Welcome to the website of Plagio Center Netherlands, the center where we measure and, if necessary, treat the deformity of the child's skull.
There are several causes that can cause a baby's skull to become deformed. The first step is to visit a pediatric physiotherapist, who will look at ways to improve balance with, among other things, neck strengthening exercises, but will also look at the baby's daily pattern.
When the child is 3 to 4 months old, a measurement can be taken and, for example, again a month later, to gain insight into whether progress is being made.
There are different measuring techniques. Plagio Center Nederland only uses a 3D scan.
With a 3D scan you see everything! With other measuring techniques such as a hot water band or a photo you can only measure at 1 point and you can miss deformations above or below. With a 3D scan that is excluded
During the initial consultation, our experts will visually inspect the area to see if there are any obvious deformations.
Then the child is given a “cap” to keep the hair tightly together. Then on mom or dad’s lap.
With a 3D scanner (Artec Lite) the expert walks around the child, the child usually finds the lights interesting but because the scanner takes 16 photos per second, movement is not a problem.
Now that a 3D model has been created on the computer, we import it into the software from which the various measuring points are automatically calculated.
These values are then put into a table so that it is clear to parents what the deformity is based on normal.
The values are discussed in order to provide advice on what to do to reduce skull deformation.
In many cases, the parents and child return to the pediatric physiotherapist to strengthen the muscles. There is a possibility to return to Plagio Center Nederland after a few weeks for a follow-up scan. The 3D scan will then be compared to the previous one to see the progress.
If the skull deformation exceeds certain values (also read “what do the numbers mean”), advice is given to consider a corrective helmet.
The child then wears this helmet 23 hours a day to correct the deformation of the skull.
Around the age of 5 months old, you can start with redression helmet therapy. Due to the rapid growth, you have the best chance of a good adjustment of the skull, if you start the treatment later, the growth is slower but you can still do a lot for the deformation.
The correction helmet is produced in collaboration with Atelier D'Orthopedie.
Read: Redress helmet
Because skull deformation does not physically affect the brain, for example, and is therefore only cosmetic, the health insurance company has chosen not to reimburse these costs.
In some cases there is a reimbursement in the supplementary package. Now only at CZ but discuss this with your own health insurance. https://www.cz.nl/vergoedingen/redressiehelm
A consultation with 3D scan costs €45.
Remedial helmet therapy costs € 1750
Monthly 3D scan until end of treatment
Introduction
Approximately 200,000 children are born in the Netherlands each year, of which approximately 10 percent have or develop a skull abnormality. A skull abnormality is caused by unequal growth of the various parts of the skull. In a baby, the skull consists of several parts that slowly grow together as the baby gets older. Because one part grows faster than the other, skull abnormalities such as a flattened head can occur. This unequal growth can occur because the skull sutures close prematurely or due to the continuous pressure when lying on its back. The latter can occur if the child has a certain preferred position, for example, always turning its head to the left. This preferred position can already be present in the womb. Since the supine position has been actively recommended for newborn babies to prevent cot death, the number of children with a skull abnormality has increased, but the number of cases of cot death has decreased drastically.
Of the skull abnormalities caused by a preferred posture, approximately 75 percent recover spontaneously. The remaining 25 percent are eligible for physiotherapy and/or receive corrective helmet therapy or undergo surgery. If a skull abnormality has occurred due to premature closure of the cranial sutures, surgery is usually necessary. However, if the skull abnormality has occurred due to pressure loading, corrective helmet therapy can provide a solution.
There are three types of skull abnormalities that are all called flattened heads. Plagiocephaly, this is a lateral flattening of the back of the head, the ears are often crooked and the face is usually asymmetrical. Brachycephaly, in which the entire back of the head is flattened and the skull is wide. Scaphocephaly is also called a boat skull, the skull is long and narrow.
When a corrective helmet
If a child has a flattened head, it is usually waited until the fifth month of life to see if the flattening improves spontaneously, often in combination with pediatric physiotherapy and posture advice. If there is no clear improvement, a corrective helmet is prescribed. This happens to approximately 1700 to 2000 children per year. A condition for applying corrective helmet therapy is that the sutures are still open.
