Patent Publication Number: US-2020289325-A1

Title: Medical Headgear

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation-in-part of U.S. patent application Ser. No. 15/881,111, filed on Jan. 26, 2018, which is a continuation-in-part of U.S. patent application Ser. No. 14/626,325, filed on Feb. 19, 2015. 
    
    
     FIELD OF THE INVENTION 
     The invention generally relates to headgear, and more specifically to a medical headgear. 
     BACKGROUND 
     Approximately twelve percent of newborns are born preterm in the U.S. These preterm newborns frequently require long, expensive, and stressful hospital stays in neonatal intensive care units (NICUs), and present a number of unique challenges. Studies have shown that the total brain weight achieved at 34 weeks can be as little as  65 % of that of a full term newborn, with the remaining brain development occurring outside the protection of the utero environment. Further studies have shown that preterm newborns exhibit decreased cerebral cortex volume and cerebellar growth when compared to their full term counterparts, frequently emerging from NICUs having developmental and neurosensory deficits. 
     Advances in preterm newborn developmental research suggest that the loud, atypical acoustic environments characteristic of NICUs may contribute to the decreased cerebral cortex volume and cerebellar growth, resulting in negative outcomes involving hearing, growth, and ultimately, cognition. Exposure of preterm newborns to environmental stimuli that do not correspond to the normal in-utero acoustic environment induces stress, which negatively impacts sleep, growth, and sensory development processes. The negative impact is thought to disrupt and alter normal brain development in response to the external environmental stimuli. 
     Generally, a mother&#39;s body and amniotic fluid surround a developing fetus, providing a natural acoustic filter, with sound attenuation increasing as a function of frequency. The gravid uterus plus amniotic fluid provides negligible sound attenuation of frequencies less than about 300 Hz, then sound attenuation increases monotonically up to 15-20 decibels (dB) at about 2,000 Hz. Above 2,000 Hz, the gravid uterus effectively blocks sound, i.e. attenuation is 15-20 dB or greater. 
     Attempts have been made to adapt NICUs to reduce the environmental noise levels, including the installation of low-noise incubation equipment and sound-absorbing materials in floors, walls, and ceilings. Other attempts include the use of single-bed NICU rooms to allow better control of the environmental noise levels. While these approaches do reduce some environmental noise, they are only marginally effective, and are often cost prohibitive for many institutions. 
     Further attempts to reduce environmental noise include the use of foam earcups that are placed over the ears of a preterm newborn, and attached through the use of an adhesive. While the foam earcups do provide limited sound attenuation, the filtered sound profile does not correspond to the normal in-utero acoustic environment. As a result, the effectiveness of the foam earcups is extremely limited. 
     Another unique challenge with preterm newborns is that their skin and facial features are very delicate and extremely susceptible to damage, such as tearing or pressure necrosis. This presents several problems for implementation of devices to support development. 
     Firstly, the foam earcups rely on a hydrogel adhesive to bond the earcup to the skin to form an acoustic seal. The hydrogel adhesive is very sensitive to conditions of application. If the foam ear cup is very lightly positioned, in order to prevent damage to the skin, the adhesive bond is very weak, and the bond between the earcups and the skin of the preterm newborn fails within a few hours. In other instances, the adhesive bond to the skin is too strong, and extreme care must be taken when peeling the bonded earcup away from the skin to remove the foam earcup. Often, the removal process results in damage to the skin, such as tearing or irritation. 
     Secondly, the underdeveloped lungs in preterm newborns frequently require respiratory support in the form of conventional mechanical ventilation, high frequency ventilation, or continuous positive airway pressure (CPAP) delivered through respiratory support tubes positioned in the oral cavity or nose by a nasal cannula. While there are many conventional respiratory support tube attachment devices available for full-term newborns and adults, these devices are not suited for the delicate skin or nasal septum of preterm newborns. Consequently, the respiratory support tubes are commonly attached to fabric caps by safety pins and rubber bands, or directly to the skin of the preterm newborn by medical tape. Extreme care must be taken during removal of the medical tape, to avoid injury to the preterm newborn. 
     Consequently, there is a strong need for a medical headgear that is suitable for use on preterm newborns, which reduces environmental noise to in-utero acoustic levels, and provides a stable support for attaching respiratory support tubes and other medical devices. 
     SUMMARY 
     An earcup for a medical headgear includes a body and a gasket attached to the body and formed of an open-cell foam. The earcup with the body and the gasket is a frequency-dependent auditory filter providing sound attenuation generally increasing as a function of frequency. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention will now be described by way of example with reference to the accompanying figures, of which: 
         FIG. 1  is a front perspective view of a rear-closing medical headgear installed on a head of a preterm newborn; 
         FIG. 2  is a rear perspective view of a rear-closing medical headgear; 
         FIG. 3  is a front perspective view of a front-closing medical headgear installed on a head of a preterm newborn; 
         FIG. 4  is a rear perspective view of a front-closing medical headgear; 
         FIG. 5  is a perspective view of an outer facing side of a rear-closing medical headgear; 
         FIG. 6  is a perspective view of an inner facing side of the rear-closing medical headgear; 
         FIG. 7  is a perspective view of an outer facing side of a front-closing medical headgear; 
         FIG. 8  is a perspective view of an inner facing side of the front-closing medical headgear; 
         FIG. 9  is a perspective view of a left side of the rear-closing medical headgear positioned on the head of the preterm newborn, and having an earcup; 
         FIG. 10  is an oblique perspective view of an outer surface of the earcup; 
         FIG. 11  is a cross-sectional view of the earcup along an A-A line of  FIG. 10 ; 
         FIG. 12  is an oblique perspective view of an inner surface of the earcup; 
         FIG. 13  is a lower oblique perspective view of the earcup having a first outer retaining flange; 
         FIG. 14  is an upper oblique perspective view of the earcup in  FIG. 13 ; 
         FIG. 15  is a lower oblique perspective view of the earcup having a second outer retaining flange; 
         FIG. 16  is an upper oblique perspective view of the earcup in  FIG. 15 ; 
         FIG. 17  is a perspective view of an outer facing side of a rear-closing medical headgear; 
         FIG. 18  is a plan view of an inner facing side of a front-closing medical headgear; 
         FIG. 19  is a plan view of an outer facing side of the front-closing medical headgear of  FIG. 18 ; 
         FIG. 20  is a sectional view of the front-closing medical headgear of  FIG. 18 ; 
         FIG. 21  is a side view of the front-closing medical headgear of  FIG. 18  positioned on the head of a newborn; 
         FIG. 22  is a perspective view of an earcup; 
         FIG. 23  is a plan view of an overhead strap; 
         FIG. 24  is a perspective view of the front-closing medical headgear of  FIG. 18 ; positioned on the head of a newborn with the overhead strap of  FIG. 23 ; 
         FIG. 25  is a sectional view of an overhead strap; 
         FIG. 26  is a plan view of an overhead strap; 
         FIG. 27  is a perspective view of the front-closing medical headgear of  FIG. 18  positioned on the head of a newborn with the overhead strap of  FIG. 26 ; 
         FIG. 28  is a plan view of an inner facing side of a front-closing medical headgear in a separated state; 
         FIG. 29  is a plan view of an outer facing side of the front-closing medical headgear of  FIG. 28  in the separated state; 
         FIG. 30  is a plan view of the outer facing side of the front-closing medical headgear of  FIG. 28  in an attached state; 
         FIG. 31  is a graph of a sound attenuation of the earcup with a gasket according to an embodiment in a one-third octave band; 
         FIG. 32  is a graph of a sound attenuation of the earcup with a gasket according to another embodiment in a one-third octave band; 
         FIG. 33  is a perspective view of an earcup according to another embodiment; 
         FIG. 34  is a side view of the earcup of  FIG. 33 ; 
         FIG. 35  is a perspective view of an earcup according to another embodiment; 
         FIG. 36  is a side view of the earcup of  FIG. 35 ; 
         FIG. 37  is a plan view of an outer facing side of a front-closing medical headgear according to another embodiment in a state with the earcups removed; and 
         FIG. 38  is a plan view of the outer facing side of the front-closing medical headgear of  FIG. 37  in a state with the earcups held in the earcup receiving spaces. 
     
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENT(S) 
     In the embodiments of  FIGS. 1-17 , a medical headgear  1  has a flexible band  100 , a pair of earcups  200 , and a plurality of medical device fasteners  300 . 
