Surgical chin support assembly and related methods

Abstract

The disclosure describes systems and assemblies providing chin support of a head of a patient for brain therapies, such as gamma radiation therapies. The chin support can be provided by a chin support assembly with a mounting bracket coupled to support sleeves that can slidably mount to posts of a head rest of a radiosurgery system. The chin support assembly can be used with a face mask for securing a patient in a desired position without requiring a head fixation frame.

Description

PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WOSURGICAL CHIN SUPPORT ASSEMBLY AND RELATED METHODSRelated Applications

[0001] This patent application claims the benefit of and priority to U.S. Provisional Patent Application Serial Number 63 / 718,894, filed November 11, 2024, the contents of which are hereby incorporated by reference as if recited in full herein.Field of the Invention

[0002] The present invention relates generally to devices used during medical procedures to stabilize the head of a patient and may be particularly suitable for use in radiosurgery procedures.Background

[0003] Stereotactic radiosurgery (STS) can be used to treat tumors or veins that have developed differently than usual and other irregularity in the brain. STS is not a standard surgery because there is no cut or incision required. Instead, the radiosurgery focuses small beams of gamma rays / radiation on a tumor or other target with extreme accuracy. Each beam has little effect on the brain tissue it passes through to the target, but a therapeutic dose of radiation can be delivered to the target where the beams converge or meet. One example of STS is Gamma Knife® radiosurgery from ELEKTA AB, Stockholm, Sweden.

[0004] To help achieve accuracy in delivery of the radiation, it can be important that the patient’s head remain very still during a therapy session. For example, the Gamma Knife® radiosurgery system can use a face mask or a head frame that will immobilize the head of the patient. See, https: / / www.elekta.com. The face mask is made of lightweight material moldable to facial contours of a respective patient. Once set, it can couple to a headrest and hold the head securely in position during radiosurgery for radiation treatment. Alternatively, if the radiosurgery treatment is carried out using a head fixation frame, the frame remains on the patient head throughout a treatment session to ensure pinpoint accuracy for the radiosurgery.

[0005] When the face mask is used, sometimes the face mask can allow movement of the patient’s head during a therapy session requiring repositioning of the patient which can result in additional time and / or reduce accuracy of delivery of the radiation to the target.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0006] There is a need for improved immobilization devices to improve treatment quality and / or reduce the need for repositioning the patient during a therapy session thereby reducing treatment time.Summary

[0007] Embodiments of the invention are directed to surgical chin support assemblies that can help hold a head of a patient in a desired position for a duration of a therapy session. The devices may be configured for CT environments and may be configured to be compatible for both CT and MRI environments.

[0008] The chin support assemblies can be used with a face mask and without requiring a head fixation frame.

[0009] A surgical chin support assembly that includes: a mounting bracket with at least one through aperture; a chin support having an aperture facing the mounting bracket; and a fixation member configured to extend through one of the at least one through aperture of the mounting bracket and into the aperture of the chin support. The fixation member is configured to be controllably translated in a longitudinal direction between extended and retracted positions whereby in the extended position the chin support is positionable against a chin of a patient.

[0010] The at least one through aperture of the mounting bracket can include a plurality of vertically spaced apart through apertures aligned along a transverse center of the mounting bracket.

[0011] The mounting bracket can be configured to be releasably attached to first and second support members that are laterally spaced apart.

[0012] The mounting bracket can be configured to be interchangeably releasably attached to the first and second support members in a first orientation and in a second orientation reversed to be upside down of the first orientation, with the first and second orientations providing the plurality of vertically spaced apart through apertures at different height positions relative to a bottom of the support members.

[0013] The surgical chin support assembly can also include first and second positional indicators positioned adjacent the at least one through aperture whereby two different height positions are correlated to the at least one through aperture.

[0014] The at least one through aperture can be provided as a plurality of vertically spaced apart through apertures, and the positional indicators can include numbers along one side of the vertically spaced apart through apertures.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0015] The numbers can be odd numbers arranged along one side of the vertically spaced apart through apertures and even numbers arranged along an opposing side of the vertically spaced apart through apertures.

[0016] The surgical chin support assembly can also include first and second sleeves releasably attached to the mounting bracket. The first and second sleeves can each have a curved channel configured to receive a post of a head rest. The first and second sleeves can each have a lock member configured to lock a respective sleeve against a corresponding post.

[0017] The fixation member can include a plurality of neighboring segments in different colors.

[0018] The fixation member can have a shaft with threads and the threads can be configured to threadably engage threads in a selected aperture of the at least one through aperture whereby rotation of the fixation member in a first rotational direction extends the chin support toward the patient and rotation of the fixation member in a second rotational direction retracts the chin support away from the patient.

