The Journal of the American Osteopathic Association, 2004/08, 104(8):339. doi: 10.7556/jaoa.2004.104.8.337, type of study: ,ret,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

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Keywords:

children [321]
diagnosis [412]
palpation [217]
pediatrics [573]
plagiocephaly [57]
retrospective study [339]

Abstract:

Introduction: The term plagiocephaly, from the Greek plagios (oblique) and kephale (head), means distortion of the head, and refers clinically to cranial asymmetry. Cranial Osteopathy, since it was first proposed, has focussed upon the diagnosis and treatment of birth trauma and cranial asymmetries, and consequently specific therapy for plagiocephalic deformities have been described. Osteopathic manipulation also has been proposed as a treatment for torticollis, a condition associated with plagiocephaly. For these reasons, we decided to look at the mechanics of the occipital bone and the adjacent atlas and bones of the cranial base, in relation to functional plagiocephaly. Methods: The records of 649 children seen in an osteopathic practice in Lyon, France, were reviewed retrospectively, in compliance with legal requirements of the Commission Nationale de l'Informatique et des Libertes (CRIL), for gender, age at presentation, birth history, obstetrical data (breech presentation, vacuum extraction, forceps delivery or cesarean section), presenting complaint, side of posterior plagiocephaly, side of frontal plagiocephaly, torticollis, motion pattern of the occipital bone upon the atlas, and motion pattern of the spheno-occipital synchrondosis. Results: We found correlation between plagiocephaly (right/left) and primipara (P = 0.024), use of forceps (P = 0.055) and extractor suction (P = 0.055). Correlation was also found between flattening of the occiput (right/left) and lateral strain of the spheno-occipital synchrondosis (P = 0.002). We found significant correlation between plagiocephaly (right/left) and occipital/atlas motion (P = 0.000). Conclusion: We found a significant correlation between the lateral strain pattern of the spheno-basilar synchrondosis and plagiocephaly and between rotational dysfunction of the occiput upon the atlas and the side of the side of posterior plagiocephaly. We suggest that thorough neonatal osteopathic examination can identify individuals predisposed to develop posterior plagiocephaly.