Plagiocephaly is a condition that describes asymmetry of the skull. It can be anterior when it affects the forehead or posterior when it affects the back of the head. The most common presentation is a mild flattening to the back of the head on one side. This arises as the ‘soft’ skull of young babies can be moulded by positioning. For this reason the condition is often called positional plagiocephaly.
Physiotherapy can help address muscle tightness or neuromuscular development and the sooner this is instigated, the faster the resolution. Cranial osteopathy has no proven benefit, whilst helmet orthoses (baby helmets) are still widely debated. CT scanning is occasionally needed to distinguish positional from craniosynostotic plagiocephaly, but surgery has very little place in the positional subtype of this condition.
Once a child has reached the age of two, their headshape is likely to last for life.
Helmets are expensive devices and need to be used for 23 hours a day. They are hot in the summer and can cause itchy, sweaty uncomfortable scalps. They can cause aggravation of skin problems or problematic patches of skin and therefore are only prescribed when necessary.
The benefits of using of helmets have yet to be scientifically proven, however from anecdotal evidence, in some cases, at the correct age and when used appropriately, they seem to be of benefit. Chris would normally assess a child early on in life and if their condition was mild or showing signs of improvement at six months of age, would not advise helmet use. If the asymmetry was moderate or severe or not showing signs of improvement, an underlying cause would be ruled out with x-rays and a physiotherapy assessment before considering helmet therapy.
If needed, the earlier helmet therapy is started the better. When started between four and six months of age, the treatment period would be approximately three months. Starting after six months extends the treatment period by one month. The benefits of treatment starting after nine months of age is debatable and almost certainly involves a prolonged treatment protocol of up to eight months. A resultant asymmetry less than 1cm is deemed an acceptable result by most study groups and most patients starting treatment under nine months of age reach a stable 5mm difference. Starting treatment after one year of age is unlikely to result in huge benefits unless severe in nature.
The indicative prices below include the surgical fee, all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.
This is from £2,000 for helmet therapy
Early recognition of the asymmetry is essential. Regular turning, early introduction of ‘tummy time’ careful placement of the cot and the toys within it to encourage a baby to look outwards, as well as the use of specialised pillows can all help. Any activities that helps a baby turn its head away from the flat area will speed up the natural improvement.
- Surgery duration: N/A
- Type of anaesthesia: N/A
- Time in hospital: Multiple outpatient helmet fittings
- Time off work: N/A
- Recovery time: 4-8 months
- First follow up appointment: 2 weeks
- Total number of follow up appointments: 4-6
- Pain management: None
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