The 2006 Children’s Healthcare of Atlanta (CHOA) publication was among the first to describe the clinical reliability and value of STARscanner^® measurements. Five cranial measurements were identified as significant clinical variables in the classification of head shape severity:

• Asymmetry
  • Posterior Symmetry Ratio (PSR)
  • Overall Symmetry Ratio (OSR)
  • Cranial Vault Asymmetry Index (CVAI)
  • Radial Symmetry Index (RSI)
• Disproportion 
  
  • Cephalic Index (CI) (*CI is only useful for brachycephalic head shapes)

“The ratios or indices found to be the best predictors in plagiocephaly (i.e., CVAI, RSI, PSR, and OSR) are useful to clinicians because they provide an accurate, reproducible comparison of one subject to another regardless of age or head circumference” when using the anatomical landmarks for the CCU reference plane."

 

Plank LH, Giavedoni B et al. Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 2006 Nov; 17(6): 1084-91.

 

In 2017, the CHOA Plagiocephaly Severity Scale originally established by Plank in 2006 was additionally validated and supported. 

 

“The CHOA severity scale provides an efficient and reproducible method for the clinical team to evaluate plagiocephaly in an infant both observationally and quantitatively and to provide a treatment plan in a less biased manner that is based on outcomes.” 

 

Holowka MA, Reisner A et al. Plagiocephaly Severity Scale to Aid in Clinical Treatment Recommendations. J Craniofac Surg. 2017 May;28(3):717-722.

Earlier this year, we announced Parts 1-3 of a five-part heads up! memo series focusing on 2D and 3D assessments. We are pleased to announce that Part 4: Focus on the CVAI, PSR, OSR, and RSI is NOW available!

 

Please contact us at STARband@orthomerica.com to request this new release. You may also request Parts 1-3 if you need them again. 

Linear measurements are most commonly referenced by specialists and payers regardless of available scanning technology. However, the CVA and CI used in identifying the severity of abnormal head shapes often do not fully capture the areas of concern or the correction obtained with CRO treatment. When accurately identifying landmarks and aligning patient head shapes with either the STARscanner or SmartSoc software, additional linear and volume data are available to classify cranial deformation, monitor 3D changes, and document treatment outcomes.

 

Part 4 of the 2D and 3D Assessment series includes a desk reference to the Significant STARscanner and SmartSoc Variables for Deformational Plagiocephaly which is available on STARbandkids.com. This chart is an important clinical reference to assist in the evaluation of both 2D and 3D measurements associated with infant skull deformities.

Download Chart

One valuable application of the additional data provided by the STARscanner and SmartSoc systems is assessing and documenting synostotic head shapes. The CVA and CI do not accurately represent the severity and correction at higher levels of the cranial vault, commonly involved with post-operative CRO treatment. Volume and quadrant measurements are likely to be more valuable in assessing changes with orthotic treatment.

 

Orthotic treatment for patients after surgery for craniosynostosis is its own specialty within a cranial remolding program. This patient population tends to be younger at the beginning of CRO treatment than the average age of patients for deformational head shapes. Post-op treatment can often last months longer and possibly require multiple bands depending on the suture involvement, surgical technique, and treatment goals.

 

If you are new to post-operative CRO treatment, take advantage of two web-meeting recordings introducing treatment considerations, head shapes related to suture involvement, band designs and modification options.

 

Included in this link you will find the recordings for Introduction to Post-Op CRO Treatment and Post-Op Cranial Remolding Treatment: Standard Modifications and Bands Designs.

(877) 737-8444 • starband@orthomerica.com