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Cranial remolding is the reshaping of the skull during early childhood with the assistance of devices designed to shape and control skull growth. Infants between three and 18 months of age can be candidates for cranial remolding, although in some cases they may need surgery as well. A number of companies manufacture cranial remolding orthoses for use in treatment of skull abnormalities. The devices are custom-fitted to the patient using a cast of the skull and must be adjusted as the child grows.
Infants can develop abnormal skull shapes for a number of reasons, ranging from positional factors like often being on their backs to congenital issues. If an infant's head appears to have an unusual shape, a pediatrician will conduct a thorough evaluation to learn more, trace the cause, and develop an appropriate treatment plan. Some deformities may require surgical correction, like a surgery to cut apart prematurely fused cranial sutures, while others can be treated with cranial remolding alone.
In cranial remolding, a headband or helmet is carefully fitted to the patient, using casts and measurements. Some physicians work with laser data acquisition systems to scan the patient's head. The device is padded for comfort and is designed to slowly help shape the growth and development of the skull. Where there is room to grow, the skull will develop outwards, and where there is pressure, the skull's growth will be inhibited. This allows for the correction of the deformity over time.
The patient may need to wear a cranial remolding orthosis for varying lengths of time, depending on the nature of the deformity and how quickly it is caught. It is important to follow care directives meticulously and to attend regular follow up appointments where a physician will inspect the patient, check on the progress of the cranial remolding, and make any necessary adjustments. Because infants grow quickly, these appointments may be frequent in some cases.
If the treatment does not proceed as expected, an additional evaluation may be conducted to learn why and to see if other treatments would be more suitable for the patient's needs. The earlier treatment is provided, the more effective it tends to be. Some abnormality in head shape is normal right after birth due to the pressure on the skull exerted during labor and delivery, but if a baby's skull remains misshapen, it can be a sign of a problem and should be addressed.