An improved mouth support device for head and neck tumor radiotherapy

Abstract

The utility model discloses an improved mouth prop for head and neck tumor radiotherapy, including a lower teeth retention sleeve, on which two symmetrically arranged support rods are fixed, and a slot is provided at the top of the support rod, and a tongue depressor is fixed on the side of the lower teeth retention sleeve. The support rod of the utility model is made of self-curing resin, and is thin in the middle and spread on both sides. The main function is to prop up the bite, and it has good retention, good repeatability, and good accuracy. It is convenient to effectively prop up the upper and lower jaws during radiotherapy, so that normal tissues are away from the radiotherapy target area, and reduce the patient's oral mucosal reaction, dry mouth and taste changes during and after radiotherapy. Adverse reactions such as changes; the tongue depressor plays a retention role, mainly to cover the tongue and the root of the tongue, so that the tongue will not be exposed or tilted up due to swallowing by the patient during radiotherapy.

Description

Technical Field

[0001] The utility model relates to the technical field of mouth braces, in particular to an improved mouth brace for head and neck tumor radiotherapy. Background Art

[0002] The incidence of head and neck tumors accounts for 5% to 8% of all malignant tumors in the body, including lip, oral cavity, nasopharynx, oropharynx, hypopharynx and laryngeal cancer. Radiotherapy is one of the important treatment methods for head and neck malignant tumors. Patients can obtain good therapeutic effects through radiotherapy, but while radiation kills tumor cells, it is inevitable to cause damage to normal tissues and organs such as oral mucosa, salivary glands, and mandibles, and the occurrence of adverse reactions increases accordingly. Among them, the most common complications are oral mucositis, dry mouth, and taste changes. How to reduce adverse reactions during and after radiotherapy is a clinical problem that needs to be solved at present. Radioactive oral complications are related to the proximity of normal tissues to high-dose areas. At present, most hospitals in China use simple devices such as open-mouth bottles, corks, disposable dental pads, syringes and other simple radiotherapy mouthpieces, which are difficult to ensure the repeatability of the upper and lower jaws and tongue positions and have poor comfort. Therefore, it is necessary to explore mouthpieces that are more suitable for patients.

[0003] To study the patients with head and neck tumors (oral cancer, nasal cancer, nasopharyngeal cancer, etc.), oral evaluation was performed before radiotherapy, and a personalized mouth spreader was made using oral compression film technology and special orthodontic materials. The purpose was to spread the upper and lower jaws of the mouth, fix the upper palate, the movable part of the tongue and the floor of the mouth, and try to locate them outside the radiation field and as far away from the high-dose area as possible. The head, neck and shoulder mask and vacuum bag were used to fix the patient's position to further improve the fixation accuracy and repeatability of the lips, tongue and mandible. The personalized mouth spreader was placed in the patient's mouth to observe the fixation effect on the tongue, the spreading effect on the upper and lower jaws and its repeatability, reduce the adverse reactions of the patient's oral mucosal reaction, dry mouth and taste changes during and after radiotherapy, and evaluate the effect of the mouth spreader on the accuracy and efficacy of radiotherapy.

[0004] The Chinese patent application number 201810231223.7 proposes an oral stent for making an individualized radiotherapy mouthpiece. Although this patent can achieve the purpose of treatment, it also has shortcomings: 1) the front of the oral cavity is blocked too much, and it is slightly difficult for the patient to breathe; 2) the mouthpiece is large and not comfortable; 3) the clinical process is cumbersome, the production is complicated and takes a long time.

[0005] The Chinese patent with application number 202121241042.6 proposes a mouthpiece for oral tumor radiotherapy based on 3D printing. The patent is a 3D digital model, which has the advantages of easy production, easy to wear, and relatively good comfort; but the distance of the bite is generally 2.5mm, and the bite opening is limited; secondly, the entire part is 3D printed as one piece, and the material is hard material, the tongue pressing part is not comfortable, and if the root of the tongue is too long, the nausea and vomiting reaction is severe, and if it is too short, the tongue root shielding effect is poor when swallowing.

[0006] In order to better solve the above problems, we propose an improved mouth prop for head and neck tumor radiotherapy. Utility Model Content

[0007] The utility model aims to solve the shortcomings of the prior art and proposes an improved mouth support device for head and neck tumor radiotherapy.

[0008] In order to achieve the above purpose, the utility model adopts the following technical solutions:

[0009] An improved mouth brace for head and neck tumor radiotherapy comprises a lower teeth retaining sleeve, on which two symmetrically arranged support rods are fixed, and the tops of the support rods are provided with slots, and a tongue depressor is fixed to the side of the lower teeth retaining sleeve.