     The flexible band  100  is elongated, extending along a longitudinal axis, having an outer surface  101   a  and an inner surface  101   b . The flexible band  100  includes a non-stretch central portion  110 , a first elastic portion  120 , a second elastic portion  130 , a first non-stretch terminating end portion  140 , and a second non-stretch terminating end portion  150 . 
     In an embodiment, the flexible band  100  is formed from a continuous length of a single layer of material of a suitable biocompatible natural or synthetic elastic material, such as neoprene rubber, styrene-butadiene rubber, neoprene-styrene-butadiene composite rubber, polyurethane, nylon, spandex, nylon-spandex blend, polyesters, polyamides, cotton-spandex blend, or a combination thereof. In an embodiment, the flexible band  100  is formed from a continuous length of two or more layers of elastic band materials having a core comprising neoprene rubber, styrene-butadiene rubber, neoprene-styrene-butadiene composite rubber, or polyurethane, with a layer of nylon or nylon-spandex laminated onto the outer surface  101   a , the inner surface  101   b , or both surfaces  101   a , 101   b . In an embodiment, the core has a thickness of  1 . 5  to  3 . 0  mm and the flexible band  100  has a total thickness of  2 . 0  mm to  3 . 5  mm, and in a further embodiment, the flexible band  100  has a total thickness of  2 . 0  mm to  3 . 0  mm. In various embodiments, the flexible band  100  may be formed from the continuous length of the elastic band material with one laminated layer on each surface  101   a ,  101   b  by die cutting, scissors, laser- cutting, or other types of cutting known to those with ordinary skill in the art. 
     In an embodiment, non-stretch portions of the flexible band  100  are formed from woven fabrics that impart the non-stretch physical characteristic. In an embodiment, the stretch or elastic portions of the flexible band  100  are formed from non-woven fabrics, knitted fabrics, or woven fabrics containing spandex that individually or when combined with a suitable core material impart the stretch or elastic physical characteristic. 
     In an embodiment, the flexible band  100  is made from a plurality of fabric segments mechanically fastened together through common methods such as stitching or adhesive. For example, the non-stretch central portion  110  and the first and second non-stretch terminating end portions  140 , 150  may be formed from a first non-stretch material, and the first and second elastic portions  120 , 130  may be formed from an elastic material. 
     The non-stretch central portion  110  has a first end (not labeled) and an opposite second end (not labeled). A first friction pad  111   a  positioned on the inner surface  101   b , between the first and second ends. The first friction pad  111   a  is formed from a grip or tacky material, such as silicone or urethane. In an embodiment, the first friction pad  111   a  is mechanically or chemically attached to the inner surface  101   b  by an adhesive or stitching. 
     In an embodiment, the first friction pad  111   a  is formed from a thin, generally rectangular sheet of silicone rubber. In another embodiment, the first friction pad  111   a  includes a single longitudinal stripe, multiple longitudinal or vertical stripes, dots, or other patterns, formed by known painting, printing, or spray processes, which chemically or mechanically adheres the first friction pad  111   a  to the inner surface  101   b . In the embodiment in which the first friction pad  111   a  is formed from the grip or tacky material applied to the inner surface  101   b  by painting, printing, or spraying, the grip or tacky material infiltrates the inner surface  101   b  of the central portion  110 . The grip or tacky material solidifies and cures at least partially within the central portion  110  of the flexible band  100  by exposure to air, heat, or the addition of a separate catalyst. In an embodiment in which the grip or tacky material is silicone, the silicone is cured by condensation curing in the presence of ambient humidity or by addition curing in the presence of a catalyst; either curing may further include the application of heat. The solidified grip or tacky material imparts non-stretch characteristics to the central portion  110 . 
     In an embodiment of  FIG. 6 , a first non-stretch pad  112   a  is optionally positioned on the inner surface  101   b  of the non-stretch central portion  110 . The first non-stretch pad  112   a  is formed from a non-stretch material such as microfiber, or other woven fabrics, which may impart the non-stretch physical property to the non-stretch central portion  110 . The first non-stretch pad  112   a  may be mechanically or chemically attached to the inner surface  101   b  by stitching or an adhesive. 
     In an embodiment, the first friction pad  111   a  is positioned on an outer surface of the first non-stretch pad  112   a.    
     In an embodiment of  FIG. 6 , a length of the non-stretch central portion  110  is proportional to a length of the first friction pad  111   a  and/or first non-stretch pad  112   a , such that increasing the length of the first friction pad  111   a  and/or the first non-stretch pad  112   a  increases the length of the non-stretch central portion  110 . Conversely, decreasing the length of the first friction pad  111   a  and/or the first non-stretch pad  112   a  decreases the length of the non-stretch central portion  110 . In another embodiment, the non-stretching physical properties and length of the central portion  110  are controlled through at least one or more rows of longitudinally extending stitching (not shown), which prevent elastic stretching along the longitudinal axis. In another embodiment, the non-stretching central portion  110  is formed from the first non-stretch material. 
     In another embodiment, the central portion  110  is made of an elastic material, and therefore stretches under an applied circumferential tensile force across the band. Optionally, the first pad  112   a  may also be formed from an elastic material, allowing the central portion  110  to maintain elasticity in the presence of the first pad  112   a.    
     The first elastic portion  120  has a terminating end connecting side, and an opposite central portion connecting side extending continuously from the first side of the non-stretch central portion  110  along the longitudinal axis. In an embodiment, when the first elastic portion  120  is formed from the elastic material and the non-stretch central portion  110  is formed from the first non-stretch material, the central portion connecting side of the first elastic portion  120  is mechanically connected to the first side of the non-stretch central portion  110  through an adhesive or stitching. 
     In an embodiment, the first elastic portion  120  is bifurcated, having a first earcup receiving space  121  positioned along an approximate middle section, an upper strap  122 , and a corresponding lower strap  123 . The first earcup receiving space  121  is defined by the upper strap  122  and the lower strap  123 , having an elastically expandable first diameter. In an embodiment, the first earcup receiving space  121  is a slit extending for a distance along the longitudinal axis and passing through the band  100 , and positioned between the upper strap  122  and lower strap  123 . In an embodiment, a width of the upper strap  122  and a width of the lower strap  123  are equal. In another embodiment, the widths of the upper strap  122  and lower strap  123  are different. In another embodiment each strap  122 , 123  displays a unique elastic tension between the straps  122 , 123 . 
     In an embodiment, the material of one or both of the straps  122 , 123  is gathered along a substantial mid-portion through a series of stitches (not shown), such that the elastic tension exerted by the straps  122 , 123  is controlled by the pattern, tightness, and length of stitching of the gathered material. For example, the use of a straight stitching pattern reduces the elastic tension, whereas a zig-zag stitching pattern can maintain the inherent elasticity of the flexible band  100  material. Additionally, the gathered material increases the unexpanded first diameter. Further, the gathered material may assist in retaining the earcups within the first receiving space  121 . 
     In an embodiment, the second elastic portion  130  is complementary and substantially similar to the first elastic portion  120 . The second elastic portion  130  has a terminating end connecting side, and a central portion connecting side extending continuously from the second side of the non-stretch central portion  110  along the longitudinal axis. Similar to the first elastic portion  130 , in an embodiment, when the second elastic portion  130  is formed from the elastic material and the non-stretch central portion  110  is formed from the first non-stretch material, the central portion connecting side of the second elastic portion  130  is mechanically connected to the second side of the non-stretch central portion  110  through an adhesive or stitching. 
     The second elastic portion  130  is bifurcated, having a second earcup receiving space  131  positioned along an approximate middle section, an upper strap  132 , and a corresponding lower strap  133 . The second earcup receiving space  131  is defined by the upper strap  132  and the lower strap  133 , having an expandable second diameter. In an embodiment, the second earcup receiving space  131  is a slit extending for a distance along the longitudinal axis and passing through the band  100 , and positioned between the upper strap  132  and lower strap  133 . 
     In an embodiment, a width of the upper strap  132  and a width of the lower strap  133  are equal. In another embodiment, the widths of the upper strap  132  and lower strap  133  are different. In another embodiment, each strap  132 , 133  displays a unique elastic tension between the straps  132 , 133 . 
