Helmet modification for soft-band bone-anchored hearing aid use during cranial orthosis.

INTRODUCTION Cranial orthosis is a commonly utilized treatment modality for moderate to severe deformational plagiocephaly that may also be used to assist in cranial vault molding following endoscopic craniosynostosis repair. Custom-fit helmets are typically worn for 23 hours a day for a treatment duration of several months. Many children with plagiocephaly or craniosynostosis also suffer from some degree of hearing loss. For those infants who require amplification, conventional hearing aids are not an option so long as the cranial molding helmet remains in place unless the helmet can be modified. Use of a softband bone-anchored hearing aid (baha) is also prohibitive given the design of most cranial orthosis helmets. We describe a case of a child with deformational plagiocephaly and mixed hearing loss who required both cranial orthosis and baha amplification. A standard orthosis helmet was modified to allow for both effective cranial vault molding and optimal positioning of a soft-band baha. Within this report we explain the minimal alterations necessary to allow for effective aural rehabilitation during a therapeutic course of cranial orthosis.