[0019] The shaft of the fixation member can have a segment devoid of threads configured to couple to the aperture of the chin support.

[0020] The fixation member can be provided as a set of fixation members, each having a different length thereby providing different longitudinal positional adjustability for the chin support relative to the mounting bracket.

[0021] The fixation member can be a center fixation member.

[0022] The surgical chin support assembly can further include side fixation members, one on each side of the center fixation member and each can extend through a respective aperture in the mounting bracket and a corresponding receiving aperture in the chin support to thereby provide lateral stability to the chin support.

[0023] The surgical chin support assembly can further include first and second sleeves with interlocking interface segments coupled to respective first and second end portions of the mounting bracket. The mounting bracket can have a lateral length sufficient to extend across a head rest. The chin support can be configured to clamp a face mask against a chain of a patient while the patient head is in the head rest and the face mask is coupled to the head rest.

[0024] Other embodiments are directed to a radiosurgery system that includes: a radiation system with a bore, a table longitudinally translatable into and out of the bore, a head rest coupled to the table with first and second posts on opposing lateral sides of the table; and a chin support assembly coupled to the first and second posts of the head rest.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0025] The chin support assembly can include: a mounting bracket with at least one through aperture; a chin support with an aperture facing the mounting bracket; and a fixation member configured to extend through one of the at least one through aperture of the mounting bracket and into the aperture of the chin support. The fixation member can be configured to be controllably translated in a longitudinal direction between extended and retracted positions whereby in the extended position the chin support is positionable against a chin of a patient.

[0026] The at least one through aperture of the mounting bracket can be arranged as a plurality of vertically stacked (vertically aligned and spaced apart) through apertures.

[0027] The plurality of vertically stacked through apertures can be aligned along a transverse center of the mounting bracket.

[0028] The chin support assembly can also include a first support member coupled to the first post and a second support member coupled to the second post.

[0029] The mounting bracket can be configured to be interchangeably releasably attached to the first and second support members in a first orientation and in a second orientation reversed to be upside down of the first orientation, with the first and second orientations providing the plurality of vertically spaced apart through apertures at different height positions relative to a bottom of the support members.

[0030] The radiosurgery system can further include first and second positional indicators that can be positioned adjacent the at least one through aperture whereby two different height positions are correlated to the at least one through aperture.

[0031] The at least one through aperture can be a plurality of vertically stacked through apertures.

[0032] Positional indicators can be arranged adjacent the plurality of vertically stacked apertures.

[0033] The positional indicators can include odd numbers arranged along one side of the vertically stacked through apertures.

[0034] The positional indicators can include even numbers arranged along one side of the vertically stacked through apertures.

[0035] The positional indicators can include odd numbers arranged along one side of the vertically stacked through apertures and even numbers arranged along an opposing side of the vertically stacked through apertures.

[0036] The radiosurgery system can further include first and second sleeves releasably attached to the mounting bracket. The first and second sleeves can each have aPCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO curved channel configured to receive a respective post. The first and second sleeves can each have a lock member configured to lock a respective sleeve against the respective post.

[0037] The fixation member can include a shaft with threads and the threads can be configured to threadably engage threads in a selected aperture of the plurality of vertically spaced apart through apertures whereby rotation of the fixation member in a first rotational direction extends the chin support toward the patient and rotation of the fixation member in a second rotational direction retracts the chin support away from the patient, and wherein the threads of the fixation member comprises a plurality of neighboring segments in different colors.

[0038] The radiosurgery system can also include a face mask coupled to the head rest. The mounting bracket can have a lateral length sufficient to extend across the head rest and the chin support can be configured to clamp the face mask against a chain of a patient while the patient head is in the head rest and the face mask is coupled to the head rest.

[0039] The radiosurgery system can be a gamma knife radiosurgery system.

[0040] The chin support can hold a pressure sensor therein.

[0041] The chin support can have a curved surface configured to abut a chin of a patient. The chin support can include a pressure sensor channel in the chin support behind the curved surface and in front of the aperture facing the mounting bracket.

[0042] Further features, advantages and details of the present invention will be appreciated by those of ordinary skill in the art from a reading of the figures and the detailed description of the preferred embodiments that follow, such description being merely illustrative of the present invention. Features described with respect with one embodiment can be incorporated with or into other embodiments although not specifically discussed therewith. That is, all embodiments and / or features of any embodiment can be combined in any way and / or combination. Applicant reserves the right to change any originally filed claim or file any new claim accordingly, including the right to be able to amend any originally filed claim to depend from and / or incorporate any feature of any other claim although not originally claimed in that manner. These and other objects and / or aspects of the present invention are explained in detail in the specification set forth below.Brief Description of the Drawings

[0043] FIG. 1 is a top, side perspective view of a surgical chin support assembly configured to cooperate with a face mask and attach to posts of a headrest according to embodiments of the present invention.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0044] FIG. 2 is a side perspective view of a support system of the surgical chin support assembly shown in FIG. 1 according to embodiments of the present invention.