     In an embodiment, the material of one or both of the straps  132 , 133  is gathered along a substantial mid-portion through a series of stitches (not shown), such that the elastic tension exerted by the straps  132 , 133  is controlled by the pattern, tightness, and length of stitching of the gathered material. For example, the use of a straight stitching pattern reduces the elastic tension, whereas a zig-zag stitching pattern can maintain the inherent elasticity of the flexible band  100  material. Additionally, the gathered material increases the unexpanded second diameter. Further, the gathered material may assist in retaining the earcups within the second receiving space  131 . 
     In an embodiment of  FIG. 17 , the first elastic portion  120  and second elastic portion  130  extend continuously as unbifurcated portions of fabric from the first side and second side of the central non-stretch portion  110  such that the portions  120 , 130  may completely cover and retain the earcup  200  (discussed in detail below). In an embodiment, the elastic tension of the first and second elastic portions  120 , 130  may be controlled by longitudinally extending stitching. Similar to the above-discussed bifurcated embodiments, the elastic tension may be controlled by the pattern, tightness, and length of the longitudinally extending stitching. For example, the use of a straight stitching pattern reduces the elastic tension, whereas a zig-zag stitching pattern can maintain the inherent elasticity of the flexible band  100  material. 
     In the embodiments of  FIGS. 2-8 , the first non-stretch terminating end portion  140  has an elastic portion connecting side extending continuously from the terminating end connecting side of the first elastic portion  120 , and an opposite terminating end. The first non-stretch terminating end portion  140  includes a first fastener  141  positioned on the inner surface  101   b . In another embodiment (not shown), the first fastener  141  is positioned on the outer surface  101   a . When the first fastener  141  is positioned on the outer surface  101   a , a friction pad (not shown) substantially similar to the first friction pad  111   a , may also positioned on the inner surface  101   b  of the first non-stretch terminating end portion  140 . 
     Attachment of the first fastener  141  imparts the non-stretching physical property to the first terminating end portion  140 . A length of the first non-stretch terminating end portion  140  is proportional to a length of the first fastener  141 , such that increasing the length of the first fastener  141  increases the length of the first non-stretch terminating end portion  140 . Conversely, decreasing the length of the first fastener  141  decreases the length of the first non-stretch terminating end portion  140 . Additionally, when the friction pad is positioned on the inner surface  101   b , the non-stretching physical property is further enhanced. 
     In an embodiment, when the first non-stretch terminating end portion  140  is formed from a non-stretch material, the non-stretch material imparts the non-stretching physical property. In an embodiment, the first fastener  141  is a hook and loop style fastener, such as a low-profile hook and loop style fastener, although one of ordinary skill in the art would appreciate that other common fasteners may be used. 
     In an embodiment, the first terminating end portion  140  is elastic, being formed from an elastic material similar to, or the same as, the elastic material forming the first elastic portion  120 . In this embodiment, the first fastener  141  may also be elastic, such as a stretchable hook and loop style fastener. 
     In another embodiment, a first part of the first terminating end portion  140  is elastic, and a second part of the first terminating end portion  140  is non-stretch. The non-stretch second part may be non-stretch through the use of a non-stretch material, or controlled through the addition of the medical device fastener  300  on the outer surface  101   a  of the band  100 , along the second part of the first terminating end portion  140 . 
     In the embodiments of  FIGS. 2-8 , the second non-stretch terminating end portion  150  has an elastic portion connecting side extending continuously from the terminating end connecting side of the second elastic portion  130 , and an opposite terminating end. In an embodiment, the second non-stretch terminating end portion  150  includes the second fastener  151  positioned on the outer surface  101   a . When the second fastener  151  is positioned on the outer surface  101   a , a second friction pad  111   b , that may be optionally attached to a second non- stretch pad  112   b , may be positioned on the inner surface  101   b  of the second non-stretch terminating end portion  150 . In another embodiment (not shown), the second fastener  151  is positioned on the inner surface  101   b . Similar to the above-discussed embodiments of the first non-stretch terminating end portion  140 , attachment of the second fastener  151  imparts the non- stretching physical property to the second terminating end portion  150 . A length of the second non-stretch terminating end portion  150  is proportional to a length of the second fastener  151 , such that increasing the length of the second fastener  151  increases the length of the second non- stretch terminating end portion  150 . Conversely, decreasing the length of the second fastener  151  also decreases the length of the second non-stretch terminating end portion  150 . Additionally, when the second friction pad  111   b  is positioned on the inner surface  101   b , the non-stretching physical property is further enhanced. 
     In an embodiment, when the second non-stretch terminating end portion  150  is formed from a non-stretch material, the non-stretch material imparts the non-stretching physical property. 
     In an embodiment, the second fastener  151  is a hook and loop style fastener complementary to the first fastener  141 , although one of ordinary skill in the art would appreciate that other common fasteners may be used, so long as the first and second fasteners  141 , 151  are complementary. 
     In an embodiment, the second terminating end portion  150  is elastic, being formed from an elastic material similar to, or the same as, the elastic material forming the second elastic portion  130 . In this embodiment, the first fastener  141  may also be elastic, such as a stretch hook and loop style fastener. 
     In another embodiment, a first part of the second terminating end portion  150  is elastic, and a second part of the second terminating end portion  150  is non-stretch. The non-stretch second part may be non-stretch through the use of a non-stretch material, or controlled through the addition of the medical device fastener  300  on the outer surface  101   a  of the band  100 , along the second part of the second terminating end portion  150 . 
     In an embodiment, the first fastener  141  is positioned on a surface opposite to that of the second fastener  151 . For example, when the first fastener  141  is positioned on the inner surface  101   b , the second fastener  151  is positioned on the outer surface  101   a . Conversely, when the first fastener  141  is positioned on the outer surface  101   b , the second fastener  151  is positioned on the inner surface  101   a.    
     In an embodiment, the flexible band  100  extends linearly along the longitudinal axis. In another embodiment, the first and second non-stretch terminating end portions  140 , 150  extend along the longitudinal axis. The non-stretch central portion  110  and first and second elastic portions  120 , 130  taken together form an arcuate bend extending a distance from the longitudinal axis at an approximate mid-point. 
     The earcup  200  is a frequency-dependent auditory filter providing sound attenuation generally increasing as a function of frequency, with limited attenuation in the in-utero auditory range. In an embodiment, earcup  200  is a frequency-dependent auditory filter providing sound attenuation that approximates the sound attenuation characteristics of a mother&#39;s gravid uterus and abdominal cavity. In an embodiment, each earcup  200  provides at least 12 A-weighted decibels (dBA) of sound attenuation of pink noise. In another embodiment, each earcup  200  provides at least 15 dBA of sound attenuation of pink noise. In another embodiment, each earcup  200  provides at least 20 dBA of sound attenuation of pink noise. 
     In an embodiment, each earcup  200  provides at least an 8 decibel (dB) noise reduction rating (NRR) or more. In an embodiment, each earcup  200  provides an 8-12 dB NRR. In another embodiment, each earcup  200  provides a 9-11 dB NRR. In an embodiment, each earcup  200  provides at least a 10 dB NRR or more. 
     In an embodiment, each earcup  200  allows sound frequencies of 300 Hz or less to pass with attenuation less than 10 dB (SPL). In an embodiment, each earcup  200  allows sound frequencies of 400 Hz or less to pass with attenuation less than 10 dB (SPL). In another embodiment, each earcup  200  allows sound frequencies of 500 Hz or less to pass with attenuation less than 10 dB (SPL). In an embodiment, each earcup  200  is a frequency-dependent auditory filter attenuating sounds between 300-500 Hz. In another embodiment, each earcup  200  is a frequency-dependent auditory filter substantially blocking sounds above 2000 Hz. In an embodiment, “substantially blocking” is understood to be at least 98% (17 dB) or more. In another embodiment, “substantially blocking” is understood to be at least 99% (20 dB) or more. 
     In an embodiment of  FIGS. 10 and 11 , the earcup  200  includes a base  210 , a sidewall  220 , an ear receiving space  230 , a flange  240 , and a gasket  250 . In an embodiment, the base  210 , the sidewall  220 , and the flange  240  are referred to as a body of the earcup  200 . The earcups  200  are made of a dense polymer, such as polycarbonate, acrylic, ABS, epoxy resin, polyurethane, and silicone, although one of ordinary skill in the art would appreciate that other dense plastics, and sound attenuating materials may also be used. The base  210  is substantially planar, having a general circular or oval-shape and an outer circumferential peripheral edge. In an embodiment, the base  210  is contoured, having a generally convex surface extending outward from the peripheral edge. 
