Success Rates of Cranial Remolding Orthosis Treatment of Plagiocephaly Based on Initial Presentation

Abstract

ABSTRACT Introduction Cranial remolding orthoses (CROs) are used to treat deformational plagiocephaly. Treatment outcomes vary widely depending on treatment timing and severity of the deformity. The relative impact of these factors on success rates is not well known. Objective This study aimed to quantify success rates of CRO treatment, based on age at initiation of treatment and the severity of cranial deformity. Study Design This is a retrospective cohort study of infants treated for positional plagiocephaly with a CRO. Methods A total of 300 infants with deformational plagiocephaly who were treated with a CRO were categorized into four groups by corrected age at initiation of orthotic treatment (<22 weeks, 22–25 weeks, 26–30 weeks, and >30 weeks) and into four groups by severity of their deformity (initial cranial vault asymmetry of 6–9 mm, 10–12 mm, 13–16 mm, and 17+ mm). Success rates were compared across the groups. A successful outcome was defined as achieving a final cranial vault asymmetry of 5 mm or less. Results The overall success rate for CRO treatment was 75%. However, success rates among the groups varied from 6% to 98%, depending on the severity and the age at initiation. Severity had a more significant effect on success rates than age at initiation. The age at initiation became more influential in determining the likelihood of success when the infant's deformity was severe. Conclusions The likelihood of achieving a successful treatment outcome with a CRO varies greatly depending on the severity of the deformity and corrected age at initiation of treatment, with severity having the greater impact. Clinical Relevance This study provides clinicians with treatment outcomes categorized by severity and corrected age at initiation to aid in setting appropriate expectations for treatment outcomes.