title: Cranial molding helmet therapy and establishment of practical criteria for management in Asian infant positional head deformity.
abstract: BACKGROUND
  The growing number of infants with deformational plagiocephaly (DP) has raised clinical questions about which children, at what age, and how molding helmet therapy (MHT) should be performed especially in Japan.
  
  
  METHODS
  A total of 1,011 Japanese pediatric head deformity infants had undergone MHT after being diagnosed with non-synostotic DP. Three ratios of left to right comparison (anterior, posterior, and overall) were created and analyzed comparing age of starting treatment, helmet wearing period, and severity of skull deformity before with after MHT.
  
  
  RESULTS
  The averages of head symmetry ratios after treatment in all groups (for the occipital region) showed apparent improvement; t(930) = -60.86, p = 0.000. (t(932) = -57.8, p = 0.000.) In the "severe" deformation group, the earlier the treatment was started, the higher symmetry ratio recovery was obtained. Treatment was especially effective when started in 4-month-old infants. In contrast to the "severe" group, the "mild" deformation group showed that MHT was most effective if treatment started before 6 months of age. Again, the earlier the treatment was started, the higher symmetry ratio was achieved, but compared to the "severe" group, it had a modest effect when treatment was started in infants older than 8 months.
  
  
  CONCLUSIONS
  This is the first large-scale molding helmet study reporting the method and efficacy in Japanese infants. It demonstrated that despite the structural and physiological differences from infants of other races, molding helmet therapy is effective in Asian-born infants, provided that intervention timing and recognition conditions are met.
authors: Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho Shinjuku-ku, Tokyo, 162-8666, Japan, yaihara@nij.twmu.ac.jp.
authors: Yasuo
authors: Y
authors: Aihara
authors: Kana
authors: K
authors: Komatsu
authors: Hitoshi
authors: H
authors: Dairoku
authors: Osami
authors: O
authors: Kubo
authors: Tomokatsu
authors: T
authors: Hori
authors: Yoshikazu
authors: Y
authors: Okada
mesh_terms: D000704:Analysis of Variance; D000075368:Anoctamins; D018118:Chloride Channels; D003398:Craniosynostoses / Q000628:therapy; D019468:Disease Management; D005260:Female; D006260:Head Protective Devices / Q000592:standards*; D006801:Humans; D007223:Infant; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D009989:Orthotic Devices / Q000592:standards; D049068:Plagiocephaly, Nonsynostotic / Q000628:therapy*; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods; D016896:Treatment Outcome
chemical_list: C575623:Ano2 protein, rat; D000075368:Anoctamins; D018118:Chloride Channels