     In an embodiment, the earcup  200  is optically transparent, enabling areas in and around the ear to be easily examined for evidence of skin breakdown or superficial edema as indicated by a change in color, swelling, bleeding or exudates, without removal of the earcup. In an embodiment, the earcup  200  is optically translucent. In an embodiment, the earcup  200  is optically opaque. 
     In an embodiment, the base  210  has a thickness of approximately 0.03 inch (0.8 mm) to 0.13 inch (3.2 mm) thick. In another embodiment, the base  210  has a thickness of approximately 0.03 inch (0.8 mm) to 0.08 inch (2.03 mm). In another embodiment, the base  210  has a thickness of approximately 0.06 inch (1.6 mm) .The sidewall  220  extends approximately orthogonally from the base  210 , having a first sidewall edge  210   a  continuously connected along the length of the peripheral edge of the base  210 , and an opposite second sidewall edge  210   b . In an embodiment, the first sidewall edge  210   a  extends approximately in the same plane as the base  210 . In an embodiment, the second sidewall edge  210   b  is contoured, having a cross-sectional half having a peak on each opposing end and valley disposed therebetween, as seen in the embodiment of  FIG. 11 . 
     Taken together, the base  210  and the continuous sidewall  220  form the ear receiving space  230 . One of ordinary skill in the art would appreciate that the dimensions of the base  210  and sidewall  220  may be varied to increase or decrease a volume of the ear receiving space  230 . 
     The flange  240  extends radially from a second sidewall edge, having an inner flange contact surface  240   b  extending orthogonally outward from the second sidewall edge, and an opposite outer flange surface  240   a . As seen in the embodiment of  FIG. 11 , the inner flange contact surface  240   b  is contoured and complementary to that of the second sidewall edge  210   b , having a cross-sectional half with a peak on each opposing end and a valley disposed therebetween. The contoured surface of the flange  240  is complementary to the natural curvature of a head of the newborn, allowing a flange contact surface (not labeled) to form a continuous seal along an entire circumference of the flange  240 . 
     In the embodiments of  FIGS. 9 and 10 , a longitudinal axis A extends lengthwise along the earcup  200 . A headgear circumferential axis C corresponds to a longitudinal axis of the medical headgear  1  when the earcup  200  is positioned in the earcup receiving space  121 , 131 . A contoured axis B extends substantially orthogonal to the circumferential axis C. The first sidewall edge  210   a  and/or the inner flange contact surface  240   b  are generally contoured along opposite edges of the earcup  200  intersecting with the contoured axis B. The contoured first sidewall edge  210   a  and/or inner flange contact surface  240   b  have a shape complimentary to the contoured shape of the head of a newborn. In an embodiment, the first sidewall edge  210   a  and/or inner flange contact surface  240   b  of the earcup  200  is asymmetrical along the longitudinal axis A. 
     In an embodiment of  FIG. 2 , the earcup  200  is a left-sided earcup  200   a  having a contoured first sidewall edge  210   a  and/or inner flange contact surface  240   b  complimentary to the contoured shape of the head of a newborn surrounding the left ear of the newborn. In an embodiment of  FIG. 2 , the earcup  200  is a right-sided earcup  200   b  having a contoured first sidewall edge  210   a  and/or inner flange contact surface  240   b  complimentary to the contoured shape of the head of a newborn surrounding the right ear of the newborn. The left-sided earcup  200   a  is a non-superimposable mirror image of the right-sided earcup  200   b , such that the earcups  200   a ,  200   b  are chiral with respect to each other. 
     In the embodiments of  FIGS. 13 and 14 , the earcup  200  further includes a first retaining flange  260   a  disposed continuously and circumferentially on the continuous sidewall  220 , between the base  210  and the flange  240 . The first retaining flange  260   a  radially extends outward from the outer surface of the continuous sidewall  200 . Taken together, the first retaining flange  260   a , the continuous sidewall  200 , and the flange  240  form a circumferentially extending band receiving space  261 . 
     In the embodiments of  FIGS. 15 and 16 , the earcup  200  further includes a second retaining flange  260   b  disposed continuously and circumferentially on the substantially planar base  210 . The second retaining flange  260   b  radially extends outward from the peripheral edge of the base  210 , in approximately the same plane as the surface of the base  210 . Taken together, the second retaining flange  260   b , the continuous sidewall  200 , and the flange  240  form the circumferentially extending band receiving space  261 . The gasket  250  is positioned on the flange contact surface of the flange  240 , extending continuously along the circumference of the flange contact surface. In an embodiment, the gasket  250  is connected to the flange  240  through an adhesive. The gasket  250  may be made of open or closed-cell foam, such as open-cell urethane foam, or silicone foam. In an embodiment, the gasket  250  is made of an open-cell foam that is breathable, whereby moisture may be able to pass therebetween. 
     In an embodiment, the gasket  250  has a thickness of 1-6 mm. In an embodiment, the gasket  250  has a thickness of 1-4 mm. In an embodiment, the gasket  250  has a thickness of 2-4 mm. In another embodiment, the gasket  250  has a thickness of 3-6 mm. In another embodiment, the gasket  250  has a thickness of 9 mm. In an embodiment, the gasket  250  has a compression force range for 25% deflection of 0.25-8 psi. In another embodiment, the gasket  250  has a compression force range for 25% deflection of 0.3-3.5 psi. 
     In an embodiment, when the earcup  200  is made from a flexible material such as silicone rubber, the use of the gasket  250  is optional. When the earcup  200  is used in the absence of the gasket  250 , the flange  240  is optionally flexible, allowing the flange  240  to resiliently conform to the contours of a user&#39;s head. 
     In the embodiments of  FIGS. 1-8 , the plurality of medical device fasteners  300  are positioned on the outer surface  101   a  of the band  100 . In an embodiment, one, two, three, four, or more medical device fasteners  300  are positioned on the outer surface  101   a.    
     In the rear-closing embodiments la of  FIGS. 1 and 5 , a pair of medical device fasteners  300  is positioned on the outer surface  101   a  of the non-stretch central portion  110 , with one medical device fastener  300  positioned proximate to the first side, and one medical device fastener  300  positioned proximate to the second side. In another rear-closing embodiment 1a, a third medical device fastener  300  is positioned on an approximate mid-portion of the non-stretch central portion  110 . 
     In the front-closing embodiments lb of  FIGS. 3 and 7 , the pair of medical device fasteners  300  is positioned on the outer surface  101   a  of the non-stretch terminating end portions  140 , 150 . Specifically, one medical device fastener  300  is positioned proximate to the elastic portion connecting side of the first terminating end portion  140 , and one medical device fastener  300  is positioned proximate to the elastic portion connecting side of the second terminating end portion  150 . In another front-closing embodiment  1   b , a third medical device fastener  300  is positioned on an approximate mid-portion of the outer surface  101   b  of the first or second terminating end portions  140 . 
     In an embodiment, a removable eyeshade (not shown) may be connected to the band  100  to modify or control the visual environment of a user newborn. The eyeshade may be connected by a hook and loop fastener or any other suitable fastening mechanism known to those of ordinary skill in the art. In an embodiment, the eyeshade is substantially similar to the removable eyeshade described in U.S. Pat. No. 7,878,968 issued to Wittmann-Price et al., with col. 3, lines 52-67 through col. 4, lines 1-8 incorporated herein by reference. 
     Assembly of the major components and the operation of the medical headgear  1  will now be described. 
     Each earcup  200  is positioned in the first and second earcup receiving spaces  121 , 131  by inserting the base  210  and the sidewall  220  through the earcup receiving spaces  121 , 131  from the inner surface  101   b  towards the outer surface  101   a  of the band  100 . As the earcup  200  is positioned in the first earcup receiving space  121 , the upper strap  122  and lower strap  123  are elastically displaced, exerting opposing elastic forces against the sidewall  220  to secure the earcup  200  in the first earcup receiving space  121 . Similarly, the earcup  200  is positioned in the second earcup receiving space  131 . 
     In the embodiments of  FIGS. 13-17 , when the earcup  200  is positioned in the first or second earcup receiving spaces  121 , 131  a portion of the upper straps  122 , 132  and lower straps  123 , 133  defining the first and second earcup receiving spaces  121 , 131  are received in the band receiving space  261 . 
