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conferenceseries
.com
Volume 05
Neonatal and Pediatric Medicine
ISSN: 2572-4983
World Pediatrics 2019
December 04-05, 2019
December 04-05, 2019 | Barcelona, Spain
32
nd
World Pediatrics Conference
The effects of helmet therapy, relative to the size of the anterior fontanelle in patients with nonsynostotic
plagiocephaly: A retrospective study
Kang Young Choi
Kyungpook National University, South Korea
Background
: Many studies have reported on the importance of treating patients with nonsynostotic plagiocephaly using
helmets, a non-surgical treatment. We retrospectively examined the effects of helmet therapy according to the size of the
anterior fontanelle.
Material andMethods
: We enrolled 200 patients with nonsynostotic plagiocephaly who received helmet therapy between
January 1, 2016 andDecember 31,
2018.Wecollected data pertaining to age at treatment initiation and treatment duration.
We measured anterior fontanelle size using X-ray imaging and divided patients into one of three groups according to the
structure’s size. Group A was 0~25%, Group B was 25~75% and Group C was 75~100% of anterior fontanelle size. Helmet
treatment feasibility was evaluated using Cranial Vault Asymmetry (CVA), Cranial Vault Asymmetry Index (CVAI),
Anterior Symmetry Ratio (ASR), Posterior Symmetry Ratio (PSR) and Overall Symmetry Ratio (OSR) at baseline and at
the end of the treatment.
Results
:The average starting age was 20w (12-40w).The mean treatment period was 13w (10-24w). Group A had 53 cases,
Group B had 102 and Group C had 45. The CVA differences between groups were 6.8mm (A & B), 9.5mm (A & C) and
2.7mm (B & C). The CVAI differences between the groups were 7.28% (A&B; p=0.001), 8.9% (A&C; p=0.003) and 1.62%
(B&C; p=0.381). There were no interval changes for ASR in Group A; Group B changed 1% from 0.9 to 0.91, Group C
changed 2% from 0.89 to 0.91. For PSR, Group A changed 6%, from 0.82 to 0.88; Group B changed 10%, from 0.79 to 0.89
and Group C changed 17%, from 0.73 to 0.9. In Group A, OSR changed 5%, from 0.85 to 0.90 in Group B, it changed 9%,
from0.81 to 0.90 and inGroupC it changed 13%, from0.78 to 0.91.There was no difference in the effects of helmet therapy
according to the sex of each group.
Conclusion
: The mean changes of CVA, CVAI and PSR were significantly greater for Group C, whose members presented
with greater anterior fontanelle size. Helmet therapy is more useful for occipital, rather than frontal, asymmetry correction.
Patients with greater fontanel sizes appeared to demonstrate relatively free cranial bone movement. Therefore, anterior
fontanelle size could act as a prognostic factor for estimating the outcomes.
Neonat Pediatr Med 2019, Volume: 05