Treatment options for head flattening in infants – plagiocephaly, brachycephaly, and torticollis
A diagnosis of Flat Head Syndrome can be confusing. Many new parents are unaware that the condition exists, and how it can be treated. We’ll go over some common treatment strategies for plagiocephaly and brachycephaly in this article, including repositioning, physical therapy, and the use of orthotics such as helmets and bands. Surgery isn’t recommended for positional cephalic disorders, and we’ll discuss why that is the case, as well.
Early treatment is critical
There is a standard pattern of treatment for positional cephalic disorders that most doctors will follow. Initially, repositioning or physical therapy may be suggested as mild techniques that can improve skull shape and development patterns. If your child has muscular torticollis, physical therapy is almost always recommended. The goal of physical therapy and repositioning is to encourage your child to strengthen the neck and back muscles necessary to lift and rotate its head voluntarily and to begin to sit up without assistance. This helps your baby reduce the amount of time that they spend on their backs, with pressure on their flat spot. Sitting and head rotation and lifting skills are often noted to coincide with an improvement in head shape even when no therapy or repositioning is used to encourage their development.
If your child’s skull shape does not improve in response to physical therapy or repositioning, the use of a helmet or band may be suggested. These orthotic devices can yield significant results within a few short months. They are, however, far more expensive than physical therapy. Regular trips to the doctor or orthotist are required, and there may be self-esteem issues later in life that result from orthotic use, although this is still a topic of debate. The technique is reserved for more severe cases of flat head syndrome or scaphocephaly, and parents are advised by both doctors and insurance companies to follow a treatment protocol of physical therapy, repositioning, and tummy time before resorting to helmet or band use. The treatment works by encouraging the skull to develop a normal shape by restricting growth in one area, and encouraging growth in other areas. Devices can be passive or active, although the actual difference between these two types is often considered negligible.
Outcome and risks
Positional cephalic disorders are a hot topic of research at present, and their long term consequences are poorly understood. Some doctors believe that the conditions are largely self-correcting, while others suggest that developmental delays and lifelong physical deformities may result from the failure to treat flat head syndrome early and correctly. This will depend of course on the severity of the condition.
Some complications associated with the condition are motor skills delays, TMJ (dysfunction of the joint that connects the upper and lower jaw), sleep apnea, and physical deformation. The risks of failing to treat flat head syndrome are unknown.
That said, most milder cases of plagiocephaly and brachycephaly will improve to some degree on their own, and may be resolved entirely. Each case is different, and many factors are involved such as the severity of the condition and the age of the child.
Can this be surgically corrected?
Surgery is a poor option for flat head syndrome. Most doctors will agree that it is unnecessary and overly risky. In order to repair these deformities via surgical means, an expensive operation that places the child’s life in danger is required. The removal or re-sectioning of cranial bones is involved, and the lack of known lasting impacts makes surgery too much of a risk.