     When the earcup  200  is positioned in the earcup receiving spaces  121 , 131 , the outer flange surface  240   a  contacts the inner surface  101   b  of the band  100 , preventing the earcup  200  from being displaced out of an outer surface side of the earcup receiving spaces  121 , 131  when an outward force is applied to the earcup  200 . 
     In the embodiment of  FIG. 17 , where the first elastic portion  120  and second elastic portion  130  extend continuously as unbifurcated portions of fabric, the outer surface of the ear cup  200  base  210  is positioned against the inner surface  101   b  of the first or second elastic portions  120 , 130 . When an inward force is applied by the band  100 , the outer surface of the base  210  contacts the inner surface  101   b , preventing the earcup  200  from being displaced when an outward force is applied to the earcup  200 . 
     In the rear-closing embodiments la of  FIGS. 1, 2, 5, and 6 , the inner surface  101   b  and first friction pad  111   a  of the non-stretch central portion  110  are positioned against the forehead, or higher on the frontal cranial bones anterior to the anterior fontanelle of a newborn. The earcups  200  in the first and second earcup receiving spaces  121 , 131  are positioned over the ears of the newborn, such that the ears extend into the ear receiving space  230 . The upper and lower straps  122 , 132 / 123 , 133  of the first and second elastic portions  120 , 130  flank upper and lower portions of the ear, applying opposing inward elastic forces on the outer flange surface  240   a , driving the inner flange surface  240   b  towards the head, compressing the gasket  250 , and ultimately forming a seal between the earcups  200  and the head of the newborn. 
     In an embodiment (not shown, but discussed above), the inner surface  101   b  of the first non-stretch terminating end portion  140  is positioned against a nape of the neck, around a base of the head. In an embodiment, the friction pad positioned on the inner surface  101   b  of the first non-stretch terminating end portion  140  also contacts the nape of the neck. The second fastener  151  on the inner surface  101   b  of the second non-stretch terminating end portion  150  is positioned over the outer surface  101   a  of the first non-stretch terminating end portion  140 , such that the second fastener  151  contacts and detachably engages the first fastener  141  on the outer surface  101   b  of the first non-stretch terminating end portion  140 . 
     In an embodiment of  FIG. 6 , the inner surface  101   b  of the second non-stretch terminating end portion  150  is positioned against the nape of the neck, around the base of the head. Optionally, the friction pad may be positioned on the inner surface  101   b  and also contacts the nape of the neck. The first fastener  141  and the inner surface  101   b  of the first non-stretch terminating end portion  140  are positioned over the outer surface  101   b  of the second non-stretch terminating end portion  150 , such that the first fastener  141  contacts and detachably engages the second fastener on the outer surface  101   b  of the second non-stretch terminating end portion  150 . 
     In the front-closing embodiments lb of  FIGS. 3, 4, 7, and 8 , the inner surface  101   b  and first friction pad  111   a  of the non-stretch central portion  110  are positioned against the nape of the neck, around the base of the head. The earcups  200  in the first and second earcup receiving spaces  121 , 131  are positioned over the ears of the newborn, such that the ears extend into the ear receiving space  230 . The upper and lower straps  122 , 132 / 123 , 133  of the first and second elastic portions  120 , 130  flank upper and lower portions of the ear, applying opposing inward elastic forces on the outer flange surface  240   a , driving the inner flange surface  240   b  towards the head, compressing the gasket  250 , and ultimately forming a seal between the earcups  200  and the head of the newborn. 
     In an embodiment of  FIG. 8 , the inner surface  101   b  and the second friction pad  111   b  of the second non-stretch terminating end portion  150  are positioned against the forehead, or higher on the frontal cranial bones anterior to the anterior fontanelle. The first fastener  141  on the inner surface  101   b  of the first non-stretch terminating end portion  140  is positioned over the outer surface  101   a  of the second non-stretch terminating end portion  150 , such that the first fastener  141  contacts and detachably engages the second fastener  151  on the outer surface  101   b  of the second non-stretch terminating end portion  150 . 
     In an embodiment (not shown but discussed above), the inner surface  101   b  and the friction pad of the first non-stretch terminating end portion  140  are positioned against the forehead, or higher on the frontal cranial bones anterior to the anterior fontanelle. The second fastener  151  on the inner surface  101   b  of the second non-stretch terminating end portion  150  is positioned over the outer surface  101   a  of the first non-stretch terminating end portion  140 , such that the second fastener  151  contacts and detachably engages the first fastener  141  on the outer surface  101   b  of the first non-stretch terminating end portion  140 . 
     A compressive force generated by the medical headgear  1  against the head is distributed across the non-stretch central portion  110 , first non-stretch terminating end portion  140 , and second non-stretch terminating end portion  150 . Since the first and second elastic portions  120 , 130  are the sole elastic portions on the medical headgear  1 , a compressive force may be generated directly over to the earcups  200  through a circumferential tensile force applied across the band  100 . The compressive force is therefore specifically isolated against the earcup  200 , contributing to the formation of the seal between the earcup  200  and the head, while being generally dispersed over the larger area of the non-stretch portions  110 , 140 , 150 . 
     In an embodiment, the bifurcated medical headgear  1  is optionally used in the absence of the earcups  200 . When the bifurcated headgear  1  is positioned on the head of the newborn, as described above, each ear of the newborn is positioned in the first or second earcup receiving spaces  121 , 131 , extending outward therethrough. 
     In an embodiment of  FIG. 17 , where the first elastic portion  120  and the second elastic portion  130  extend continuously as unbifurcated portions of fabric, the medical headgear  1  is optionally used in the absence of the earcups  200 . When the unbifurcated headgear  1  is positioned on the head of a newborn, as described above, the inner surfaces  101   b  of the first or second elastic portions  120 , 130  are positioned directly against the ears of a newborn in the absence of the earcups  200 . Additionally, when the unbifurcated medical headgear  1  is positioned on the head of a newborn, as described above, the inner surfaces  101   b  of the first or second elastic portion  120 , 130  are positioned against the head, above the ears of the newborn in the absence of the earcups  200 . 
     Another front closing embodiment 1b of the medical headgear  1  is shown in  FIGS. 18-21 . Like reference numbers indicate like elements and only the differences with respect to the other embodiments will be described in detail herein. 
     As shown in the embodiment of  FIG. 18 , the first friction pad  111   a  is disposed directly on the inner surface  101   b  of the flexible band  100 . The first friction pad  111   a  includes a non-stretch layer  111   a - 1  and a friction layer  111   a - 2  in the embodiment of  FIGS. 18-20 ; the application of the first friction pad  111   a  to the central portion  110  will now be described in detail with reference to  FIGS. 18 and 20 . The below description applies equally to the application of the second friction pad  111   b  to the second non-stretch terminating end portion  150 . 
     As described in the embodiments above, the first friction pad  111   a  can be formed from a grip or tacky material, such as silicone or urethane, applied to the inner surface  101   b  by painting, printing, or spraying. The embodiment of  FIGS. 18-20  will be described with reference to silicone but the description applies equally to urethane and other grip or tacky materials that exhibit the properties described herein. 
     In the embodiment shown in  FIGS. 18 and 20 , a non-stretch layer  111   a - 1  of silicone is applied in a liquid state directly on a defined area  113  of the inner surface  101   b  in the non-stretch central portion  110  of the flexible band  100 . As shown in  FIGS. 18 and 20 , each of two opposite sides of the defined area  113  are spaced apart from a respective upper side  102  or lower side  103  of the central portion  110  by a friction pad distance  115 . The friction pad distance  115 , in an embodiment, is 1 mm to 5 mm. In an alternative embodiment, the friction pad distance  115  is zero and the defined area  113  extends fully to the upper side  102  and lower side  103  of the central portion  110 . In an embodiment, the defined area  113  may be delineated by a stencil or screen for the painting, printing, or spraying application processes in which the liquid silicone is spread by a squeegee or knife blade. In another embodiment, the defined area  113  may be created manually by the user executing the painting, printing, or spraying application process. 
