Q: Dr. Eppley, My daughter has Plagiocephaly that we were told would round out on its own and were refused helmet therapy. I saw your information about skull implants. I am very interested to know if this can be used on children, my daughter is 21 months. She has 10 mm asymmetry with flattening on her back right side and left forehead.

A: While skull implants can be made for plagiocephaly patients at any age, in young children with a lot of craniofacial growth yet to occur, augmentation of skull contour defects is best done by the application of intraoperatively shaped hydroxyapatite bone cements. These materials are more biocompatible with growing bone and will integrate into the bone as the process of appositional skull growth continues. I have seen case where bone has completely grown into and/or over such applied bone cements in children.

As a general rule I do not use synthetic preformed skull implants in patients who have not yet reached near complete craniofacial growth. While they are tremendously effective and make the surgery very predictable and allow for a quicker recovery, what happens to the bone around such an implant when applied at at early age is unknown.

Dr. Barry Eppley
Indianapolis, Indiana