Torticocephaly; A Distinct Clinical Entity from Primary Positional Plagiocephaly?

Background. Nonsynostotic deformational plagiocephaly and primary congenital muscular torticollis are two abnormalities increasingly being diagnosed in America today. Currently, there are no distinctive measurements to differentiate these two abnormalities. Objective. To determine whether anthropomorphic measurements distinguish positional plagiocephaly associated with torticollis from primary positional plagiocephaly. Methods. A retrospective chart review of more than 30 patients with positional plagiocephaly was performed. Seventeen patients had a confirmed diagnosis of torticollis associated with positional plagiocephaly, and 16 patients had positional plagiocephaly without any associated torticollis. All of the patients underwent cranial surface scanning with Starscanner software upon initial consultation before any intervention. The anthropomorphic measurements obtained included; head circumference, cranial breadth and length, cephalic ratio, radial symmetry index, cranial quadrant volumes, and ratios of cranial quadrant volumes. We compared these measurements between the two groups of patients; primary positional plagiocephaly and positional plagiocephaly with torticollis (torticocephaly) using two sample t-tests to determine statistical significance. Results. Results involving head circumference, cephalic ratio, cranial length, cranial breadth, the radial symmetry index, cranial quadrant volumes, and ratio of quadrant volumes are pending. Conclusions. The anthropomorphic measurements, radial symmetry ratio and cranial quadrant volumes define a distinct clinical entity in the positional plagiocephaly associated with torticollis; torticocephaly. Torticocephaly demonstrates a greater degree of cranial asymmetry when compared to primary positional plagiocephaly