     The non-stretch layer  111   a - 1 , being in a liquid state at application, infiltrates the inner surface  101   b  and at least partially mixes with the material of the flexible band  100  within the inner surface  101   b , as shown in  FIG. 20 . In various embodiments, the non-stretch layer  111   a - 1  can mix with a material of the core of the flexible band  100  and/or with a nylon layer laminated onto the core. The non-stretch layer  111   a - 1  solidifies and cures at least partially within the central portion  110  of the flexible band  100  by exposure to air, heat, or the addition of a separate catalyst. In an embodiment in which the grip or tacky material is silicone, the silicone is cured by condensation curing in the presence of ambient humidity or by addition curing in the presence of a catalyst; either curing may further include the application of heat. The non-stretch layer  111   a - 1  imparts non-stretch characteristics to a non-stretch composite region  114  in which the non-stretch layer  111   a - 1  has solidified; the non-stretch composite region  114  can include a part of a core of the flexible band  100  and/or a part of a nylon layer laminated onto the core. In contrast to the embodiment described above with reference to the first friction pad  111   a  of  FIGS. 6 and 8 , the non-stretch layer  111   a - 1  of the embodiment of  FIGS. 18-20  does not entirely form the first friction pad  111   a  and, as shown in  FIG. 20 , is approximately flush with the inner surface  101   b  after solidification. 
     The friction layer  111   a - 2  of silicone is applied in a liquid state directly on the non-stretch composite region  114  in the defined area  113 , as shown in  FIG. 20 . The friction layer  111   a - 2  is confined to the defined area  113  at liquid application in a same manner as the non-stretch layer  111   a - 1 . The friction layer  111   a - 2  solidifies and cures by exposure to air, heat, or the addition of a separate catalyst. In an embodiment in which the grip or tacky material is silicone, the silicone is cured by condensation curing in the presence of ambient humidity or by addition curing in the presence of a catalyst; either curing may further include the application of heat. The solidified grip or tacky material of the friction layer  111   a - 2  forms a remainder of the first friction pad  111   a . In an embodiment, the friction layer  111   a - 2  protrudes from the inner surface  101   b  by a distance of approximately  0 . 5  mm. As shown in  FIG. 20 , the exterior edge of the friction layer  111   a - 2 , and thereby the exterior edge of the first friction pad  111   a , has a rounded profile upon solidification and curing. In another embodiment, the exterior edge of the friction layer  111   a - 2  and the first friction pad  111   a  may have a right angle corner profile. 
     In an alternative embodiment, the non-stretch layer  111   a - 1  and the friction layer  111   a - 2  are applied together in a single liquid state application directly on the defined area  113  of the inner surface  101   b  in the non-stretch central portion  110  of the flexible band  100 . In further alternative embodiments, the friction layer  111   a - 2  is formed from a separately solidified and cured piece of silicone. In an embodiment, the friction layer  111   a - 2  is cut from a continuous sheet of silicone to a size matching the dimensions of the defined area  113 . In another embodiment, the friction layer  111   a - 2  is formed in a mold to have a solidified and cured size matching the dimensions of the defined area  113 . The separately formed friction layer  111   a - 2  is then bonded to the non-stretch composite region  114  by applying a layer of adhesive to at least one of the composite region  114  and the separately formed friction layer  111   a - 2  and pressing the composite region  114  and friction layer  111   a - 2  together. In an embodiment, the adhesive is a layer of liquid silicone. In a further alternative embodiment, the separately formed friction layer  111   a - 2  is attached with the adhesive directly to the inner surface  101   b  ; in this embodiment, the non-stretch layer  111   a - 1  and composite region  114  are created by the solidification and curing of the adhesive applied to the friction layer  111   a - 2 . 
     In the embodiment shown in  FIGS. 18-21 , the first fastener  141  is a hook and loop style fastener and the second fastener  151  is formed by the outer surface  101   a  of the flexible band  100 . In an exemplary embodiment, the first fastener  141  is a low profile hook fastener which engages loops of a layer of nylon material laminated to form the outer surface  101   a . 
     In the embodiment shown in  FIGS. 18-21 , the earcup receiving spaces  121 ,  131  have an approximately oval shape and are die cut into the elastic portions  120 ,  130  of the flexible band  100 . 
     The flexible band  100  has a longitudinal direction L and a width direction W extending perpendicular to the longitudinal direction L. The width direction W, as shown in  FIGS. 18, 19, and 21 , extends between an upper side  102  and a lower side  103  of the flexible band  100 . In the embodiment shown in  FIGS. 18-21 , the terminating end portions  140 ,  150  each have a width in the width direction W which is narrower than a width of the elastic portions  120 ,  130  and a width of the central portion  110  in the width direction W. In the embodiment shown in  FIGS. 18, 19 and 21 , the terminating end portions  140 ,  150  each have a width that is  40 - 80 % of the width of the central portion  110 . In a further embodiment, the terminating end portions  140 ,  150  each have a width that is  60 - 70 % of the width of the central portion  110 . 
     In comparison with the embodiment shown in  FIGS. 7 and 8 , the narrower width of the terminating end portions  140 ,  150  is taken entirely from the lower side  103  of the flexible band  100  in the embodiment of  FIGS. 18-21 ; that is, the upper side  102  of the flexible band  100  in  FIGS. 18-21  has a same position relative to the elastic portions  120 ,  130  and central portion  110  as the flexible band  100  in  FIGS. 7 and 8 . As shown in  FIG. 21 , the narrower width of the terminating end portions  140 ,  150  allows the front closing medical headgear lb of the embodiment of  FIGS. 18-21  to be positioned with the circumferential axis C having a shallower angle, lower on the forehead of the newborn. 
     An earcup  200  according to another embodiment is shown in  FIG. 22 . The earcup  200  shown in  FIG. 22  has a gasket  250  which includes a first gasket layer  252  and a second gasket layer  254 . The first gasket layer  252  is attached to the flange  240  by an adhesive, such as glue or tape. The second gasket layer  254  is attached to a side of the first gasket layer  252  opposite the flange  240  by an adhesive. In an embodiment, the adhesive attaching the first gasket layer  252  to the flange  240  and the second gasket layer  254  to the side of the first gasket layer  252  is a double-side adhesive tape, such as a polyethylene tape with double-sided acrylate adhesive. The adhesive attaching the second gasket layer  254  to the first gasket layer  252  provides a stiffness limiting shear of the combined gasket layers  252 ,  254  in a plane parallel to a face of the flange  240  but does not impact a combined compressibility of the gasket layers  252 ,  254  in a direction toward the flange  240 . 
     The first gasket layer  252  and the second gasket layer  254  have a same thickness. In an exemplary embodiment, each of the first gasket layer  252  and the second gasket layer  254  has a thickness of 3 mm and the gasket  250  has a thickness of 6 mm. In the embodiment shown in  FIG. 22 , the edges of the second gasket layer  254  have a rounded profile. 
     In other embodiments shown in  FIGS. 23-27 , the medical headgear  1  includes an overhead strap  400 . The overhead strap  400  has an overhead band  410  and a plurality of overhead fasteners  420 . The overhead band  410  is formed from a same material as the flexible band  100 . In the shown embodiment, each of the overhead fasteners  420  is a hook fastener capable of engaging loops in the material of an outer surface  410   a  of the overhead band  410  and/or the outer surface  101   a  of the flexible band  100 . In other embodiments, the overhead fasteners  420  may be any type of fabric fasteners known to those with ordinary skill in the art. 
     In the embodiment shown in  FIG. 23 , the overhead band  410  has a linear, rectangular shape with one overhead fastener  420  attached to each of two opposite ends of the overhead band  410 . As shown in  FIG. 24 , the overhead fastener  420  at a first end of the overhead band  410  is attached to the outer surface  410   a  of the overhead band  410  and the outer surface  101   a  of the flexible band  100  at the central portion  110 . The overhead fastener  420  at an opposite second end of the overhead band  410  is attached to the outer surface  410   a  of the overhead band  410  and the outer surface  101   a  of the flexible band  100  at the non-stretch terminating end portion  140 . The overhead strap  400  extends centrally from front to back over the head of the newborn. 
     In another embodiment shown in  FIG. 25 , the overhead band  410  comprises a plurality of sections  410   a  held together by additional hook fasteners  430 . The plurality of sections  410   a  are positioned to overlap one another, allowing for adjustment of an overall length of the overhead strap  400 . 
