Long Term Effects of Positional Plagiocephaly

There is considerable controversy with respect to brain abnormalities and brain compromise in children with positional plagiocephaly. Studies have demonstrated that affected children can have impaired muscle coordination and brain development. Most neurosurgeons however believe that the amount of brain damage, if it occurs, is minimal. While some untreated children may improve the shape of their head spontaneously before the age of five a significant number of children with this condition not treated continue to have misshaped heads.

Strabismus, a condition which occurs when the muscles of the eyes do not move together, can occur with the distortion of the orbits that occurs in uncorrected positional plagiocephaly. This requires surgery to correct. Asymmetric or irregular growth of the jaw can occur since the base of the skull is distorted. Not enough children with these conditions have reached adulthood so the need for surgical correction of the jaw at this point is unknown. There is increasing evidence that children with uncorrected positional plagiocephaly have a higher incidence of middle ear infection. It is thought that this occurs because the Eustachian tube is not correctly positioned. Ear tubes (myringotomy tubes) may be necessary in children with multiple ear infections to preserve hearing.