A Preliminary Investigation of Postoperative Molding to Improve the Result of Cranial Vault Remodeling

In Brief Craniosynostoses most frequently require correction by craniotomy and cranial vault remodeling to facilitate neurologic development and normal cranial shape. Although the skull can be fairly accurately contoured intraoperatively, the final shape is dependent on many factors, including bone and brain growth and bone resorption. Although molding helmets have been used for positional head molding and in the management of endoscopic suturectomy, very few studies have evaluated their use in the postoperative care of patients undergoing open cranial remodeling. The authors sought to evaluate the use of postoperative helmet therapy after surgical correction for nonsyndromic single suture craniosynostosis. A retrospective review of six patients with nonsyndromic craniosynostosis who underwent cranial remodeling by a single surgeon with postoperative helmet therapy in 2003 and 2004 was performed. The four female and two male patients ranged in age from 5 months to 13 months at the time of surgery. All the patients were seen and measured by the same orthotist, and helmet therapy was begun 2 to 4 weeks after surgery. Postoperative helmet therapy lasted for 6 months. All patients showed an improved cephalic index when compared with the initial postoperative measurements. There were no adverse consequences associated with helmet therapy. Helmet therapy after craniosynostosis surgery improves cephalic index and skull shape beyond the results obtained at surgery. The authors conclude that postoperative helmet therapy is an effective treatment adjunct to craniosynostosis surgery for patients with nonsyndromic single suture synostosis. Craniosynostoses most often require correction by craniotomy and cranial vault remodeling in order to facilitate neurologic development and normal cranial shape. The authors studied the use of postoperative helmet therapy after surgical correction for nonsyndromic single suture craniosynostosis.. Although molding helmets have been used a great deal for positional head molding and in the management of endoscopic suturectomy, very few studies have evaluated their use in the postoperative management of patients undergoing open cranial remodeling. The authors found that helmet therapy after craniosynostosis surgery improves cephalic index and skull shape beyond the results obtained at surgery.