     In another embodiment shown in  FIG. 26 , the overhead band  410  has a Y-shape with one overhead fastener  420  positioned on each of the three ends of the overhead band  410 . As shown in  FIG. 27 , the overhead fastener  420  at a first end of the overhead band  410  is attached to the outer surface  101   a  of the flexible band  100  at the first elastic portion  120 , the overhead fastener  420  at a second end of the overhead band  410  is attached to the outer surface  101   a  of the flexible band  100  at the second elastic portion  130 , and the overhead fastener  420  at a third end of the overhead band  410  is attached to the outer surface  101   a  of the flexible band  100  at the central portion  110 . The overhead strap  400  extends over the head of the newborn with an intersection of the Y-shape positioned over the crown of the head. In another embodiment, the overhead strap  400  may be positioned in a reversed orientation with two of the overhead fasteners  420  attached to the central portion  110  and one of the overhead fasteners  420  attached to the non-stretch terminating end portion  140 . In a further embodiment, the Y-shaped overhead band  410  may comprise a plurality of linear sections overlapping with one another and attached with additional hook fasteners. 
     Another front closing embodiment lb of the medical headgear  1  is shown in  FIGS. 28-30 . Like reference numbers indicate like elements and only the differences with respect to the other embodiments will be described in detail herein. 
     In the front closing embodiment 1b shown in  FIGS. 28-30 , the terminating end portions  140 ,  150  each have a width that is 30-60% of the width of the central portion  110  in the width direction W, and in a further embodiment, is 40-50% of the width of the central portion  110  in the width direction W. Further, the width of the central portion  110  is narrower than a width of the elastic portions  120 ,  130 . 
     The central portion  110  in the embodiment of  FIGS. 28-30  has a first central portion  110   a  removably attachable to a second central portion  110   b . As shown in  FIGS. 28 and 29 , the first central portion  110   a  extends continuously from the central portion connecting side of the first elastic portion  120 . The second central portion  110   b  extends continuously from the central portion connecting side of the second elastic portion  130 . The first central portion  110   a , as shown in  FIG. 28 , has a third fastener  161  disposed on the inner surface  101   b  at an end of the first central portion  110   a  opposite the first elastic portion  120 . The second central portion  110   b , as shown in  FIG. 29 , has a fourth fastener  171  disposed on the outer surface  101   a  at an end of the second central portion  110   b  opposite the second elastic portion  130 . In an embodiment, the third fastener  161  and the fourth fastener  171  are both hook fasteners and, in a further embodiment, are low profile hook fasteners which engage loops of layers of nylon material laminated to form the outer surface  101   a  and the inner surface  101   b.    
     As shown in  FIG. 30 , to form the central portion  110 , the first central portion  110   a  is overlayed on the second central portion  110   b . The third fastener  161  on the inner surface  101   b  of the first central portion  110   a  engages the outer surface  101   a  of the second central portion  110   b  and the fourth fastener  171  on the outer surface  101   a  of the second central portion  110   b  engages the inner surface  101   b  of the first central portion  110   a , removably securing the first central portion  110   a  to the second central portion  110   b . The first central portion  110   a  and the second central portion  110   b  may be positioned overlaying each other in a range of positions along the longitudinal direction L, varying an overall length of the flexible band  100  in the longitudinal direction L. 
     The above described embodiments of the medical headgear  1  are suitable for use on preterm newborns, reduce environmental noise to in-utero acoustic levels, and provide a stable support for attaching respiratory support tubes and other medical devices. 
     For both rear-closing embodiments la of  FIGS. 1, 2, 5, and 6 , and front-closing embodiments lb of  FIGS. 3, 4, 7, 8, 18, 19, and 28-30  the band  100  may be positioned on the head such that the anterior and posterior fontanelles of the newborn are exposed, enabling the fontanelles to be easily examined, for example to inspect the anterior fontanelle for evidence of intraventricular hemorrhage. 
     While the above embodiments are written in the context of newborns, and more specifically, towards preterm newborns, the medical headgear  1  is not limited to such an application. Rather, one of ordinary skill in the art would appreciate that the scale of the medical headgear  1  can be increased for application in adolescents and adults, without departing from the scope and spirit of the invention. 
     Additionally, the medical headgear  1  may optionally be used without the earcups  200 . Without the earcups  200 , the medical headgear  1  may serve as a securing device for attachment of respiratory support tubes or other medical equipment. 
     The gasket  250 , in an embodiment, is formed of a first foam material. The first foam material of the gasket  250 , in an embodiment, is an open-cell urethane foam material that has a density of approximately 15 lb/ft 3  and a compression force deflection value for 25% deflection of 0.3-3.5 psi. The term “approximately” with reference to the density of the open-cell urethane foam material described herein and described in other embodiments below is defined as +/−10%. In the embodiment shown in  FIG. 22 , the first gasket layer  252  and the second gasket layer  254  are each formed of the first foam material. In other embodiments, the first foam material can be any open-cell foam material or any closed-cell foam material having the characteristics described herein. In other embodiments, the first foam material can be a silicone foam material. 
     An exemplary graph of sound attenuation with the earcup  200  incorporating the gasket  250  of this embodiment is shown in  FIG. 31 .  FIG. 31  is a graph of exemplary experimental results of the earcup  200  using the gasket  250 ; the actual attenuation provided by the earcup  200  with the gasket  250  can vary from the precise values shown in  FIG. 31  according to the ranges provided below. The attenuation values shown in  FIG. 31  and described below are all measured in ⅓ octave frequency bands, and conversion of the attenuation values shown in  FIG. 31  and described below into one octave frequency bands can be performed according to mathematical processes known in the art. 
     As shown in  FIG. 31 , the earcup  200  with the gasket  250  according to the exemplary embodiment is a frequency-dependent auditory filter providing sound attenuation that generally increases as a function of frequency. The earcup  200  with the gasket  250  provides a sound attenuation less than or equal to 16 dB for sound frequencies of 315 Hz or less. The earcup  200  with the gasket  250  provides a sound attenuation less than 10 dB for sound frequencies of 125 Hz or less. In a range from 100 Hz to 1000 Hz, the sound attenuation generally increases as a function of frequency from less than 9 dB at 100 Hz to less than 30 dB at 1000 Hz. In an embodiment, the sound attenuation at 1000 Hz is 17-20 dB. In the shown exemplary embodiment, the sound attenuation increases from 2-3 dB at 100 Hz to 12 dB at 1000 Hz. From 2000 Hz to 10000 Hz, the sound attenuation is greater than 20 dB. 
     The earcup  200  with the gasket  250  provides a reduction in the overall A-weighted sound level of pink noise greater than 15 dB. The A-weighted sound level is a single value created by converting the overall sound measurements made with a source of pink noise to a single value using an A-weighted filter, as would be understood by those with ordinary skill in the art. In another embodiment, the earcup  200  with the gasket  250  provides a reduction in the overall A-weighted sound level of pink noise of 16-33 dB. In another embodiment, the earcup  200  with the gasket  250  provides a reduction in the overall A-weighted sound level of pink noise of 16-20 dB. 
     A gasket  250 ′, according to another embodiment, is used with the earcup  200  in a manner structurally similar to the gasket  250  described above and shown in the embodiments of  FIGS. 11, 12, and 22 , but is formed of a second foam material. The second foam material of the gasket  250 ′, in an embodiment, is an open-cell urethane foam material that has a density of approximately 20 lb/ft 3  and a compression force deflection value for 25% deflection of 6-14 psi. In other embodiments, the second foam material can be any open-cell foam material or any closed-cell foam material having the characteristics described herein. In other embodiments, the second foam material can be a silicone foam material. 
     In an embodiment, the gasket  250 ′ is attached to the earcup  200  in only a single layer of the second foam material and has a thickness of 3 mm. In another embodiment, as with the gasket  250  shown in  FIG. 22 , the gasket  250 ′ includes a first gasket layer  252  and a second gasket layer  254 . Each of the first gasket layer  252  and the second gasket layer  254  has a thickness of 3 mm and the gasket  250  has a thickness of 6 mm. Each of the first gasket layer  252  and the second gasket layer  254  is formed of the second foam material in an embodiment. In another embodiment of the gasket  250 ′, the second gasket layer  254  is formed of the second foam material and the first gasket layer  252  is formed of a third foam material. The third foam material is an open-cell urethane foam material that has a density of approximately 17 lb/ft 3  and a compression force deflection value for 25% deflection of 8-20 psi. 
