How Can A Child’s Flat Back Of The Head be Fixed?

Q: Dr. Eppley, I have a nephew with occipital plagiocephalhy. He’s 2 years old and we’ve been told there’s nothing else to do from a medical point of view. I’d like to know if there’s anything else that can be done, and when will it be a good time for him to go through any procedure if there’s still an option. We’d also like to know if it would better to wait, or to act now if there was something that could be done. Thanks.

A: At two years of age, a flat spot on the back of the head (occipital plagiocephaly) is not worthy of major skull surgery. (taking the bone off and reshaping it) This is what is meant by ‘nothing to do’. This does not mean there is actually nothing to do because there is, just not that particular surgery. Building up the flat area on the back of the head (skull augmentation) would be the appropriate surgery. This can even be done through a very small incision using an injectable bone cement technique. (injectable cranioplasty)

The question is not whether it can be done but when it should be done, if at all. There are no concrete answers to these questions. Such surgery is simple and takes less than an hour to do. Whether the size of the flatness justifies surgical improvement is a personal question as well as the timing of it. It can be done at two years of age or age 60. Correcting the flatness of the back of the head is a cosmetic issue. Thus the procedure and its timing are an individual decision.

Dr. Barry Eppley