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Ortotična oskrba deformacije lobanje pri dojenčku - pregled literature : diplomsko delo
ID Krstič, Zala (Author), ID Lampe, Tomaž (Mentor) More about this mentor... This link opens in a new window, ID Horvat, Josip (Co-mentor), ID Levec, Tina (Reviewer)

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Abstract
Uvod: Ker dojenčki prve tedne in mesece preživijo v vozičku in posteljici, se lahko zaradi mehkosti in njene prilagodljivosti le ta splošči na določenih mestih. To se ponavadi zgodi na področju zatilja ali ob straneh. V navedenem primeru govorimo o deformacijski brahiocefaliji in plagiocefaliji, najpogostejši deformaciji lobanje. Zdravljenje je odvisno od resnosti stopnje deformacije. Zaradi znane hitre rasti možganov in lobanje se v prvih štirih mesecih priporoča zgolj opazovanje. Pri hujših kranialnih deformacijah pa je edina učinkovita metoda zdravljenje s kranialnimi ortozami. Zaradi sodobne tehnologije in uporabe CAD/CAM sistema pa je danes izdelava kranialnih ortoz in potek zdravljenja enostavnejši in natančnejši. Namen: Namen diplomskega dela je s pomočjo že obstoječih raziskav ugotoviti učinkovitost zdravljenja kranialnih deformacij s kranialnimi ortozami, kdaj je najprimernejši čas za začetek zdravljenja, kakšna so izboljšanja kranialne asimetrije ob koncu zdravljenja in to metodo primerjati z ostalimi oblikami konzervativega zdravljenja. Metode dela: V diplomskem delu je uporabljena deskriptivna metoda dela, pregled že obstoječe literature na področju kranialnih korekcijskih ortoz, deformacijske plagiocefalije in brahiocefalije. Rezultati: Zdravljenje s kranialnimi ortozami, fizioterapija in remodeliranje so se izkazale za učinkovite metode zdravljenja kranialnih deformacij. Terapija z ortozami se je izkazala za edino učinkovito metodo pri hujših kranialnih deformacijah in pri dojenčkih s prisotnim tortikolisom in nevromuskularnimi motnjami v razvoju. Bistvena izboljšanja so kazali mlajši dojenčki, vendar pa velja za učinkovito metodo zdravljenja tudi starejših otrok. Večja izboljšanja kranialne asimetrije je dosežena pri dojenčki, ki so ortozo nosili več kot 20 ur na da. Razprava in zaključek: Ključnega pomena učinkovitosti zdravljenja s kranialnimi ortozami je starost dojenčka ob začetku zdravljenja in upoštevanje navodil ortotika. Pri dojenčkih mlajših od 6 mesecev so se pokazala večja izboljšanja kranialne asimetrije. Tudi pri starejših otrocih se lahko doseže izboljšanje asimetrije vendar je potek zdravljenja daljši, prav tako je bistvenega pomena nošenje ortoze več kot 20 ur na dan. Optimalen čas nošenja ortoze je 23 ur na dan, preostala ura se posveti higieni in pregledu stanja kože. Najprimernejši čas za začetek zdravljenja je ocenjen pri petih oziroma šestih mesecih. Velja za hujše kranialne deformacije. Fizioterapija in remodeliranje sta se prav tako izkazali za učinkoviti metodi vendar pri mlajših dojenčkih z blažjimi do zmernimi kranialnimi deformacijami.

Language:Slovenian
Keywords:diplomska dela, ortotika in protetika, deformacije lobanje, deformacijska plagiocefalija, deformacijska blahiocefalija, kranialne ortoze, 3D-tiskanje
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[Z. Krstič]
Year:2020
Number of pages:33 str.
PID:20.500.12556/RUL-117998 This link opens in a new window
UDC:617.3
COBISS.SI-ID:25541635 This link opens in a new window
Publication date in RUL:08.08.2020
Views:1465
Downloads:252
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Secondary language

Language:English
Title:Orthotic treatment of skull deformity in infat - literature review : diploma work
Abstract:
Introduction: As infants spent their first weeks and months laying in pram and crib, their head tends to flatten in certain areas because of its softness and adaptabillity. It usually occurs on occipital area or on the side of the skull. When this happens we are talking about deformational brachiocephaly and plagiocephaly, the most common skull deformities. Medical treatment depends on the severity of the deformity. Because rapid brain and skull growth is so well known, observation is recommended in the first four months. Helmet therapy is known as the only effective treatment in severe deformities. Because of modern technology and use of CAD/CAM system, the production of cranial orthosis and treatment nowadays are much easier and precise. Purpose: The aim of this diploma work is to investigate the effectiveness of helmet treatment, when is the optimal time to start the treatment, what are the cranial asymmetry improvements at the end and compare this therapy with other conservative treatments based on the existing studies. Methods: When writing, I used desctiptive method, overview of the existing studies based on cranial corrective orthosis, deformational plagiocephaly and brachiocephaly. Results: Helmet treatment, psysiotherapy and positioning are proved to be effective treatments of cranial deformities. Helmet therapy proved to be the only effective treatment with severe deformities and infants with present torticollis and neuromuscular developmental delays. Younger infants showed better improvement, but the helmet treatment was also effective with older infants. Better improvements in cranial asymmetry were shown in infants, who worn the helmet for more then 20 hours per day. Discussion and conclusion: The age at initiation of helmet therapy and patient compliance are the only risk factors for helmet therapy failure. Infants younger then 6 months showed better cranial asymmetry improvements. Older infants showed improvements but with longer treament duration, also wearing a helmet more then 20 hours per day has a big importance. 23 hours per day is the optimal time for wearing a helmet, the other hour is meant for hygiene and examination of the skin. Best outcome for helmet treatment starts between 5 and 6 months of age. This applies for severe deformations. Psysiotherapy and positioning also proved to be effective but in younger infants with mild to moderate cranial deformities.

Keywords:diploma theses, orthotics and prosthetics, skull deformities, deformational plagiocephaly, deformational brachiocephaly, cranial orthosis, 3D printing

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