     An exemplary graph of sound attenuation with the earcup  200  incorporating the gasket  250 ′ of this embodiment is shown in  FIG. 32 .  FIG. 32  is a graph of exemplary experimental results of the earcup  200  using the gasket  250 ′; the actual attenuation provided by the earcup  200  with the gasket  250 ′ can vary from the precise values shown in  FIG. 32  according to the ranges provided below. The attenuation values shown in  FIG. 32  and described below are all measured in ⅓ octave frequency bands, and conversion of the attenuation values shown in  FIG. 32  and described below into one octave frequency bands can be performed according to mathematical processes known in the art. 
     A graph of sound attenuation characteristics of the earcup  200  with the gasket  250 ′ is shown in  FIG. 32 . The earcup  200  with the gasket  250 ′ provides a sound attenuation greater than or equal to 10 dB for sound frequencies in a range from 80 Hz to 125 Hz. Across an entirety of a range from 100 Hz to 1000 Hz, the sound attenuation is greater than or equal to 10 dB. In an embodiment, the sound attenuation is greater than or equal to 13 dB across an entirety of a range from 100 Hz to 630 Hz. The sound attenuation remains generally constant in the range from 100 Hz to 630 Hz and, in an embodiment, is within 13-30 dB throughout an entirety of the range. In another embodiment, the sound attenuation is within 13-20 dB throughout an entirety of a range from 100 Hz to 1000 Hz. From 2000 Hz to 10000 Hz, the sound attenuation is greater than approximately 30 dB. 
     The earcup  200  with the gasket  250 ′ provides a reduction in the overall A-weighted sound level of pink noise greater than 22 dB. The A-weighted sound level is a single value created by converting the overall sound measurements made with a source of pink noise to a single value using an A-weighted filter, as would be understood by those with ordinary skill in the art. In another embodiment, the earcup  200  with the gasket  250 ′ provides a reduction in the overall A-weighted sound level of pink noise of 22-40 dB. In another embodiment, the earcup  200  with the gasket  250 ′ provides a reduction in the overall A-weighted sound level of pink noise of 22-26 dB. 
     The earcup  200  with the gasket  250 ′, like with the gasket  250 , is a frequency-dependent auditory filter providing sound attenuation that generally increases as a function of frequency; the attenuation is generally higher at higher frequencies, as shown in  FIG. 32 . However, the earcup  200  with the gasket  250 ′ provides a greater, more constant level of sound attenuation at lower frequencies than the earcup  200  with the gasket  250 . The lower frequency range, for example below 250 Hz or around 100 Hz, is a common range for noise sounds occurring during medical transport, such as in a ground ambulance or air ambulance helicopter. In an embodiment, the earcup  200  with the gasket  250 ′ is used in such applications to provide greater attenuation of lower frequency sound than the earcup  200  with the gasket  250 . 
     An earcup  200 ′ according to another embodiment is shown in  FIGS. 33 and 34 . Like reference numbers refer to like elements, and only the differences with respect to the earcup  200  shown in the embodiment of  FIGS. 13-16  will be described in detail herein. 
     As shown in  FIG. 33 , the earcup  200 ′ has a retaining flange  260  disposed circumferentially on the base  210  and extending radially outward from a peripheral edge of the base  210 , in approximately a same plane as a surface of the base  210 . The retaining flange  260  only extends from portions of the circumferential peripheral edge of the base  210 . As shown in  FIG. 33 , the retaining flange  260  extends radially from the base  210  along a longitudinal direction E of the earcup  200 ′. The retaining flange  260  does not extend radially outward from the base  210  in a lateral direction perpendicular to the longitudinal direction E. In the longitudinal direction E, the retaining flange  260  protrudes beyond the sidewall  220  approximately a same distance as the flange  240  protrudes beyond the sidewall  220 . 
     As shown in  FIG. 34 , in the earcup  200 ′, both the flange  240  and the retaining flange  260  have a tapered shape. A tapering axis T, shown in  FIGS. 33 and 34 , extends through the earcup  200 ′ at an acute angle with respect to the longitudinal direction E of the earcup  200 ′. The flange  240  and the retaining flange  260  each have a minimum thickness along the tapering axis T. The thickness of each of the flange  240  and the retaining flange  260  increases away from the tapering axis T to a maximum thickness at a point furthest from the tapering axis T. 
     An earcup  200 ″ according to another embodiment is shown in  FIGS. 35 and 36 . Like reference numbers refer to like elements, and only the differences with respect to the earcup  200 ′ shown in the embodiment of  FIGS. 33 and 34  will be described in detail herein. 
     As shown in  FIGS. 35 and 36 , the retaining flange  260  has a rounded profile along the longitudinal direction E of the earcup  200 ″, with the rounded profile decreasing in thickness further from the base  210  in the longitudinal direction E. In the longitudinal direction E, the retaining flange  260  protrudes beyond the sidewall  220  and may protrude a shorter distance than the flange  240  protrudes beyond the sidewall  220 . The flange  240  of the earcup  200 ″ has a constant thickness throughout an entirety of the flange  240  and the retaining flange  260  has a constant thickness at the circumferential peripheral edge of the base  210 . 
     Another front closing embodiment lb of the medical headgear  1  is shown in  FIGS. 37 and 38 . Like reference numbers indicate like elements and only the differences with respect to the other embodiments will be described in detail herein. In the embodiment shown in  FIGS. 37 and 38 , the medical headgear  1  has a first earcup strap  124  extending over the first earcup receiving space  121  and a second earcup strap  134  extending over the second earcup receiving space  131 . 
     As shown in  FIGS. 37 and 38 , the earcup straps  124 ,  134  each are connected at a pair of opposite ends to the flexible band  100  in the elastic portions  120 ,  130  and extend approximately centrally over the respective earcup receiving spaces  121 ,  131 . The earcup straps  124 ,  134  are positioned between the upper straps  122 ,  132  and the lower straps  123 ,  133  in the width direction W. In the shown embodiment, the earcup straps  124 ,  134  extend at an angle with respect to the longitudinal direction L of the medical headgear  1 . In other embodiments, the earcup straps  124 ,  134  could extend in other directions, provided the earcup straps  124 ,  134  extend approximately centrally over the earcup receiving spaces  121 ,  131 . In various embodiments, a width of each of the earcup straps  124 ,  134  in a plane defined by the width direction W and the longitudinal direction L is approximately equal to or less than a width of the terminating end portions  140 ,  150  in the same plane. 
     Each of the earcup straps  124 ,  134  is formed of a same material as the flexible band  100  and is elastically stretchable. In an embodiment, the earcup straps  124 ,  134  are integrally formed with the flexible band  100  by cutting out sections of the earcup receiving spaces  121 ,  131  that are around the earcup straps  124 ,  134 . In another embodiment, the earcup straps  124 ,  134  are initially formed separately from the flexible band  100  and the opposite ends of the earcup straps  124 ,  134  are attached to the flexible band  100  by, for example, sewing or an adhesive. In an embodiment in which the flexible band  100  is formed form a plurality of layers, the earcup straps  124 ,  134  are integrally formed in or attached to an outermost layer forming the outer surface  101   a.    
     As shown in  FIG. 38 , the earcups  200 ′, or the earcups  200  in another embodiment, are positioned and held within the earcup receiving spaces  121 ,  131  as described in the embodiments above. The earcup straps  124 ,  134  extend over and abut the base  210  of each of the earcups  200 ′. The earcup straps  124 ,  134  are elastically stretched by the insertion of the earcups  200 ′ and, although the earcups  200 ′ remain held within the earcup receiving spaces  121 ,  131 , the earcup straps  124 ,  134  apply an elastic force urging the earcups  200 ′ toward the inner surface  101   b  of the flexible band  100 . The earcups  200 ′ are still removably positionable and rotatable within the earcup receiving spaces  121 ,  131  despite the elastic force imparted by the earcup straps  124 ,  134 . 
     When a user wears the medical headgear  1  of the embodiment shown in  FIGS. 37 and 38 , the elastic force imparted by the earcup straps  124 ,  134  urges the earcups  200 ′ toward the user&#39;s head, forming a better acoustic seal between the gasket  250  and the user&#39;s head. 
     While the invention has been described in detail and with reference to specific embodiments, one of ordinary skill in the art would appreciate that the described embodiments are illustrative, and that various changes and modifications can be made without departing from the scope of the invention.