Ann Rehabil Med.  2014 Aug;38(4):541-547. 10.5535/arm.2014.38.4.541.

A New Ultrasound Method for Assessment of Head Shape Change in Infants With Plagiocephaly

Affiliations
  • 1Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. coolkwon@cu.ac.kr

Abstract


OBJECTIVE
To compare a new ultrasound measurement method with calliper cephalometry in infants with deformational plagiocephaly (DP) and to assess the differences of two methods according to the severity of DP.
METHODS
Fifty-two infants with DP were divided into two groups according to the degree of cranial vault asymmetry (CVA); group 1 included 42 infants with CVA over 10 mm, and group 2 included 10 infants with CVA under 10 mm. Cranial vault asymmetry index (CVAI) and occipital angle ratio (OAR) were measured by using calliper and ultrasound measurements, respectively. The occipital angle was defined as the angle between the lines projected along the lambdoid sutures of the skull.
RESULTS
The occipital angles of the affected sides were significantly greater than those of unaffected sides in both groups. The CVAI and OAR were significantly greater in group 1 than in group 2 (CVAI, 9.3%+/-2.3% vs. 4.6%+/-1.5%; OAR, 1.05+/-0.4 vs. 1.01+/-0.0; p<0.05). The OAR was positively correlated with the CVAI in all infants (r=0.789) and in group 1 (r=0.784; p<0.05).
CONCLUSION
Our study revealed that OAR using the new ultrasound measurement was positively correlated with the CVAI in infants with DP. Therefore, the occipital angle measurement using ultrasound combined with cephalometry could provide better understanding about the characteristics of the overall cranial bone and lambdoid suture complex in infants with DP.

Keyword

Plagiocephaly; Deformational; Ultrasound; Cephalometry; Craniofacial abnormalities

MeSH Terms

Cephalometry
Craniofacial Abnormalities
Head*
Humans
Infant*
Plagiocephaly*
Plagiocephaly, Nonsynostotic
Skull
Sutures
Ultrasonography*

Figure

  • Fig. 1 Cranial vault asymmetry index (CVAI) was calculated using caliper (A). The cranial diagonal diameter was measured on unaffected (a) and affected sides of skull (a>b). Cranial vault asymmetry (CVA) is defined as the difference between the cranial diagonal diameters (a-b) divided by long cranial diagonal diameter (a); and CVAI is CVA multiplied by 100. An occipital angle was measured on ultrasound image in unaffected (B) and affected skull (C). A straight line between the two end points was drawn along the calvaria on the left and right sides of the lambdoid suture (arrow). The occipital angle was defined as the angle between straight lines that was drawn from each end point of the lambdoid suture along the skull. The occipital angle was 167° at unaffected (B) and 184° at affected skull (C).


