Positional Skull Deformities
Positional skull deformities are frequently seen by Dr. Sundine. The incidence of positional skull deformities (deformational plagiocephaly) has significantly increased following the “Back to Sleep” recommendation from the American Academy of Pediatrics. Other causes of positional skull deformities include positional molding in the uterus, multiple gestation, and torticollis.
Physical findings include: a parallelogram shaped head when viewed from above, flatness on one side of the forehead with corresponding flatness on the opposite side of the back of the skull, the ear is pushed forward opposite the side of the flatness of the forehead. The diagnosis can usually be made from physical examination. In rare cases, a CT scan of the head may be required.
In many cases the treatment can be quite simple with positioning while the patient is sleeping. In some cases the child may require the use of a molding helmet that restricts growth in the prominent areas and allows for growth in the flattened areas. The best results from a molding helmet occur when the helmet is started before 6 months of age. Only in the cases of the most severe of deformities that have been refractory to molding helmet therapy would surgery be considered.
Traumatic Deformities
Frequently Dr. Sundine is called upon to treat patients with traumatic deformities of the face. These deformities may be soft tissue in nature or may involve fractures of the facial bones. Dr. Sundine is a faculty member of the AO/ASIF (Association for the Study of Internal Fixation) where he teaches other surgeons on how to treat facial fractures.
