title: Effect of molding helmet on head shape in nonsurgically treated sagittal craniosynostosis.
abstract: OBJECTIVE
  Sagittal craniosynostosis is traditionally considered to be a surgical condition. Poor results of simple suturectomy follow from early reclosure of the suture. A wider craniectomy or use of interposing materials has not improved the outcome. However, endoscopic suturectomy supplemented with postoperative use of a molding helmet has shown good results. Because suturectomy reunites within 8-12 weeks of surgery, the authors questioned if the improved outcome was primarily related to use of the helmet.
  
  
  METHODS
  In 4 patients whose families opted for calvarial reconstruction when the infant was 4-6 months old, instead of endoscopic suturectomy, a molding helmet was used to minimize compensatory changes in the interim. Patients underwent 3D CT scanning to confirm craniosynostosis. Follow-up visits were made at intervals of 4 weeks for adjustment of the helmet, head circumference measurements, clinical photographs, and cranial index measurement.
  
  
  RESULTS
  There was significant improvement in the head shape within 6 weeks of use of the molding helmet. The cranial index score improved from a mean (± SD) of 67% ± 3% to 75% ± 2%.
  
  
  CONCLUSIONS
  These cases demonstrate that molding helmets improve head shape even without a suturectomy in patients with sagittal craniosynostosis, challenging the traditional view.
authors.affiliation: Department of Neurosurgery, Children’s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien, Detroit, MI 48201, USA. ssood@med.wayne.edu
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sood
authors.forename: Arlene
authors.initials: A
authors.lastname: Rozzelle
authors.forename: Blerina
authors.initials: B
authors.lastname: Shaqiri
authors.forename: Natasha
authors.initials: N
authors.lastname: Sood
authors.forename: Steven D
authors.initials: SD
authors.lastname: Ham
mesh_terms: D002508:Cephalometry; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011184:Postoperative Period; D012886:Skull / Q000601:surgery*; D016896:Treatment Outcome