.

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