• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.80-86
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• 2020

Positional plagiocephaly is increasing in infants. Positional plagiocephaly is an asymmetric deformation of skull due to various reasons; first birth, assisted labor, multiple pregnancy, prematurity, congenital muscular torticollis and position of head. Positional plagiocephaly can mostly be diagnosed clinically and by physical examinations. The simplest way to assess the severity of plagiocephaly is to use a diagonal caliper during physical examination, which measures the difference between the diagonal lengths on each side of the head. Plagiocephaly can be treated surgically or conservatively. Positional plagiocephaly, which is not accompanied by craniosynostosis, is treated conservatively. Conservative treatments involve a variety of treatments, such as change of positions, physiotherapy, massage therapy, and helmet therapy. Systematic approaches to clinical examination, diagnosis and treatment of positional plagiocephaly can be necessary and the age-appropriate treatment is recommended for patients with positional plagiocephaly.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.28-32
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• 2011

Purpose: A cranioremodeling helmet for correcting plagiocephaly was recently developed. However, no discrete objective methods to evaluate how the deformity is being corrected have been developed. We have established an easy and cost-effective method that can be used not only to show the correction process, but can also be used by physicians to assess the degree of plagiocephaly two-dimensionally. Methods: For two-dimensional evaluation, a length of malleable memory wire (2 mm in diameter) resembling "Sun-Wukong's headband" was placed on the patient's head. The wire around the patient's head was positioned on a plane including points 1 cm above the eyebrow and 1 cm above the auricle. The wire was placed on a sheet of paper and the outline was marked using pens of various colors during each visit. The degree of plagiocephaly correction could then be shown to the patient's parents at every consultation. Results: The method established by the present study easily shows the horizontal cross-section transformation of the head, illustrates plagiocephaly correction by the helmet, and shows the degree of correction in a two-dimensional manner. Conclusion: A soft-shell helmet is widely used for correcting plagiocephaly. However, evaluating the effectiveness of the helmet has been determined in a subjective manner, and a more objective method is now in demanded. Our study found that a "Sun-Wukong's headband" wire can accurately measure two-dimensional changes. Future studies will be required to identify landmarks needed for assessing plagiocephaly correction.

• 대한두개안면성형외과학회지
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• 제15권2호
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• pp.47-52
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• 2014

Background: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (${\geq}18$ months). Methods: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. 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 cranial molding helmet treatment in older infants (${\geq}18$ months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA ${\leq}5mm$) significantly decreased when the wearing time per was shorter. Conclusion: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

• Archives of Plastic Surgery
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• 제51권2호
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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.

• Journal of International Society for Simulation Surgery
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• 제1권2호
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• pp.83-86
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• 2014

Purpose This paper was purposed to suggest the method to produce the supportive helmet (head correction) for the infants who are suffering from plagiocephaly and to evaluate the level of transformation through 3D model. Method Either of CT or X-ray restored images has been used in making the supportive helmet (Head correction) in general, but these methods of measuring have problems in cost and safety. 3D surface measurement technology was suggested to solve such matters. Results It was to design the transformed model of the head within 0.7cm in average by scanning the surface of head and performing 3D restoration with marching cube and the changing rate of the head was compared in numerical data with 3D model. Conclusion The suggested methods displayed the better performance than the conventional method in respect of the speed and cost.

• Journal of International Society for Simulation Surgery
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• 제2권1호
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• pp.13-16
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• 2015

Purpose We conducted a study on the reconstruction of the head's shape in 3D using the ToF depth sensor. A time-of-flight camera (ToF camera) is a range imaging camera system that resolves distance based on the known speed of light, measuring the time-of-flight of a light signal between the camera and the subject for each point of the image. The above method is the safest way of measuring the head shape of plagiocephaly patients in 3D. The texture, appearance and size of the head were reconstructed from the measured data and we used the SDF method for a precise reconstruction. Materials and Methods To generate a precise model, mesh was generated by using Marching cube and SDF. Results The ground truth was determined by measuring 10 people of experiment participants for 3 times repetitively and the created 3D model of the same part from this experiment was measured as well. Measurement of actual head circumference and the reconstructed model were made according to the layer 3 standard and measurement errors were also calculated. As a result, we were able to gain exact results with an average error of 0.9 cm, standard deviation of 0.9, min: 0.2 and max: 1.4. Conclusion The suggested method was able to complete the 3D model by minimizing errors. This model is very effective in terms of quantitative and objective evaluation. However, measurement range somewhat lacks 3D information for the manufacture of protective helmets, as measurements were made according to the layer 3 standard. As a result, measurement range will need to be widened to facilitate production of more precise and perfectively protective helmets by conducting scans on all head circumferences in the future.