Comorbidities of deformational plagiocephaly in infancy: A scoping review.

AIM: While deformational plagiocephaly (DP) is suspected to be associated with comorbidities, their nature and prevalence are unclear. This scoping review aims to report DP comorbidities occurring until the age of 2 years, their prevalence and whether they depend on the child's age and sex. METHODS: Relevant studies were identified by searching the Cochrane, MEDLINE, EMBASE, PubMed and EBSCO databases from 1992 to 30 April 2021. Data on study characteristics, comorbidities and assessment instruments were extracted and qualitatively synthesised. Risk of bias was assessed and studies with high risk of bias were excluded. RESULTS: Studies meeting selection criteria (n = 27) often evaluated groups from tertiary clinics, implying selection bias. Studies reported on developmental delay (n = 16), limited speech production (n = 1), auditory (n = 3), visual (n = 3), mandibular (n = 3) and neurological impairments (n = 1). The data did not allow prevalence calculation or modifying effect of sex. Due to biased data, the review provided no evidence on DP comorbidities. Weak evidence suggested that in the selective samples, DP was associated with motor and language delays in the first year. CONCLUSION: Due to biased data, no evidence on comorbidity in infants with DP was available. Our study underlined the need of risk of bias assessment in scoping reviews.

Craneosinostosis sagital. A propósito de un caso / Sagittal craniosynostosis. A case report

La craneosinostosis es el cierre precoz de una o más suturas craneales. Comprende un amplio espectro de malformaciones craneales, desde el cierre aislado de una sola sutura, al cierre de varias suturas, o asociado a otras malformaciones, constituyendo las craneosinostosis sindrómicas. El pediatra debe distinguir las deformidades posicionales o plagiocefalias posturales, más frecuentes, de las craneosinostosis, que requieren tratamiento quirúrgico y cuyo diagnóstico precoz mejora el pronóstico. Se presenta el caso de un lactante con escafocefalia debida a craneosinostosis aislada (AU)

Craniosynostosis is the premature fusion of one or more of the cranial sutures. It includes a wide spectrum of cranial malformations, from closing of an isolated suture to the closing of several sutures, or associated to other malformations, constituting syndromic craniosynostosis. The pediatrician must distinguish the positional deformities or postural plagiocephaly, more frequent, from the craniosynostosis, that needs surgical treatment and whose early diagnosis improves the prognosis. We present the case of an infant with scafocephaly due to isolated craniosynostosis (AU)

Tortícolis congénito comopresentación de escoliosis cervical / Congenital torticollis as presentation of cervical scoliosis

El tortícolis congénito es una de las causas más habituales de consulta pediátrica. En niños menores de 6 meses, las causas más frecuentes son de origen muscular por alteraciones en el músculo esternocleidomastoideo o por una mala posición intraútero, pero no hay que olvidar las malformaciones óseas. Las alteraciones oculares también son una causa de tortícolis, pero generalmente aparecen en niños mayores de 6 meses. Presentamos el caso de una niña de 6 meses de edad, remitida a nuestra consulta por presentar un tortícolis congénito. En la exploración destacó un aplanamiento occipital derecho y un tortícolis derecho, sin anomalías palpables en los músculos del cuello. Mediante tomografía computarizada (TC) se diagnosticó una hemivértebra cervical. Se descartó la presencia de craneosinostosisy patología medular. Se valoró el caso en los servicios de oftalmología y traumatología. La evolución de la paciente fue satisfactoria mediante tratamiento conservador, y la niña presentó un desarrollo psicomotor dentro de la normalidad. En los niños con un tortícolis congénito lo más importante es averiguar la causa de la afección. En este caso, se trataría de una escoliosis cervical. El tratamiento suele ser rehabilitador, con controles visuales, siempre teniendo en cuenta la posibilidad quirúrgica para prevenir otras posibles deformidades secundarias (AU)

Introduction: The congenital torticollis is one of the frequent causes of pediatric consultation. In children smaller than 6months, the most common cases are originated by alterations in the sternocleidomastoid muscle or by an inadequate position of the baby inside the womb, but bone malformations shouldn’t be forgotten as other of the possible causes. Ocular alterations could also be a torticollis cause but generally in children older than 6 months. Clinical case: Girl of 6 months remitted because of a congenital torticollis. She had an occipital flattening and a right torticollis without palpable anomalies at neck muscles. By means of a tomography she was diagnosed of a cervical hemivertebra. Craneosynostosis and medullar pathology were also discarded. This diagnosis was valued by ophthalmologist and traumatologist. The evolution of the conservative treatment was satisfactory and the psychomotor development was inside the normal standards. Conclusions: In a case of congenital torticollis the most important thing is to investigate the a etiology. In this case it was a cervical scoliosis. The treatment consisted on a process of rehabilitation with visual controls, without forgetting the future possibility of a surgery to prevent other possible secondary deformities (AU)