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Cranial Remolding Orthosis

Home Cranial Remolding Orthosis

What is a Cranial Remolding Orthosis (CRO)? 
The STARband Cranial Remolding Orthosis is part of Orthomerica's STAR family of Cranial Remolding Orthoses used to provide treatment in infants 3-18 months of age with head deformities including, Plagiocephaly, Brachycephaly and Scaphocephaly. The cranial remolding orthosis is a type of treatment in which a baby is fitted with a specialized custom-made helmet to correct the shape of the skull over time. This helmet therapy is not painful or uncomfortable to the baby. The typical start time for the CRO is 4-7 months of age, when their skull is still soft. After completing the break-in schedule, the CRO is worn 23 hours a day. The duration of a helmet can vary depending on severity and growth of the baby, but most treatments lasts 3 months.

Types and Characteristics of Cranial Deformities

 Deformational Plagiocephaly

  • The most common type of skull deformity in infants.
  • Normally noticed by caregivers at about six to ten weeks of age.
  • Characterized by an asymmetrical skull shape.
  • Unilateral occipital flattening.
  • Ear is positioned  more anterior on the side of the occipital flattening.
  • Forehead may be asymmetrical and is positioned more anterior on the side of the occipital flattening. 
  • Facial asymmetry may be present. 
  • May be accompanied by torticollis, limited neck range of motion, weakness and preferential head positioning. 

Deformational Brachycephaly 

  • Central occipital flattening.
  • Increased cranial vault height posteriorly. The head is excessively wide for its length.
  • May be accompanied by a prominent, bossed forehead.

Deformational Brachycephaly with Asymmetry

  • Combination of brachycephalic and plagiocephalic characteristics.  
  • The shape is disproportionately wide for its length and is also asymmetrical. 
  • May or may not include asymmetries to the forehead and facial structure. 

Deformational Scaphocephaly

  • Very elongated head shape that is excessively long for its width. 
  • May be accompanied by a preminent, bossed forehead.
  • Deformational Scaphocephaly cause by extrinsic forces is uncommon although it is sometimes seen in premature infants who are often positioned side lying, such as NICU infants. 
  • Scaphocephaly caused by extrinsic positioning may be confused with sagittal synostosis, a more serious deformity that usually requires surgery to correct.      
    Courtesy of Orthomerica Products, Inc.
Courtesy of Orthomerica Products, Inc.

What to expect?
Upon determining that your child is ready for a Cranial Remolding Orthosis (CRO), the process of mold acquisition and fitting of the device in our office is easy on both the parent and the child. We utilize Smartsoc scanning in our facilities, which enables us to capture the child's head shape by simply scanning the child's head. This is done first by putting a specialized hat on the child that provides feedback to the scanning software. Then, we utilize a series of stickers on the child to mark anatomical features. After that, we can scan the child's head with a mobile device that allows the child to sit in your lap while we scan the surface to obtain the head shape. This process allows us to have an accurate mold of the child's head that will be used in fabrication of the CRO. 

Once the child is scanned for a CRO, it is required we fit the device within 10 days of the initial scan to ensure proper fit of the device. Typically, we will set up a fit and delivery appointment prior to you leaving the office after a scan is completed to ensure we will get the child fit within an appropriate time. Fitting the CRO requires the practitioner to apply the orthosis to the child and trim the device to fit appropriately. This process may take a few trips to accomplish as we want to ensure we do not remove too much of the brace while still ensuring it will be comfortable and effective for the child to wear. Once the device is fit, the practitioner will instruct the parents on wear time and break-in schedule for the child to follow. Follow up visits will be established to chart the child's growth and determine when to discontinue use of the helmet. Keep in mind that this brace works when the child grows. The CRO does not push onto the child's head, but rather, it controls growth direction and allows flattened areas to round out.

Courtesy of Orthomerica Products, Inc. 

Actual Patient Results
   

Before Cranial Remolding Orthosis                After Cranial Remolding Orthosis

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