Plagiocephaly

• asymmetry of skul

• normal head circumference

• most common abnormal head shape

• congenital or acquired

• often from infant sleeping in one position

• no impairment of cerebral development

• if sutures are ridged or sleep nomral

  • skull XR

• inirially changing side to which child faces for sleeping

• regularly changing sides

• encouraging time in prone position

• can try cranial remodelling helmet - 4-8mo

Craniostenosis/syntosis

• premature fusion of one or more sutures

• abnormal head shape depends on sutures

• diagnosis confirmed by xr

• promt referral is necessary

  • surgery@ 5-10mo

prominent bat/shell ears

• almost adult size and firmness by 5-6yo

• but ear cartilage not strong enough to cope iwth surgery \<3yo

facial deformity

• refer

Clef lip/cleft palate

• 1;600 births

• recognised in time for repair

• submucosal cleft

  • uvula is bifit

  • deep goove in midline of palate covered only by mucous membrane

  • ideal age fofr repair \<3mo

choanal atresia

• unilateral or bilateral

tongue tie

tongue may be heart shaped

infants unable to proturde tongue over lower lip

breast feeding problems

\<4mo - freunulum thin and avascular

frenulotomy

otherwise leave surgery to 2yrs

Branchial cyst

• rare

• located inferior to external auditory meatus

• or anterior to SCM

• opening may discharge mucopus

• refer