Natural Progression of Cranial Shape Following Helmet Therapy for Deformational Plagiocephaly

<b>Objectives:</b> This study aimed to examine the natural progression of the cranial shape from the end of helmet therapy for deformational plagiocephaly to 1 year of age. <b>Methods:</b> This study included infants with moderate to severe deformational plagiocephaly who began treatment at our department between December 2022 and July 2023. The cranial shape was assessed using a 3D scanner (VECTRA^®H2) at the start of treatment, end of treatment, and 12 months of age. Changes in the Cranial Vault Asymmetry Index (ΔCVAI), an indicator of cranial deformity, and the severity of deformity (normal, mild, moderate, severe, very severe) were assessed between the end of treatment and 12 months. <b>Results:</b> The study included 32 infants: 30 were full-term and 2 were preterm (gestational ages: 34 and 36 weeks). The median age at the start of treatment was 4 months (range: 2-7 months), with a mean CVAI of 10.5 ± 2.2%. At the end of treatment, the median age was 9 months (range: 5-11 months), with a mean CVAI of 4.2 ± 1.8%. The ΔCVAI from the end of treatment to 12 months of age was 0.3 ± 0.8%. Regarding severity, an improvement was observed in one infant (3%) (from moderate to mild), no change in 28 infants (88%) (23 classified as normal, three as mild, and two as moderate), and worsening in three infants (9%) (one from mild to moderate and two from normal to mild). <b>Conclusions:</b> The severity of cranial deformity showed minimal worsening during the natural progression from the end of helmet therapy to 1 year of age.