Background: Craniosynostoses most frequently require correction by craniotomy and cranial vault remodeling in order to allow adequate brain growth. Although the skull can be fairly accurately contoured, the final resultant shape is dependent on many factors including bone and brain growth and bone resorption. 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 craniosynostoses. The purpose of our study was to evaluate the use of postoperative helmet therapy after surgical correction for nonsyndromic single suture craniosynostosis. Methods: A retrospective review of 4 patients with nonsyndromic single suture synostosis who underwent cranial remodeling by a single surgeon with post-operative helmet therapy between 2003 and 2004 was performed. The 3 female and 1 male patient ranged in age from 5 months to 15 months at the time of surgery. All the patients were seen and measured by the same orthotist and helmet therapy was begun 2-4 weeks after surgery. Measurements were performed using a caliper and included cranial circumference, skull base, cranial vault, orbitotragal depth, head width, and head depth. Patients had serial visits to the orthotist for measurements and adjustments at 3 week intervals. Postoperative helmet therapy lasted for 6 months. The helmet was made out of 3/8” co-polymer thermoplastic with an interface foam of ½” closed cell pelite. Results: All patients showed an improved cephalic index when compared to the initial postoperative measurements. Measurements were compared to the normative data previously published by Farkas. Conclusion: Helmet therapy after craniosynostosis surgery improves cephalic index and skull shape beyond the results obtained at surgery. We conclude that post-operative helmet therapy is an effective treatment adjunct to craniosynostosis surgery for patients with nonsyndromic single suture synostosis.
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