Posted by: Savannah | 2007/07/31


Positional Plagiocephaly -- Surgery??

My son (now 6 months) has been diagnosed with positional plagiocephaly when he was just over 4 months, which basically means his head is misshapen due to pressure experienced in the womb (limited space due the multiple gestation).

Initially they thought the seams on his head had already closed and then surgery would have been the only option, but the seams are open (although narrow). He had undergone some physical therapy for his neck musles and that has improved, but the shape of his head is not improving at all -- in fact, it seems to be worsen and his little face is become slightly skew now (right eye is about half cm below left eye and his right ear to the front). Now the neurologis indicated that we may want to consider surgery to correct this, although it will be viewed as cosmetic (but medical aid will pay). It is a rather serious operation and there are some risks involved (bleeding being the most prominent), but we are looking into it at the moment. Will obviously go for a second opinion, but time is of the essence since they want to do it (if we take this route) before he gets too mobile... I am a bit at a loss since I am no sure what to do... The deformity is not impacting on his brain or physical development, but his face is getting rather misformed due to the condition and this will obvioulsy one day impact on his emotional developmetn (you know how cruel people can be), but do we do this cosmetic operation (medical aid will pay) and take the risk or do we wait it out and see if it corrects by itself...!!

What would your advice be - I have researched the subject quite extensively on the INternet and in the States the effectively treat the condition with something called a DOC BAND -- basically a kind of helmet you put on the kid to re-shape the head. Do you know anything about this treatment?


Expert's Reply



This is very difficult for me to answer without being able to see your baby son. Plagiocephaly is an increasing problem all over the world possibly as a result of babies now sleeping on their backs.In the vast majority [90% +] of babies the head shape returrns to normal with time. In a few severe cases the hemet is used and is also very effective. I am at a loss to explain why the neurosurgeon wants to oprerate here other than to correct your baby's facial bones and this seems a bit risky at this stage when he is growing rapidly. I advise you to get a second opinion ASAP and to specifically ask if the helmet treatment would do away with the need for any operation.

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