Re: mild, moderate, severe?

[Guest guest]

Our ortho did three measurements: Cranial Base, Cranial Vault, and

Facial Assymmetry. One is the diagonal across the top of the head,

one is from the corner of the eye to the ear on each side, and one is

from just under the nose to the ear on each side. The difference in

the measurement of each side is the " asymmetry " The normal range for

differences is 2-3mm. was 10mm cranial base, 7mm cranial

vault and 5mm facial asymmetry. He was labeled mild, although

descriptions I have read lead me to believe he was moderate (due to

forehead bossing, ear misalignment, and one eye bigger than the

other) He was banded late (1 week shy of his first birthday) and has

been in the band only two weeks. We have seen great improvement

already and our ortho made a comment in passing at our last visit

yesterday that he was almost done!! So I guess he really was mild!

We haven't had any measurments done since the initial evaluation, but

I imagine they'll be doing them again soon.

Hope this helps!

Kristi

(4) and (1yr - Doc banded 9/14/02)

OH

> I often read people referring to their kid's plagio as being mild

> moderate or severe. I am wondering what kind of metric you and your

> Dr uses to give this label.

>

> In our case Gus' head was measured diagonally. Tthe flat area to

the

> opposite corner was called the " low side " and the opposite diagonal

> was called the " high side " . The difference between the 2

measurements

> was 1.7 cm. Our ortho said this was moderate. The worst she had

seen

> was 2.7 cm and she would be happy if the difference was under .5 cm.

>

> So what kind of measurements did you use and what was the range

from

> bad to good?

[Guest guest]

That measurement (where they sort of measure from in front of the eye

to the opposing corner of the head) is called Transcranial

Anthropometry -> I have my copy of " Analysis of Posterior

Plagiocephaly: Deformational versus Synostotic " in front of me.

My Zack had a 0.9 cm difference when he was first measured and Zoey

had a 1.2 cm difference. Repositioning got Zoey from 1.2 to 0.6 cm

in two months, Zack actually got a little worse he went from 0.9 to

1.0. Thus Zack is wearing a helmet and appears to be showing

progress (the tech estimated he was at 0.7cm last fitting).

According to my not so easy to read medical article, the mean

difference from their study of 76 kids who came in for treatment was

1.2 cm. Thus I would call 0.9 to 1.5 moderate, less than 0.9 mild

and greater than 1.5 severe (this based solely on this one study).

The good news from the article was the average helmet-kid went from

1.2cm to 0.6cm in 4 months, while the average repositioning-only-kid

went from 1.2cm to 1.0cm in 4 months.

I should really scan this and post it, shouldn't I...I'll talk to the

guy at work with the scanner

Ken

Zack and Zoey's dad

[Guest guest]

> So what kind of measurements did you use and what was the range

from

> bad to good?

Abby's head was actually never measured. Her " severe " category was

simply done by looking at her head shape. Every Dr & clinic is

different!

Debbie Abby's mom dOCGrad

MI

[Guest guest]

We never had measurements just the birds eye view-but it is hard not to see a

difference when you son has a book end for a head:-) He looks good now

though. Sorry I could not be of more help!

beck

[Guest guest]

You know, I have no idea what the measurements were for my twins.

Basically, I relied on what calssification my neurosurgeon told me

they were in. My daughter's case of plagio was an obviously mild one

in comparison to other photos I have seen. And my son's brachy was a

bit flatter than my daughter's head but not too much, so he was

classified as mild-to-moderate. Neither my neuro or ortho seemed to

be overly concerned about measurements, due tot he fact that its

close to impossible to know if you're measuring the same *exact* part.

Niki

Kaylie & Danny (STAR grads)

Phila., PA

> I often read people referring to their kid's plagio as being mild

> moderate or severe. I am wondering what kind of metric you and your

> Dr uses to give this label.

>

> In our case Gus' head was measured diagonally. Tthe flat area to

the

> opposite corner was called the " low side " and the opposite diagonal

> was called the " high side " . The difference between the 2

measurements

> was 1.7 cm. Our ortho said this was moderate. The worst she had

seen

> was 2.7 cm and she would be happy if the difference was under .5 cm.

>

> So what kind of measurements did you use and what was the range

from

> bad to good?

[Guest guest]

In a message dated 10/1/2002 11:52:49 AM Eastern Daylight Time, orissiro@... writes:

On the other

hand until there is measurement there is no way to track the

effectiveness of the treatments across patients. (I always have this

small worry that in 5 years they are going to say: "oh well that

whole helmet thing was a scam" or worse "that whole 'back to sleep'

thing was based on bad data".)

I really think the numbers can be a good indication of what's taking shape, or not, but I also feel that eyeballing it is just as good, because it can be quite obvious when changes are made. We could visually tell because it was so obvious that his ears moved, his flat spot popped out and we didn't need any numbers to tell us that. I'm actually kind of glad we didn't play the numbers game, only because it would probably drive me nuts if he was off .1 millimeter or whatever. Unfortunately, you won't have to wait 5 years for Doctors to say this is a scam, there are Doctors that are telling people right now that bands/helmets don't work and they are a scam. I can tell them from first hand experience that it does work, it worked for my son, and I have no regrets today because of the band and its effectiveness. Pictures speak volumes, and they tell me a lot more about my son's appearance than the numbers ever will. So if any Doctor were to tell me that, watch out!!

' Mom

[Guest guest]

I am surprised at how many people just have eyeball assessments- I

wonder if it is true that measurements are not accurate. On the other

hand until there is measurement there is no way to track the

effectiveness of the treatments across patients. (I always have this

small worry that in 5 years they are going to say: " oh well that

whole helmet thing was a scam " or worse " that whole 'back to sleep'

thing was based on bad data " .)

Ken, if you can scan in that article I would love to read it.

We go in to get remeasured tommorrow so I will ask about measuring

styles then as well.