[0010] Preferably, the support rod is made of self-curing resin, and the tongue depressor and the lower teeth retention sleeve are both made of soft film, and the thickness of the soft film is 3 mm.

[0011] Preferably, the support rod comprises a lower support portion and an upper support portion, the lower support portion is fixed on the lower tooth retention sleeve, the upper support portion is mounted on the lower support portion via an adjustment mechanism, and the adjustment mechanism is used to adjust the distance between the lower support portion and the upper support portion.

[0012] Preferably, the adjustment mechanism includes a screw, a knob, and a rotating block. The screw is threadedly sleeved in the lower support portion, a knob is fixedly sleeved on the screw, a rotating block is fixed to the top end of the screw, and the rotating block is rotatably sleeved in the upper support portion.

[0013] Preferably, anti-slip patterns are provided on the inner wall of the lower teeth retention sleeve.

[0014] Compared with the prior art, the beneficial effects of the utility model are:

[0015] 1. In the utility model, the support rod is made of self-curing resin, and is thin in the middle and spread on both sides. Its main function is to open the bite. The bottom can be bonded to the lower tooth retention sleeve by a special adhesive, and the upper part is made into a slot according to the shape of the upper teeth. When biting, the upper part is embedded in the occlusal surface of the upper teeth, so as to open the bite, and achieve good retention, good repeatability and good accuracy, which is convenient for effectively opening the upper and lower jaws during radiotherapy, so that normal tissues are away from the radiotherapy target area, and the adverse reactions such as oral mucosal reaction, dry mouth and taste changes of patients during and after radiotherapy are reduced;

[0016] 2. In the present invention, the tongue depressor plays a role of retention, mainly covering the tongue and the tongue root, so that the tongue will not be exposed or tilted upward due to swallowing by the patient during radiotherapy;

[0017] 3. In the present invention, the distance between the lower support portion and the upper support portion can be adjusted by the adjustment mechanism, so as to facilitate the adjustment of the size of the oral opening. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figure 1 This is a schematic structural diagram of an improved mouth support device for head and neck tumor radiotherapy proposed by the utility model;

[0019] Figure 2 This is a schematic structural diagram of a lower teeth retaining sleeve of an improved mouth brace for head and neck tumor radiotherapy proposed by the utility model;

[0020] Figure 3 The utility model is a schematic diagram of the structure of a support rod of an improved mouth support device for head and neck tumor radiotherapy.

[0021] In the figure: 1 lower teeth retention sleeve, 2 tongue depressor, 3 support rod, 31 lower support part, 32 upper support part, 4 slot, 5 anti-slip groove, 6 screw rod, 7 knob, 8 rotating block. DETAILED DESCRIPTION

[0022] The technical solutions in the embodiments of the present invention will be described clearly and completely below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all of the embodiments.

[0023] Reference Figure 1 , Figure 2A modified mouth brace for head and neck tumor radiotherapy comprises a lower tooth retention sleeve 1, on which two symmetrically arranged support rods 3 are fixed, and a card slot 4 is provided at the top of the support rod 3. The support rod 3 is made of self-curing resin and is thin in the middle and expanded on both sides. The main function is to open the bite. The bottom can be bonded to the lower tooth retention sleeve 1 by a special adhesive, and the card slot 4 is made on the top according to the shape of the maxillary teeth. When biting, the top is embedded in the occlusal surface of the upper teeth, thereby opening the bite, which has good retention and can be The invention has good repeatability and precision, and is convenient for effectively spreading the upper and lower jaws during radiotherapy, so that normal tissues are away from the radiotherapy target area, and adverse reactions such as oral mucosal reaction, dry mouth and taste changes during and after radiotherapy are reduced. A tongue depressor 2 is fixed on the side of the lower teeth retention sleeve 1, and an anti-slip pattern 5 is arranged on the inner wall of the lower teeth retention sleeve 1. The tongue depressor 2 and the lower teeth retention sleeve 1 are both made of soft film with a thickness of 3 mm. The tongue depressor 2 plays a retention role, mainly to cover the tongue body and tongue root, and the tongue will not be exposed or tilted upward due to swallowing by the patient during radiotherapy.

[0024] Reference Figure 3 The support rod 3 includes a lower support portion 31 and an upper support portion 32. The lower support portion 31 is fixed on the lower tooth retention sleeve 1. The upper support portion 32 is installed on the lower support portion 31 through an adjusting mechanism. The adjusting mechanism is used to adjust the distance between the lower support portion 31 and the upper support portion 32. The distance between the lower support portion 31 and the upper support portion 32 can be adjusted by the adjusting mechanism, which is convenient for adjusting the size of the oral opening.

