Scientific literature indicates that sleeping with the head consistently turned to one side can cause deformational molding, leading to facial and skull asymmetry.
<h4>Background</h4>Plagiocephaly is defined as an asymmetrical distortion of the skull, resulting in an oblique trapezoid or parallelogram head shape. Deformational plagiocephaly (DP) is caused by forces acting on one side of the back of the head, distorting normal skull symmetry.<h4>Objective</h4>The aims of this systematic review and meta-analysis were to critically assess the evidence for nonobstetric risk factors for DP and to make evidence-based recommendations for reducing the prevalence of DP.<h4>Methods</h4>The selection criterion was studies reporting risk factors for DP. Case reviews, case series, expert opinions, and systematic reviews were excluded. PubMed and Web of Science were searched from August 21, 2010, to August 21, 2022. Publication bias was assessed using funnel plots. Meta-analyses were presented using forest plots.<h4>Results</h4>A total of 19 studies (cohort studies: n=13, 68%; case-control studies: n=5, 26%; and cross-sectional studies: n=1, 5%) with a total of 14,808 participants were included. Of the 43 investigated potential nonobstetric factors, 16 (37%) were associated with DP. Of these 16 factors, 12 (75%) had odds ratios (ORs) with 95% CIs not crossing 1: insufficient vitamin D intake (OR 7.15, 95% CI 3.77-13.54), head position preference (OR 4.75, 95% CI 3.36-6.73), bottle-only feeding (OR 4.65, 95% CI 2.70-8.00), reduced tummy time (OR 3.51, 95% CI 1.71-7.21), sleeping position (OR 3.12, 95% CI 2.21-4.39), fewer motor milestones reached by the age of 6 months (OR 2.56, 95% CI 1.66-3.96), obesity (OR 2.45, 95% CI 1.02-5.90), maternal education level (OR 1.66, 95% CI 1.17-2.37), male sex (OR 1.51, 95% CI 1.07-2.12), formula feeding (OR 1.51, 95% CI 1.00-2.27), head circumference (OR 1.22, 95% CI 1.06-1.40), and mechanical ventilation (OR 1.10, 95% CI 1.00-1.14). No evidence of publication bias was detected.<h4>Conclusions</h4>This study provides a comprehensive assessment of the nonobstetric factors associated with DP and presents 11 evidence-based recommendations for reducing its prevalence. The primary limitation is that only publication bias was assessed.<h4>Trial registration</h4>PROSPERO CRD42020204979; https://www.crd.york.ac.uk/prospero/display_record.php? ID=CRD42020204979.
Abnormal stress in cranial sutures is strongly related to deformational plagiocephaly (DP) and is responsible for morphological changes in the skull, facial asymmetry, and abnormal facial tension. To evaluate the effect of biomechanical therapy on cranial sutures of DP we performed in silico analysis of normal skull in the supine position (Model 1), DP in the supine position (Model 2), and DP wearing moulding helmet (Model 3). By utilizing 3D point cloud data, we generated finite element models (FEMs) and developed 14 cranial sutures. We evaluated the mechanical causes of the continuous progression of moderate to severe DP by comparing the Von Mises Stress (VMS) distributions of 14 cranial sutures between Model 1 and Model 2, and used the same method to compare Model 2 with Model 3 to determine the reasons for the alleviation of DP. When the DP wore a moulding helmet, the VMS on the compressed side of the cranial sutures was reduced, and the skull support site shifted to the contralateral side. DP was associated with abnormal stress accumulation on the compressed side of the cranial sutures. Balancing the forces on both sides of the lambdoid suture, allowing the skull to accept a larger force area and applying stress to the cranial sutures on the uncompressed side may be the mechanism for the prevention and treatment of DP. The asymmetry caused by DP may be associated with abnormal stress accumulation in cranial sutures, and eliminating abnormal stress accumulation in cranial sutures and applying stress to contralateral cranial sutures are key measures of treatment. The force distribution area of the moulding helmet and the degree of head position adjustment may serve as an early indicator for assessing the moulding helmet’s efficacy. Adding bilateral lambdoid suture support straps to the moulding helmet may be the key to improving the efficacy. Our study revealed that the mechanical principles of helmet therapy and osteopathic treatment may support the use of osteopathic treatment as a first-line approach for treating DP.
ABSTRACT To help determine whether ocular torticollis causes facial asymmetry, we analyzed photographs of patients with long-standing head tilts for amounts of tilt and facial asymmetry. Significant facial asymmetry that correlated with the side of the head tilt was found in patients with congenital superior oblique muscle paresis, but not in patients with traumatic superior oblique muscle paresis nor in patients with dissociated vertical deviation. The mechanism explaining the development of facial asymmetry in these patients may be deformational molding of the face and skull from the infant's sleeping with its head turned predominantly to one side during the first 6 to 12 months of life. Early strabismus surgery to correct the head tilt may help prevent facial asymmetry, but ensuring that the infant sleeps with alternating head positions may be more important.
Everything we examined (3)
This check searched the claim as stated. It did not run a separate search for evidence against it.