O futuro das crianças com assimetria craniana posicional: revisão de escopo sobre consequências a longo prazo

Abstract

Introduction: Positional cranial asymmetries (PCAs), such as plagiocephaly and brachycephaly, are common deformities in infants secondary to prolonged supine positioning. Although considered benign, there is evidence suggesting possible long- term aesthetic and functional impacts. Given the increasing number of cases and the scarcity of consolidated studies, this scoping review aimed to map the available evidence on these long-term outcomes, associated or not with therapeutic approaches related to PCAs. Objective: To synthesize the evidence available in the literature on the short- and long-term evolution of infants and children with non-synostotic positional cranial asymmetries, considering both the natural course of the condition and possible therapeutic interventions such as physiotherapy, cranial orthosis, and repositioning techniques. Methods: A scoping review was conducted according to the PRISMA-ScR guidelines. Eight studies were analyzed, identified through PubMed, Scopus, Web of Science, Cochrane Library, Embase, and LILACS/BVS databases, with no language restriction, using descriptors related to positional cranial asymmetry, cranialgrowth, and therapeutic approaches. Results: The studies showed a spontaneous improvement trend in mild cases, whereas moderate and severe deformities presented a higher risk of motor and cognitive delays and partial aesthetic persistence. Early interventions, such as physiotherapy and cranial orthosis, demonstrated better outcomes compared to observation alone. Conclusion: Evidence indicates that although most PCAs evolve favorably, early monitoring is essential to prevent functional and aesthetic repercussions, reinforcing the importance of physiotherapeutic and multidisciplinary management from the first months of life.