[0045] FIG. 3 is a top view of support system shown in FIG. 2.

[0046] FIG. 4 is a side view of the support system shown in FIG. 2.

[0047] FIG. 5 is a patient-facing (rear) view of the support system shown in FIG. 2.

[0048] FIG. 6 is a front (facing away from the patient), side perspective view of the support system shown in FIG. 2.

[0049] FIG. 7 is a front view of the support system shown in FIG. 6.

[0050] FIG. 8 is a side perspective view of a support system of the surgical chin support assembly shown in FIG. 1, with the mounting bracket shown in FIG. 2 flipped upside down to provide additional positional adjustment options for a chin support according to embodiments of the present invention.

[0051] FIG. 9A is a rear view of the support system shown in FIG. 8.

[0052] FIG. 9B is a front view of the support system shown in FIG. 9A.

[0053] FIG. 10A is a side perspective view of a support system of the surgical chin support assembly configured to have a mounting bracket configured to have a single use orientation (upward) according to embodiments of the present invention.

[0054] FIG. 10B is a rear view of the support system shown in FIG. 10A.

[0055] FIG. 10C is a front view of the support system shown in FIG. 10A.

[0056] FIG. 10D is a side perspective view of a support system of the surgical chin support assembly configured to have a mounting bracket configured to have a single use orientation (downward) according to embodiments of the present invention.

[0057] FIG. 10E is a rear view of the support system shown in FIG. 10D.

[0058] FIG. 10F is a front view of the support system shown in FIG. 10A.

[0059] FIGS. 11A and 11B are side perspective schematic illustrations of other embodiments of a sleeve for supporting a mounting bracket for the chin support according to embodiments of the present invention.

[0060] FIG. 12A is a patient-facing (rear), side perspective view of a surgical chin support assembly according to embodiments of the present invention.

[0061] FIG. 12B is a patient-facing (rear) view of the surgical chin support assembly shown in FIG. 12A.

[0062] FIG. 13 is a front, side perspective view of the surgical chin support assembly shown in FIG. 12A.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0063] FIG. 14 is a front view of the surgical chin support assembly shown in FIG.13

[0064] FIG. 15 is a side perspective view of an example chin support of the surgical chin support assembly according to embodiments of the present invention.

[0065] FIG. 16 is a front view of the chin support shown in FIG. 15.

[0066] FIG. 17 is a top or bottom view of the chin support shown in FIG. 15.

[0067] FIG. 18 is a side view of the chin support shown in FIG. 15.

[0068] FIG. 19A is a side perspective view of another example chin support of the surgical chin support assembly according to embodiments of the present invention.

[0069] FIG. 19B is a side perspective view of another example chin support of the surgical chin support assembly according to embodiments of the present invention.

[0070] FIG. 19C is a side perspective view of the chin support of FIG. 19B, shown without the pressure sensor according to embodiments of the present invention.

[0071] FIG. 20 is a front view of the chin supports shown in FIGS. 19A and 19B.

[0072] FIG. 21A is a top or bottom view of the chin support shown in FIG. 19A.

[0073] FIG. 21B is a top or bottom view of the chin support shown in FIG. 19B.

[0074] FIG. 22A is a side view of the chin support shown in FIG. 19A.

[0075] FIG. 22B is a side view of the chin support shown in FIG. 19B.

[0076] FIG. 23A is a side view of a set of fixation members (shown as bolts) selectable for use in the mounting bracket of the surgical chin support assembly to provide patient-specific positional adjustment of the chin support coupled to the mounting bracket according to embodiments of the present invention.

[0077] FIG. 23B is an end view of the set of bolts shown in FIG. 23A.

[0078] FIG. 24A is a perspective view of an example headrest with posts provided by a radiosurgery system.

[0079] FIG. 24B is an enlarged, partial front side, perspective view of the headrest and posts shown in FIG. 24A.

[0080] FIG. 25 is a side perspective view of the surgical chin support assembly coupled to the posts of the headrest shown in FIGS. 24A and 24B according to embodiments of the present invention.

[0081] FIGS. 26A and 26B are enlarged side perspective views of a portion of the surgical chin support assembly shown in FIG. 25 illustrating a sequency of alignment and locking of the sleeves to the posts of the headrest according to embodiments of the present invention.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0082] FIGS. 27 and 28 are front views of the surgical chin support assembly coupled to posts of a head frame of a radiosurgery system and illustrating two alternative orientations of the mounting bracket, allowing for a plurality of different indexing positions of the chin support to accommodate different patient head sizes and chin anatomy thereof according to embodiments of the present invention.

