Browsing by Author "Ozkilic, Alper"

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    The Role of Age on Effectiveness of Active Repositioning Therapy in Positional Skull Deformities
    (2020) Ozkilic, Alper; Cevik, Serdar; Isik, Semra
    Purpose: Non-synostotic positional deformities are currently diagnosed in nearly half of the newborns, however not any evidence-based guidelines are available for management. The aim of this study is to assess the effect of active repositioning treatment at infants with positional skull deformities. Method: A retrospective data of 158 infants treated with active repositioning as a conservative treatment for at least 2 months were analyzed in this study. Anthropometric 3D scanner measurements of pre-and post-treatment diagonal difference, cranial vault asymmetry index, cranial ratio were evaluated for each patient. Infants were separated to 4 different groups according to their morphologic deformation types as plagiocephaly, brachycephaly, scaphocephaly and combined (brachycephaly+plagiocephaly), and 2 groups according to age at onset of treatment. Results: In combined group, pre-treatment mean diagonal difference and cranial vault asymmetry index values decreased from 9.38 mm and 6.9% to 6.94 mm and 4.9% respectively. In plagiocephaly group, mean pre-treatment results changed from 10.32 mm and 7.5% to 7.83 mm and 5.5% respectively after treatment. All these changes were statistically significant. Effectiveness of timing of repositioning treatment on different positional skull deformities was analyzed and outcome was found significantly improved when the active repositioning treatment was started before 4 months of age. Conclusion: Improvement rates of the asymmetry decrease with age due to decreasing skull enlargement rate. Early diagnosis, especially before 4 months of age, more parental education, and close follow-up are important for babies with this condition who may benefit just from repositioning treatment.
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    The role of age on helmet therapy in deformational plagiocephaly and asymmetric brachycephaly
    (2020) Cevik, Serdar; Isik, Semra; Ozkilic, Alper; 0000-0002-6929-7135; 31482314; K-6580-2015
    Purpose This study aimed to investigate the effect of age at helmet therapy onset on treatment efficacy in moderate-to-severe deformational plagiocephaly (DP) and combined DP and asymmetrical brachycephaly (AB) in infants. Methods Ninety-eight infants who were referred to our institution and who underwent helmet therapy between 2014 and 2018 were retrospectively reviewed. Patients with DP [cranial vault asymmetry index (CVAI) > 7% and DD > 10 mm] and AB [CVAI > 7% and cephalic ratio (CR) >= 94] were included. Pre- and post-treatment calvarial asymmetries (difference among DD, CVAI, and CR) were measured using 3D screening systems (SmartSoc and Omega Scanner 3D). Infants were classified according to age at treatment onset: group 1 (age, < 6 months) and group 2 (age, >= 6 months). Results CVAI was statistically different between treatment onset and end in subgroups. Moreover, the regression of CVAI between groups DP1 (- 7.5% +/- 1.2%) versus DP2 (- 5.4% +/- 1.5%; p = 0.001) and groups AB1 (- 6.6% +/- 1.4%) versus AB2 (- 4.4 +/- 2.5; p = 0.0013) was statistically significant. CVAI was < 3.5% and CR was <= 89 (assumed as normal cranial shape) after treatment in 48%, 40%, 32%, and 6% of infants in groups DP1, DP2, AB1, and AB2, respectively. Conclusion These findings emphasize the efficacy of helmet therapy for DP and AB. Helmet is an appropriate treatment option particularly for infants with severe DP and AB, and early onset of helmet therapy before the age of 6 months is advised.