• Archives of Plastic Surgery
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• v.39 no.4
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• pp.338-344
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• 2012

Background It is known that nonsynostotic plagiocephaly does not spontaneously improve, and the craniofacial deformities that result from it. This study was conducted to analyze the effectiveness of helmet therapy for the nonsynostotic plagiocephaly patient, and to suggest a new treatment strategy based on this analysis. Methods A total of 108 pediatric patients who had undergone helmet therapy after being diagnosed with nonsynostotic plagiocephaly were included in this study. The patients were classified according to the initiation age of the helmet therapy, severity, and helmet wearing time. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. Results The discrepancy of CVA and CVAI of all the patients significantly decreased after helmet therapy. According to the initiation time of helmet therapy, the treatment effect was best at 5 months old or less. The helmet wearing time per day was proportional to the treatment effect up to 20 hours. In addition, the rate of the successful treatment (final CVA ${\leq}$ 5 mm) significantly decreased when the initiation age was 9.1 months or older and the treatment period was less than 7.83 months. Conclusions This study showed the effectiveness of the helmet therapy for nonsynostotic plagiocephaly patients. Based on analysis of this study, helmet therapy should be started at the age of 9 months or younger for 7.83 months or more, and the helmet wearing time should be more than 20 hours a day.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.169-181
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• 2024

Background With the advent of cranial orthoses as therapeutic medical devices for the treatment of severe positional head deformities in Japan, an increasing number of patients are being treated with them. However, assessing the effectiveness of a treatment is often difficult due to the use of different metrics. This study aimed to evaluate the effectiveness of cranial orthoses for deformational plagiocephaly using two- (2D) and three-dimensional (3D) evaluation metrics. Methods We conducted a retrospective study of infant patients with deformational plagiocephaly who underwent cranial orthosis treatment. We evaluated the severity of deformational plagiocephaly using cranial asymmetry (CA) and the cranial vault asymmetry index (CVAI) as 2D metrics, and anterior and posterior symmetry ratios as 3D metrics. The patients were divided into 24 subgroups based on the initial severity of each outcome and their age at the start of treatment. We analyzed the changes in outcomes and correlations within improvements across the age and severity categories. Results Overall, 1,038 infants were included in this study. The mean CA, CVAI, and anterior and posterior symmetry ratios improved significantly after cranial orthosis treatment. The improvement in each score was greater in patients with more severe initial deformities and in those who underwent treatment at a younger age. Conclusion Cranial orthosis treatment was effective in correcting deformational plagiocephaly in infants, as demonstrated by improvements in both 2D and 3D metrics. Patients with more severe initial deformities and those who underwent treatment at a younger age showed greater improvement.

• Imaging Science in Dentistry
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• v.34 no.3
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• pp.165-169
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• 2004

Craniofacial dysostosis is considered to be one of rarely observed syndromes characterized by premature closing of all cranial sutures. The first patient was a 4-year-old male infant who had been complaining of empyema. Clinical findings showed exophthalmos, hypertelorism and facial asymmetry. Conventional radiographs demonstrated abscence of cranial sutures and underdeveloped maxilla. CT scan demonstrated the digital impressions of the inner surface of the cranial vault, enlarged and depressed sella turcica. The second patient was a 2-year-old female infant who had been complaining of facial deformity. Clinical findings showed hypertelorism and underdeveloped maxilla. Radiographs showed premature synostosis of all cranial sutures, depressed and enlarged sella turcica, and hypoplastic maxilla. 3 years after operation, her look improved. However, resurgery may be considered to decreasing intracranial pressure and for correction of facial deformity. Two interesting cases showing ‘cloverleaf’ skulls were presented.

• Journal of the korean academy of Pediatric Dentistry
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• v.11 no.1
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• pp.249-254
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• 1984

This is a case report of Crouzon's disease as a kind of craniofacial dysostosis by premature closure of unilateral coronal suture, showed plagiocephalic skull. 5-year-old boy was visited for the treatment of dental caries and oral examination. Physical examination showed hypertelorism, internal strabismus, and saddle nose. Intraoral radiographs showed congenital missing of upper right and left deciduous and permanent lateral incisors. Cephalometric analysis showed shortening the posterior cranial base length, clockwise growth pattern and class III and open bite tendency. Posterior-anterior and submentovertex view showed multiple radiolucencies-digital impression on inner surface of cranial vault. Maxillo-facial and neuro-surgical treatment was required to improvement of facial esthetics and optic complications. Continuous examination was needed to the growth and development.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.667-670
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• 2005

