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BRACHYCEPHALY. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, 
SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32024                                                                            

 

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OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

A PROSPECTIVE STUDY OF CRANIAL ORTHOTIC TREATMENT OF INFANTS WITH 

ISOLATED DEFORMATIONAL BRACHYCEPHALY 

Kevin M. Kelly1, Edward Joganic2, Stephen P. Beals3, Jeff A. Riggs4, Mary Kay McGuire4, Timothy R. 

Littlefield*4 

1 University of Iowa, Iowa City, IA, USA.  
2 Barrow Cleft and Craniofacial Center, Phoenix, AZ, USA.  
 3 Southwest Craniofacial Center, Phoenix, AZ, USA. 

 4 Cranial Technologies, Tempe, AZ, USA.  

 *Email: tlittlefield@cranialtech.com 

DOI: https://doi.org/10.33137/cpoj.v1i2.32024  

 

OBJECTIVES 

The study objectives were to prospectively evaluate 

treatment results of infants presenting with isolated 

deformational brachycephaly following use of a cranial 

orthosis, and to investigate the role of entrance age on 

efficacy of treatment. 

METHODS 

128,014 infants presenting for consultation to one of 

thirty clinics were included from January 2013 through 

December 2017.  Nonsynostotic, nonsyndromic infants 

presenting with isolated deformational brachycephaly, 

characterized as a Cephalic Index > 90, and craniofacial 

asymmetry < 3 mm, were identified and filtered from the 

database.   An Analysis of Variance (ANOVA) was 

performed, examining the change in cephalic index with 

respect to three independent variables (entrance age, 

treatment time, initial cephalic index). 

RESULTS 

4,205 infants were identified.  Mean entrance age was 5.8 

months, and mean treatment time was 13.5 weeks.  There 

was a statistically significant (p<0.001) improvement in 

cephalic index from 95.0 to 89.4 (an 81.4% improvement 

towards normal).  The ANOVA analysis demonstrated an 

inverse relationship between entrance age, and both 

treatment outcome and treatment time.   Cephalic index 

improved by 5.8%, 5.4%, and 4.3% in the >3 to < 6, > 6 

to < 9, and >9 to 12 < month groups respectively.  

Likewise, there was a statistically significant relationship 

between entrance age and treatment time (p<0.001).  

Treatment time was 11.9, 15.8, and 17.4 weeks 

respectively. 

 

CONCLUSION 

As discussed, deformation of the cranium in infancy 

represents a spectrum of deformity, ranging from severe 

asymmetric yet proportional distortion of the skull in 

plagiocephaly, to nearly symmetric yet disproportional 

distortion in brachycephaly.  As such, the condition is 

best described as deformational plagiocephaly-

brachycephaly (DPB) with isolated plagiocephaly and/or 

isolated brachycephaly being at either ends of the 

spectrum.  These findings demonstrate that the cranial 

orthosis is successful in the treatment of deformational 

brachycephaly, and that entrance age influences 

treatment results, with younger infants demonstrating 

both improved outcomes and shorter treatment times.   

KEY WORDS  

 Deformational Brachycephaly, Cranial Orthosis, 

Flat Head Syndrome, Cephalic Index  

ADDRESS CORRESPONDENCE  

Timothy R. Littlefield, Cranial Technologies, Inc., 

1395 W. Auto Drive, Tempe AZ, 85248 

[tlittlefield@cranialtech.com], Phone:  480-403-

6332, Fax: 480-505-1842 

 

 

https://doi.org/10.33137/cpoj.v1i2.32024
mailto:tlittlefield@cranialtech.com
https://doi.org/10.33137/cpoj.v1i2.32024
mailto:tlittlefield@cranialtech.com

