Principle working of Skully Care:

The Skully Care app is a measuring tool for babies having a Plagio or/and Brachycephaly. The severity can vary from a mild asymmetric skull to very severely, a C-curve in the face with asymmetrical shape of the eyes, mouth, cheeks.

To explain the principle workings of Skully Care we show you the process the user goes through in the following steps.

Step 1: take a photo guided by the app.

For a correct measurement the image must contain a top view of the baby’s head. This photo needs to include both of the ears and the tip of the nose as anatomical landmarks. To include these landmarks we advise the user to take the picture with a distance of 60 cm between the head and the phone. And the contours of the head need to be clearly visible.

Sometimes the ears aren’t visible or the baby has too much hair. To solve this we have supplied you with a cap. This cap compresses his hear, so the contours are clearly visible and it pushes also the ear-tips slightly outward.


To make a correct photo you are guided by the app. The interactive guidance will help you step by step.


Step 2: processing the image:

After taking a correct photo the algorithm makes the calculation. 

A. On the contours of the head the following 3 points are located:

Figure 1: image with anatomical landmarks.

1: The contour of the head where the tip of the nose is located. (Figure 1, most upper point).

2: The position of the left ear on the contours of the head.
(Figure 1, left point).

3. The position of the right ear on the contours of the head.
(Figure 1, right point).

B. After the algorithm of Skully Care has detected the main landmarks it draws 4 lines. The relative length of these lines determines the asymmetry and/or flattening.

Figure 2: image with lines

  1. Ear-to-ear line: From the left ear to right ear.(Figure 2 the ‘horizontal’ line).

  2. Nose-Occiput (back of the head) line: From nose, crossing midpoint ear-ear line to back of the head. (Figure 2 the ‘vertical’ line).

  3. Diagonal 1: This line is constraint with the midpoint Nose-Occiput line and is placed under a 30 degrees angle compared to the Nose-Occiput line (clockwise). The line begins and stops at the contours of the head.

  4. Diagonal 2: Again the same steps of Diagonal 1 but now 30 degrees angle counter-clockwise.

Step 3: calculating results.

Skully Care calculates the severity by measuring the length of the lines and put these in an equations. These equations calculate the so called ‘CVAI’ and the ‘CI’. For further information about de CVAI and the CI take a further look in our library, the knowledge base.

Figure 3: length of lines are measured

1. The CVAI is calculated as follows:


Diagonal a: largest of diagonal 1 or diagonal 2.

Diagonal b: shortest of diagonal 1 or diagonal 2.

The diagonals are positioned at 30 degrees from the mid line.


2. The CI is calculated as follows:

Step 4: the results

The results are accessible in the app, shareable with the parents, and are able to export to your Electronic Medical Record

Step 5: treatment

You can add a treatment plan and filmed exercises to each baby. This is also shareable with the parents. They receive a free parents-version of the Skully Care app.








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