[0025] Reference Figure 3 The adjusting mechanism includes a screw rod 6, a knob 7, and a rotating block 8. The screw rod 6 is sleeved in the lower support portion 31 through a thread. The screw rod 6 is fixedly sleeved with a knob 7. The top of the screw rod 6 is fixed with a rotating block 8. The rotating block 8 is rotatably sleeved in the upper support portion 32. The screw rod 6 can be driven to rotate by rotating the knob 7. At this time, the screw rod 6 can be driven to rise and fall through the threaded transmission relationship between the screw rod 6 and the lower support portion 31, so that the rise and fall of the upper support portion 32 can be adjusted synchronously.

[0026] Working principle: When in use, the support rod 3 is made of self-curing resin, and is thin in the middle and expanded on both sides. Its main function is to open the bite. The bottom can be bonded to the lower tooth retention sleeve 1 through a special adhesive, and the upper part is made into a slot 4 according to the shape of the maxillary teeth. When biting, the upper part is embedded in the occlusal surface of the upper teeth, thereby opening the bite, which has good retention, good repeatability and good accuracy. It is convenient to effectively open the upper and lower jaws during radiotherapy, keep normal tissue away from the radiotherapy target area, and reduce the patient's oral mucosal reaction, dry mouth and taste changes during and after radiotherapy. Adverse reactions such as; the tongue depressor 2 has a retention effect, mainly to cover the tongue and the root of the tongue, and the tongue will not be exposed or tilted up due to swallowing by the patient during radiotherapy; the distance between the lower support part 31 and the upper support part 32 can be adjusted by the adjustment mechanism, which is convenient for adjusting the size of the oral opening.

[0027] The working principle of the adjustment mechanism is: the screw rod 6 can be driven to rotate by rotating 7, and at this time, the screw rod 6 can be driven to rise and fall through the threaded transmission relationship between the screw rod 6 and the lower support part 31, so that the rise and fall of the upper support part 32 can be adjusted synchronously.

[0028] Through clinical trials and subjective judgment of patients, the tongue depressor 2 and the lower teeth retention sleeve 1 are both made of soft film with a thickness of 3mm. The 3mm thick soft film ensures retention and stability while having a better shielding effect on the back of the tongue, and is easy to fold and bend, making it convenient for patients to put on and take off, and it is also comfortable. 2mm is too soft. Although it has better folding and bending, is comfortable, and is easy to put on and take off, it has poor retention and poor shielding effect on the back of the tongue, and the back of the tongue will lift up when the patient swallows. 4mm is too thick. Although it has good retention and stability, and has a good shielding effect on the back of the tongue, it has poor comfort and poor bending, making it inconvenient for patients to put on and take off, which is especially a burden for some elderly patients and patients with poor oral hygiene. (See the table below for details)

[0029]

[0030] Comparison of radiation doses received by target area and surrounding healthy tissues in patients undergoing radiotherapy

[0031]

[0032] The following are the results of the experiments on cases 1, 2, 3, 4, and 5:

[0033] Case 1: Xu, male, 36 years old, diagnosed: right nasal extranodal NKT cell lymphoma stage IE, 6 courses of R-chop chemotherapy followed by local radiotherapy, radiotherapy sites: nasal cavity, bilateral cervical II-III lymph node drainage area; radiotherapy dose: PGTVp 56Gy / 2Gy / 28f, PTV 50.96Gy / 1.82Gy / 28f (wearing a mouth supporter). Conclusion description: The tongue, floor of mouth and mandible are far away from the high-dose radiotherapy area. The patient had a slight change in taste during radiotherapy, but no oral ulcers or dry mouth symptoms. Follow-up one month after radiotherapy: Grade I dry mouth, taste changes recovered, no oral ulcers, and mild dry mouth did not affect the patient's life.

[0034] Case 2: Zhang, male, 61 years old, diagnosis: postoperative chemotherapy for right nasal malignant melanoma, 1 course of dacarbazine combined with cisplatin chemotherapy followed by local radiotherapy, radiotherapy sites: nose, bilateral neck II-lymph node drainage area; radiotherapy dose: PGTVtb 66Gy / 2.13Gy / 31f, PTV 57.97Gy / 1.82Gy / 31f (wearing a mouth supporter). Conclusion description: The main irradiation site of the patient is the nasal cavity. The purpose of using a mouth supporter is to protect the normal oral tissue (including: tongue, floor of mouth and mandible), keep normal tissue away from the high-dose area of ​​radiotherapy, and reduce the occurrence of side effects. Congestion of the throat wall occurred in the 4th week of radiotherapy, no ulcers were seen, degree dry mouth, I degree taste, follow-up 1 month after radiotherapy: dry mouth improved significantly, taste changes recovered, and no oral ulcers.

