Abstract
OBJECTIVE:to review the pathophysiology of craniosynostosis and positional deformities of the skull, and analyze the types of treatment, especially cranial orthoses.
METHODS:Review of the literature on observational studies, clinical trials and reviews in the PubMed database from 1980 to 2018 and manual search of non-referenced articles. The following keywords were used: craniosynostosis, plagiocephaly, nonsynostotic, skull, cranial, associated with: surgical treatment, pathophysio-logy, cognition, orthotic devices, head protective devices. We analyzed the title and abstract before requesting the full article. If they were ambiguous, we analyzed the whole article to determine its relevance.
RESULTS:Treatment of craniosynostosis is surgical by cranial reconstruction. On the other hand, there is controversy over supervised position changes and use of cranial orthosis to manage positional deformities. Although correcting the esthetic defect is the main purpose of orthoses, their potential influence on cognitive and motor development, visual disorders, endocranial hypertension and orthognathic defects is discussed. There are no differences between conservative management with changes of supervised position and orthoses, in the modification of the cranial index. In addition, some patients improve spontaneously when they acquire cephalic support and begin to incorporate. On the other hand, there are complications with orthoses that can become serious.
CONCLUSION:There is no recommendation for the use of restrictive measures such as cranial orthotics devices to treat patients with cranial positional deformities. reconstructive surgery is the treatment of choice for craniosynostosis.
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