In the first 6 months, the skull increases in size by approximately 8.5 cm. This growth is so rapid that physiotherapy is often sufficient for treating a flattened head. The skull can easily correct itself. When the child is between 6 and 18 months old, the skull grows only 0.6 cm per month. Sufficient to correct the skull, but not enough to be able to do this on its own. This is the moment when corrective helmet therapy can be prescribed. It is important that corrective helmet therapy is started in the fifth to ninth month of life. If the child is older, it is assessed whether corrective helmet therapy is still useful. The skull often grows too slowly at that time to be easily corrected to a desirable result.
The principle
The redress helmet holds back those parts of the skull that have grown too quickly and thus slows down the growth of those parts. At the same time, the helmet gives space to the parts that have lagged behind in growth, allowing those parts to grow freely. As a result, the redress helmet provides a clear improvement in a flattened back of the head. If the forehead shows a deviation, some improvement is possible. The symmetry can also improve.
The Treatment and Procedure
Procedure: In general, when a flattened skull is found, the child health clinic doctor can refer the patient to a plastic surgeon, pediatrician or rehabilitation physician. This specialist will assess on the basis of a clinical examination (ultrasound or X-ray) whether corrective helmet therapy is indicated or useful. The patient will then be referred to an orthopedic instrument maker, who will then measure and produce the helmet. Before the measurement, the parents will be extensively informed about the treatment, the process and the use of the corrective helmet.
To measure: With a 3D scanner we measure the head in a few seconds, this scanner is not harmful. However, the scanner flashes, these flashes are 16 times per second which means that the scanner takes 16 photos per second. Because of the many photos, movement is not a problem, the software then sticks all the photos together after which a 3D model is generated.
Production: This 3D scan is processed in the computer, the corrections are made. Then a 3D model is generated and printed with a 3D printer a helmet is made, in the helmet a thick foam lining (plastazote) is placed. This foam layer is used to guide the growth process and any changes in the shape of the skull. To make it easy to put on the helmet there is an opening on one side with a closing strap. This helmet has a good tight fit, making a chin strap unnecessary.
The helmet is ready two weeks after fitting. The helmet can then be fitted and a few more adjustments are made. This generally takes about 45 minutes. After delivery of the helmet, a check-up appointment is made immediately. During the entire redress helmet period, the child will come for regular check-ups.
When a baby is diagnosed with Deformational Plagiocephaly, it is important to determine whether the baby would benefit from a corrective helmet.
So what is the Cephalic Index? The Cephalic Index, also called cranial ratio or cephalic ratio, is the measurement that will be used to categorize the shape of your baby's head.
The CI is the measured width of the head divided by the length of the head multiplied by 100 and expressed as a percentage.
Cephalic Index (CI) Scale
Normal: 75 – 90 mm
Soft: 91 – 93 mm
Moderate: 94 – 97 mm
Serious: >97 mm
Normocephaly or plagiocephaly = CI >76%-<90%
Brachycephaly = CI >90%
Scaphocephaly = CI <76%
Scale for measuring plagiocephaly
Normal head shape: 0 – 4 mm
Mild plagiocephaly: 5 – 9 mm
Moderate plagiocephaly: 10 – 15 mm
Severe plagiocephaly: >15 mm
Head symmetry is measured using cranial anthropometric landmarks, sliding or spreading calipers, and a head circumference tape. Head circumference is an important parameter; however, it is not an indicator of plagiocephaly, synostotic or nonsynostotic, because in both types the absolute head circumference can be normal despite the skull being deformed. Clinicians should consider screening for head shape, while head circumference is measured at every visit in a healthy child.
These numbers may seem confusing, but they have proven to be a great help in monitoring children with skull shape problems. If you would like help determining whether your child would benefit from a corrective helmet, please contact us at info@plagio.nl.
Plagio Center Netherlands
Hardwareweg 7
3821 BL Amersfoort
info@plagio.nl
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