Objective: To compare effectiveness between helmet therapy and counter positioning for deformational plagiocephaly (DP).
Method: Retrospective data of children diagnosed with DP who visited our clinic from November 2010 to October 2012 were reviewed. The subjects who were 10 months of age or younger, and showed 10 mm or more of diagonal difference were included for analysis. For DP treatment, information on both helmet therapy and counter-positioning was given and either of two was chosen by each family. Head circumference, cranial asymmetry measures such as diagonal difference, cranial vault asymmetry index, radial symmetry index and ear shift were obtained by 3 dimensional head-surface laser scan at the time of initiation and termination of therapy.
Results: Total 27 subjects were included in this study, where 21 had helmet therapy and 6 underwent counter positioning. There was no significant difference of baseline characteristics, head circumference and cranial asymmetry measurements at the initiation of therapy. The mean duration of therapy was 4.30±1.27 months in the helmet group and 4.08±0.95 months in the counter positioning group (p=0.770). While cranial asymmetry measurements improved in both groups, significantly more improvement was observed with helmet therapy. There was no significant difference of the head circumference growth between two groups at the end of therapy.
Conclusion: This study showed that helmet therapy resulted in more favorable outcomes in correcting cranial and ear asymmetry than counter positioning on moderated to severe DP without compromising head growth. Further study with more subjects and longer follow-up period is warranted.