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Plagiocephaly refers to a misshapen (asymmetrical) shape of the head (cranium) from repeated pressure to the same area of the head. Plagiocephaly literally means "oblique head" (from the Greek words "plagio" for oblique and "cephale" for head).

How is Positional plagiocephaly different from craniosynostosis?

Craniosynostosis is premature fusion of one or more of the sutures in the skull. True synostosis may limit the size of the cranial vault (skull) and therefore impair brain growth. The diagnosis is made after a clinical evaluation by a craniofacial surgeon and/or a neurosurgeon. X-rays and CT scans of the head may be performed to confirm the diagnosis of craniosynostosis. Surgery is usually the recommended treatment.

In positional plagiocephaly, there is no fusion of the skull sutures. It is a clinical diagnosis made after a thorough medical history and physical examination by a craniofacial surgeon or neurosurgeon. X-rays and/or CT scans are usually not necessary. Treatment of deformational plagiocephaly generally includes positioning and/or helmeting.

What causes positional plagiocephaly?

By keeping an infant's head in one position for long periods of time, the skull flattens (external pressure). Occasionally, a baby is born with this flattening because of a tight intrauterine environment (i.e., in multiple births, small maternal pelvis, or with a breech position). Other factors which may increase the risk of positional plagiocephaly include the following:

Muscular Torticollis

One cause of positional plagiocephaly may be muscular torticollis. Muscular torticollis is a congenital (present at birth) finding in which one or more of the neck muscles is extremely tight, causing the head to tilt and/or turn in the same direction. Torticollis is often associated with the development of plagiocephaly since the infant holds his/her head against the mattress in the same position repeatedly.

Prematurity

Premature infants are at a higher risk for plagiocephaly since the cranial bones become stronger and harder in the last 10 weeks of pregnancy. Also, since many premature infants spend extended periods of time in the neonatal intensive care (NICU) unit on a respirator, their heads are maintained in a fixed position, increasing the risk for this condition.

Back Sleeping

Infants who sleep on their backs or in car seats without alternating positions for extended periods of time are also at a higher risk for deformational plagiocephaly.

What is the treatment for positional plagiocephaly?

Specific treatment will be determined by your child's physician based on the severity of the positional plagiocephaly. Frequent rotation of your child's head would be the first recommendation once your infant has been diagnosed with plagiocephaly. Alternating your infant's sleep position from the back to the sides, and not putting infants on their backs when they are awake may also help prevent and treat positional plagiocephaly. Some cases do not require any treatment and the condition may resolve spontaneously when the infant begins to sit.

If the deformity is moderate to severe and a trial of re-positioning has failed, your child's physician may recommend a cranial remodeling band.

How does a remolding cranial band correct positional plagiocephaly?

Canial Bands are made of an outer plastic shell with a foam lining. Gentle, persistent pressures are applied to capture the natural growth of an infant's head, while inhibiting growth in the prominent areas and allowing for growth in the flat regions. As the head grows, adjustments are made frequently. The helmet essentially provides a tight, round space for the head to grow into.

How long will my child wear a corrective cranial band?

The average treatment with a cranial bandis usually three to six months, depending on the age of the infant and the severity of the condition. Careful and frequent monitoring is required. Helmets must be prescribed by a licensed physician with craniofacial experience.

How much does the cranial band cost?

The cost for the cranial band is $1700.00 and includes all cranial scans, routine followups and adjustments.

Do insurance companies pay for cranial bands?

Most insurance companies have their own protocols on what requirements must be met before a cranial band will be paid for. Please contact our office at 419-476-4248 so that one of our insurance billing specialists can help you navigate through the process.

What if insurance does not pay for a cranial band?

If you have trouble obtaining insurance coverage to cover the cost of your child's cranial band or wish to proceed with treatment before insurance authorization is finalized, Cole Orthotic Pediatric Center offers CareCredit: http://carecredit.com to assist you in arranging a convenient payment plan for the treatment. Please contact our office for details:

419-476-4248.

      Your child’s  first visit to our office:

Once your child has a prescription for a cranial band, the next step is to contact our office for an appointment. Our professional staff is trained to assist you with obtaining insurance authorization for the treatment. This ‘pre-authorization’ process can take up to 4 weeks, depending on your specific insurance plan.

Once insurance authorization is complete your child’s the first visit to our office will include a thorough discussion about your child’s cranial treatment plan. We will then proceed to scan your child’s head to produce the necessary digital data to fabricate the custom cranial band.

Before leaving our office we will schedule a follow-up appointment for the fitting of your child’s cranial band. This next appointment will be in approximately 10 -14 days.

First Fitting Appointment:

The initial fitting and instructional process takes approximately 90 minutes during which time  modifications will be made to the band to insure an optimal fit. We will then be providing both written and verbal instructions on the proper application of the band, wearing schedule and hygienic care.

Follow-up Appointments

Follow-up appointments are routinely made every 3-4 weeks but at times it may be necessary to see your child more often if the cranial band requires additional modifications resulting from cranial growth. Traditionally follow-up appointments last between 15-30 minutes at which time we will re-evaluate your child’s head and cranial band for proper fit. We will then take a comparative scan of your child’s head to evaluate the amount correction that has been obtained since the last visit. Based on the data further modifications may be performed on the band to allow for additional growth on the affected side.

Through-out the entire process the family will receive copies of their child’s cranial scan data, allowing them to follow along with their progress. We will also be sharing this data with the referring physician and therapist.

Treatment Outcome:

The day will come when your child no longer requires cranial band treatment. Based on the final cranial scanner data, clinical examination and discussion with the family and physician, we will determine if it is appropriate to end the cranial band treatment.

"What is Positional Plagiocephaly?" Informational Guide

StarScanner Facility

Cole Orthotic Pediatric Center utilizes the state of the art STARscanner™ laser data acquisition system.The cranial scanner utilizes 3-D surface scanning technology and allows cranial band practitioners to collect and compare head shape information during the treatment of positional plagiocephaly and brachcephaly.

Benefits Over Casting Method

The STARscanner™ eliminates the casting process, which is often a traumatic

experience for infants and care givers.

• Scans are safe and fast - less than two  

   seconds.

• Quick turnaround time leads to earlier

  treatment and improves initial fit and function.

 • The STARscanner™ measures the

   improvement of overall symmetry and

   substantiates the efficacy of orthotic treatment.

• Scans provide quantifiable pre- and post-treatment documentation for families

   and referral services.

Please call our office at 419-476-4248 for more information on this exciting new technology or to schedule an appointment for your child.

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