Reference

1. Argenta L, David L, Thompson J. Clinical classification of positional plagiocephaly. J Craniofac Surg. 2004; 15:368–372. PMID: 15111792.
Article
2. Spermon J, Spermon-Marijnen R, Scholten-Peeters W. Clinical classification of deformational plagiocephaly according to Argenta: a reliability study. J Craniofac Surg. 2008; 19:664–668. PMID: 18520381.
3. Peitsch WK, Keefer CH, LaBrie RA, Mulliken JB. Incidence of cranial asymmetry in healthy newborns. Pediatrics. 2002; 110:e72. PMID: 12456939.
Article
4. van Vlimmeren LA, Takken T, van Adrichem LN, van der Graaf Y, Helders PJ, Engelbert RH. Plagiocephalometry: a non-invasive method to quantify asymmetry of the skull; a reliability study. Eur J Pediatr. 2006; 165:149–157. PMID: 16211401.
Article
5. Mulliken JB, Vander Woude DL, Hansen M, LaBrie RA, Scott RM. Analysis of posterior plagiocephaly: deformational versus synostotic. Plast Reconstr Surg. 1999; 103:371–380. PMID: 9950521.
Article
6. Dias MS, Klein DM. Occipital plagiocephaly: deformation or lambdoid synostosis? II. A unifying theory regarding pathogenesis. Pediatr Neurosurg. 1996; 24:69–73. PMID: 8841076.
7. Littlefield TR, Kelly KM, Pomatto JK, Beals SP. Multiple-birth infants at higher risk for development of deformational plagiocephaly. Pediatrics. 1999; 103:565–569. PMID: 10049957.
8. Argenta LC, David LR, Wilson JA, Bell WO. An increase in infant cranial deformity with supine sleeping position. J Craniofac Surg. 1996; 7:5–11. PMID: 9086895.
Article
9. Boere-Boonekamp MM, van der Linden-Kuiper LT. Positional preference: prevalence in infants and follow-up after two years. Pediatrics. 2001; 107:339–343. PMID: 11158467.
Article
10. de Chalain TM, Park S. Torticollis associated with positional plagiocephaly: a growing epidemic. J Craniofac Surg. 2005; 16:411–418. PMID: 15915106.
Article
11. Bruneteau RJ, Mulliken JB. Frontal plagiocephaly: synostotic, compensational, or deformational. Plast Reconstr Surg. 1992; 89:21–33. PMID: 1727260.
Article
12. Biggs WS. Diagnosis and management of positional head deformity. Am Fam Physician. 2003; 67:1953–1956. PMID: 12751657.
13. David DJ, Menard RM. Occipital plagiocephaly. Br J Plast Surg. 2000; 53:367–377. PMID: 10876272.
Article
14. Hummel P, Fortado D. Impacting infant head shapes. Adv Neonatal Care. 2005; 5:329–340. PMID: 16338671.
Article
15. Mortenson PA, Steinbok P. Quantifying positional plagiocephaly: reliability and validity of anthropometric measurements. J Craniofac Surg. 2006; 17:413–419. PMID: 16770174.
16. Sze RW, Parisi MT, Sidhu M, Paladin AM, Ngo AV, Seidel KD, et al. Ultrasound screening of the lambdoid suture in the child with posterior plagiocephaly. Pediatr Radiol. 2003; 33:630–636. PMID: 12879318.
Article
17. Akel I, Yazici M. Growth modulation in the management of growing spine deformities. J Child Orthop. 2009; 3:1–9. PMID: 19308606.
Article
18. Davis MT, Loyd AM, Shen HY, Mulroy MH, Nightingale RW, Myers BS, et al. The mechanical and morphological properties of 6 year-old cranial bone. J Biomech. 2012; 45:2493–2498. PMID: 22939291.
Article
19. Regelsberger J, Milovanovic P, Schmidt T, Hahn M, Zimmermann EA, Tsokos M, et al. Changes to the cell, tissue and architecture levels in cranial suture synostosis reveal a problem of timing in bone development. Eur Cell Mater. 2012; 24:441–458. PMID: 23188743.
Article
20. Duterloo HS, Enlow DH. A comparative study of cranial growth in Homo and Macaca. Am J Anat. 1970; 127:357–368. PMID: 4985059.
21. Mathijssen IM, van Splunder J, Vermeij-Keers C, Pieterman H, de Jong TH, Mooney MP, et al. Tracing craniosynostosis to its developmental stage through bone center displacement. J Craniofac Genet Dev Biol. 1999; 19:57–63. PMID: 10416148.
Article
22. Moenning A, Jager R, Egert A, Kress W, Wardelmann E, Schorle H. Sustained platelet-derived growth factor receptor alpha signaling in osteoblasts results in craniosynostosis by overactivating the phospholipase C-gamma pathway. Mol Cell Biol. 2009; 29:881–891. PMID: 19047372.
23. Maloul A, Fialkov J, Whyne CM. Characterization of the bending strength of craniofacial sutures. J Biomech. 2013; 46:912–917. PMID: 23352773.
Article
24. Jaslow CR. Mechanical properties of cranial sutures. J Biomech. 1990; 23:313–321. PMID: 2335529.
Article
25. Herring SW. Mechanical influences on suture development and patency. Front Oral Biol. 2008; 12:41–56. PMID: 18391494.
Article
26. Regelsberger J, Delling G, Tsokos M, Helmke K, Kammler G, Kranzlein H, et al. High-frequency ultrasound confirmation of positional plagiocephaly. J Neurosurg. 2006; 105(5 Suppl):413–417. PMID: 17328267.
Article
27. Anderson PJ, Netherway DJ, David DJ, Self P. Scanning electron microscope and micro-CT evaluation of cranial sutures in health and disease. J Craniofac Surg. 2006; 17:909–919. PMID: 17003620.
Article
28. Reinholt LE, Burrows AM, Eiting TP, Dumont ER, Smith TD. Brief communication: histology and micro CT as methods for assessment of facial suture patency. Am J Phys Anthropol. 2009; 138:499–506. PMID: 19170212.
Article
29. Benz MG, Benz MW. Reduction of cancer risk associated with pediatric computed tomography by the development of new technologies. Pediatrics. 2004; 114:205–209. PMID: 15231929.
Article
30. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001; 176:289–296. PMID: 11159059.
Article
31. Hall EJ. Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol. 2002; 32:700–706. PMID: 12244457.
Article
32. Robinson S, Proctor M. Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr. 2009; 3:284–295. PMID: 19338406.
Article
33. Rogers GF. Deformational plagiocephaly, brachycephaly, and scaphocephaly. Part II: Prevention and treatment. J Craniofac Surg. 2011; 22:17–23. PMID: 21187782.
34. Yoo HS, Rah DK, Kim YO. Outcome analysis of cranial molding therapy in nonsynostotic plagiocephaly. Arch Plast Surg. 2012; 39:338–344. PMID: 22872837.
Article
35. McGarry A, Dixon MT, Greig RJ, Hamilton DR, Sexton S, Smart H. Head shape measurement standards and cranial orthoses in the treatment of infants with deformational plagiocephaly. Dev Med Child Neurol. 2008; 50:568–576. PMID: 18754893.
Article
36. Wilbrand JF, Wilbrand M, Pons-Kuehnemann J, Blecher JC, Christophis P, Howaldt HP, et al. Value and reliability of anthropometric measurements of cranial deformity in early childhood. J Craniomaxillofac Surg. 2011; 39:24–29. PMID: 20418107.
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