[0035] Case 3: Shu, female, 65 years old, diagnosed with nasal extranodal NK / T cell lymphoma stage B symptoms (night sweats), 1 course of p-Gemox chemotherapy followed by local radiotherapy, radiotherapy site: nasal cavity, radiotherapy dose: PTV50Gy / 2Gy / 25f (wearing a mouth supporter). Conclusion description: The main irradiation site of the patient is the nasal cavity. Wearing a mouth supporter keeps the normal oral tissue (including: tongue, floor of mouth and mandible) away from the high-dose area of ​​radiotherapy, reducing the occurrence of side effects. There was no taste change, oral ulcers and dry mouth during radiotherapy. Follow-up one month after radiotherapy: no taste change, oral ulcers and dry mouth.

[0036] Case 4: Cheng, female, 55 years old, diagnosed: nasopharyngeal diffuse large B-cell lymphoma stage IIE group B, 8 courses of R-CHOP chemotherapy followed by local radiotherapy, radiotherapy sites: nasal cavity + nasopharynx + bilateral cervical II-III lymph node drainage area, radiotherapy dose: PTV50Gy / 2Gy / 25f (without wearing a mouth supporter). Conclusion description: The main irradiation sites of the patient are nasopharynx + nasal cavity, and the mouth supporter is not worn during radiotherapy. The entire normal oral tissue is exposed to the radiation field. The patient developed congestion and obvious pain in the throat wall in the second week of radiotherapy, scattered small ulcers, I degree dry mouth, and completely lost taste after 3 weeks of radiotherapy. Large ulcers appeared on the posterior wall of the pharynx and the posterior edge of the bilateral tongue at 5 weeks of radiotherapy. Follow-up one month after radiotherapy: II degree dry mouth, slightly restored taste, no oral ulcers but with pain on the edge of the tongue.

[0037] Case 5: Han, male, 58 years old, diagnosed with palatine adenoid cystic carcinoma cT4N1M0IVa stage, 3 courses of TP chemotherapy followed by local radiotherapy, radiotherapy sites: nasal cavity + nasopharynx + bilateral cervical II-III lymph node drainage area, radiotherapy dose: PTV 50Gy / 2Gy / 25f (wearing ordinary mouthpiece). Conclusion description: The main irradiation site of the patient is the nasal cavity. Wearing an ordinary mouthpiece pushes the normal oral tissue (including: tongue, floor of mouth and mandible) away from the high-dose area of ​​radiotherapy. The mouthpiece does not fix the tongue well, especially the root of the tongue, so that normal tissue is exposed to the radiation field. During radiotherapy: slight taste changes, II degree oral ulcers, II degree dry mouth. Follow-up 1 month after radiotherapy: taste changes recovered, I degree dry mouth, no oral ulcers.

[0038] The above description is only a preferred specific implementation manner of the present invention, but the protection scope of the present invention is not limited thereto. Any technician familiar with the technical field can make equivalent replacements or changes within the technical scope disclosed by the present invention according to the technical scheme and the utility model concept of the present invention, which should be covered by the protection scope of the present invention.

Claims

1. An improved mouth support for head and neck tumor radiotherapy, comprising a lower teeth retention sleeve (1), characterized in that: Two symmetrically arranged support rods (3) are fixed on the lower teeth retention sleeve (1), and a clamping groove (4) is provided at the top of the support rod (3). A tongue depressor (2) is fixed on the side of the lower teeth retention sleeve (1), and the support rod (3) is made of self-curing resin. The tongue depressor (2) and the lower teeth retention sleeve (1) are both made of soft film, and the thickness of the soft film is 3 mm.

2. The improved mouth support for head and neck tumor radiotherapy according to claim 1, characterized in that: The support rod (3) comprises a lower support part (31) and an upper support part (32); the lower support part (31) is fixed on the lower tooth retention sleeve (1); the upper support part (32) is mounted on the lower support part (31) via an adjustment mechanism; the adjustment mechanism is used to adjust the distance between the lower support part (31) and the upper support part (32).

3. The improved mouth support for head and neck tumor radiotherapy according to claim 2, characterized in that: The adjusting mechanism comprises a screw rod (6), a knob (7) and a rotating block (8); the screw rod (6) is sleeved in the lower supporting portion (31) via a thread; the knob (7) is fixedly sleeved on the screw rod (6); the top end of the screw rod (6) is fixedly sleeved with a rotating block (8); and the rotating block (8) is rotatably sleeved in the upper supporting portion (32).

4. The improved mouth support for head and neck tumor radiotherapy according to claim 1, characterized in that: The inner wall of the lower teeth retention sleeve (1) is provided with anti-slip grooves (5).

Images