Congenital facial cleft is a rare entity and appears along by the line of different processes of the facial development. An isolated cleft of the nose has been reported not often in the literature. We treated a patient with an isolated nasal cleft associated with undefined cranial anomaly. On 3D CT scan was seen a bony cleft traversing the pyriform aperture lateral to the anterior nasal spine. The nasal septum and frontal process of the maxilla were intact. There also was found bilateral bony defects in the frontal bone and bilateral frontal boss. The nasal cleft and frontal defect and boss were corrected by two stages: anterior two-third of the cranial vault with bilateral frontal boss was remodeled at the age of two years and the nasal cleft was repaired with a local rotation flap at age 3.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.474-478
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• 2005

Craniosynostosis is a congenital anomaly characterized by premature closure of cranial sutures. Surgical intervention should be performed during infancy. However, surgical correction of craniosynostosis remains bone defect and secondary angle occasionally. Currently, publications investigating solutions to bone defect and secondary angle created by cranioplasty are getting much interest. We have used $BoneSource^{(R)}$ which is relatively safe as an implantable substance for providing solutions for this problem. From June 2002 to January 2004, five children with craniosynostosis underwent frontocalvarial contouring using $BoneSource^{(R)}$ and concurrent cranial vault remodeling. The patient ages ranged from 8.0 months to 4.9 years(mean, 2.5 years). The quantity of $BoneSource^{(R)}$ implanted ranged from 10 to 25g, with a mean of 13g. This paper presents the first series of children treated with $BoneSource^{(R)}$ for frontocalvarial contouring in the surgical correction of craniosynostosis. No patients experienced any complications. Our results shows excellent retention of contour without causing asymmetry or irregularity. No visible evidence of interference with craniofacial growth were observed. Through our experiences, $BoneSource^{(R)}$ is found to be very useful for frontocalvarial contouring in children undergoing correction of craniosynostosis.

• Fashion & Textile Research Journal
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• v.24 no.4
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• pp.443-450
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• 2022

This study developed a three-dimensional helmet mold design software that can design helmets for treating the infant plagiocephaly (flat head syndrome) using three-dimensional head scan data. For this, the three-dimensional head data of sixth SizeKorea body measurement project as well as the data produced by a head modeling software were used to prepare the head shape data of plagiocephaly patients. A total of 14 landmarks and 10 dimensions of heads required for helmet mold shape design and plagiocephaly diagnosis were automatically measured using an anthropometric analysis software. Using the software developed in this study, plagiocephaly can be diagnosed not only visually by three-dimensional head data visualization but also quantitatively by calculating the medically defined indices such as cranial index, which measures the proportions of the head, and the cranial vault asymmetry index, which measures the asymmetry of the head. The basic shape of the helmet mold was automatically generated based on the head scan data. Additionally, it is possible to fine tune the shape of the mold to reflect individual characteristics by using a free form deformation technique. Finally, the designed helmet mold was converted into the data that can be printed on a three-dimensional printer for generating the actual prototype.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.159-161
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• 2006

Although meningioma is a common and benign intracranial tumor, meningioma en plaque is a rare tumor, especially in the cranial vault. Meningioma en plaque[MEP] usually occurs in the area of the sphenoid wing, and it causes cosmetic and visual problems, as well as the problems that are due to its mass effect. The authors present here a case of convexity meningioma en plaque that involved the skull and scalp with diffuse hyperostosis as the presenting salient radiological findings, which caused marked intraoperative bleeding.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.422-425
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• 2012

Osteoma is one of the most common tumors of the cranial vault and the facial skeleton. For osteoma in the facial region, endoscopic resection is widely used to prevent surgical scarring. Tumors in a total of 14 patients were resected using an endoscopic holmium-doped yttrium aluminium garnet (Ho:YAG) laser with a long flexible fiber. Aside from having the advantage of not leaving a scar due to the use of endoscopy, this procedure allowed resection at any position, was minimally invasive, and caused less postoperative pain. This method yielded excellent cosmetic results, so the endoscopic Ho:YAG laser is expected to emerge as a good treatment option for osteoma.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.48-50
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• 2016

A 10-year-old spayed female Maltese dog weighting 3.4 kg was referred with growing firm mass at the parietal bone region from 2 weeks ago. A firm, partially calcified mass ($1.9cm{\times}4.4cm$) was palpated in the region of the frontal and parietal skulls but had no neurologic signs. Computed tomography (CT) characteristics of mass were round to oval shape, fine granular appearance, and well defined margins. Mass involving the calvarial bones had invasion into the cranial vault with a significant intracranial portion. Histologically, the tumor was characterized by the presence of multiple lobules containing osteoid or cartilage in the center that were separated by anastomosing fibrous septae. This is case report described the clinical and histopathological features of multilobular tumor of skull in a Maltese dog.