title: Prevalence of positional plagiocephaly in teens born after the "Back to Sleep" campaign.
abstract: OBJECTIVE
  To determine the prevalence of positional plagiocephaly and brachycephaly in teenagers born after the "Back to Sleep" campaign but before orthotic helmet treatment became widely available and to provide long-term outcomes data on those children with plagiocephaly who were not treated with remolding therapy.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Local high schools in the Minneapolis-St Paul Metro area.
  
  
  METHODS
  Subjects were selected if they attended participating high schools and were born after the Back to Sleep campaign began. Skull measurements, including transcranial diameter, length, and width, were taken. Overall facial appearance was inspected for any apparent abnormal characteristics. Cranial vault asymmetry and cephalic index were calculated for each participant. Plagiocephaly was diagnosed if cranial vault asymmetry was >1 cm. Brachycephaly was diagnosed if the cephalic index was >0.90.
  
  
  RESULTS
  There were 1045 participants, ranging from 12 to 17 years old, with an average age of 15.7 years. The prevalence of plagiocephaly was 1.1%. The prevalence of brachycephaly was 1.0%. The overall prevalence of a deformational cranial abnormality was 2.0%. Of those who met diagnostic criteria of plagiocephaly or brachycephaly, 38.1% were noted to have abnormal facial characteristics.
  
  
  CONCLUSIONS
  The prevalence of plagiocephaly and brachycephaly in teenagers is significantly lower than the 20% to 48% prevalence found in infants in previous studies, suggesting most children will outgrow the condition without intervention. Additional studies are needed to determine which patients might benefit from treatment and which will likely have resolution without intervention, since treating all infants who meet criteria results in significant overtreatment.
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Pediatric ENT Associates, Minneapolis, Minnesota, USA. barne284@umn.edu
authors.forename: Brianne Barnett
authors.initials: BB
authors.lastname: Roby
authors.forename: Marsha
authors.initials: M
authors.lastname: Finkelstein
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Tibesar
authors.forename: James D
authors.initials: JD
authors.lastname: Sidman
mesh_terms: D000293:Adolescent; D003393:Cranial Sutures / Q000473:pathology; D003398:Craniosynostoses / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D005146:Facial Asymmetry / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D049068:Plagiocephaly, Nonsynostotic / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012886:Skull / Q000473:pathology; D012890:Sleep; D016683:Supine Position