[0083] FIG. 29 is a schematic illustration of an example radiation system that can be used with the surgical chin support assembly to immobilize a head of a patient according to embodiments of the present invention.

[0084] FIG. 30A is a top perspective view of the surgical chin support assembly with a pressure gauge module comprising the pressure gauge sensor in the chin support according to embodiments of the present invention.

[0085] FIG. 30B is an enlarged view of a portion of the chin support assembly and pressure sensor shown in FIG. 30A.Detailed Description

[0086] The present invention now is described more fully hereinafter with reference to the accompanying drawings, in which some embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art.

[0087] Like numbers refer to like elements throughout. In the figures, the thickness of certain lines, layers, components, elements or features may be exaggerated for clarity. The term “FIG.” may be used interchangeably with the word “Figure” or the term “Fig.” in the specification and / or drawings.

[0088] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms "comprises" and / or "comprising," when used in this specification, specify the presence of stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0089] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the specification and relevant art and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein. Well-known functions or constructions may not be described in detail for brevity and / or clarity.

[0090] It will be understood that when an element is referred to as being "on", "attached" to, "connected" to, "coupled" with, "contacting", "supported by" etc., another element, it can be directly on, attached to, connected to, coupled with or contacting the other element or intervening elements may also be present (e.g., indirectly supported, attached, coupled, contacting, connected, coupled, etc. . .). In contrast, when an element is referred to as being, for example, "directly on", "directly attached" to, "directly connected" to, "directly coupled" with, "directly supported by" or "directly contacting" another element, there are no intervening elements present. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed "adjacent" another feature may have portions that overlap or underlie the adjacent feature.

[0091] Spatially relative terms, such as "under", "below", "lower", "over", "upper" and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is inverted, elements described as "under" or "beneath" other elements or features would then be oriented "over" the other elements or features.Thus, the exemplary term "under" can encompass both an orientation of "over" and "under." The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms "upwardly," "downwardly," "vertical," "horizontal" and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.

[0092] The term "about" with respect to a number indicates that the value may vary between + / - 20%.

[0093] The term "bed" is used interchangeably with "table" and refers to a patient support surface or frame thereof (which is typically relatively rigid) that, in operativePCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO position, at least partially resides in a radiosurgery therapy system, such as a Gamma Knife® radiotherapy system. The bed can typically translate in a longitudinal direction to position the patient.

[0094] The term "MRI-compatible" means that a device is safe for use in an MRI environment that can operate as intended in an MRI environment and not introduce artifacts into MRI images. As such, if residing within the high-magnetic field region of the magnet, the MRI-compatible device is typically made of a non-ferromagnetic material(s) suitable to reside and / or operate in a high magnetic field environment. The term "high magnetic field" refers to magnetic fields above 0.5T, typically between 1.5T to 10T.

[0095] Embodiments of the invention are particularly suitable for veterinarian or human therapeutic or diagnostic use but may be used for research or other purposes.

[0096] The term "sterile" and derivatives thereof means that the component meets regulatory clinical cleanliness standards for medical procedures.

[0097] The term "fiducial marker" refers to a marker that can be electronically identified using image recognition and / or electronic interrogation. The fiducial marker can be provided in any suitable manner, such as, but not limited to, a defined geometric shape, a reflector or other marking or component on or in the device, a coating or fluid-filled component or feature or combinations of different types of fiducial markers that makes the fiducial marker(s) have sufficient signal intensity (brightness) for identifying location and / or orientation information for the device and / or components thereof.

[0098] Although particularly suitable for STS treatments, embodiments of the present invention are not limited to radiosurgery use and can be used for gene, e.g., antibody, and / or stem-cell based therapy delivery or other therapy delivery to intrabody targets in the brain. In some embodiments, the systems can be used to deliver a therapy which can include ablation of tissue and / or delivery of a therapeutic substance comprising cells and / or pharmacologic material to a target in the brain.

[0099] Referring now FIG. 1, an example surgical chin support assembly 10 is shown. The surgical chin support assembly 10 comprises a chin support 15 that is configured to securely engage a chin of a patient. The surgical chin support assembly 10 includes a support system 12 that comprises a mounting bracket 20 and support members 30i, 302. The chin support 15 is adjustably coupled to the mounting bracket 20 allowing the chin support 15 to be adjustable longitudinally, e.g., to selectively and / or controllably translate toward and away from the mounting bracket 20, and therefore the chin of a patient for patient-specificPCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO adjustability to provide a secure attachment. The surgical chin support assembly 10 can also be configured to provide positional adjustment of the chin support 15 in the vertical direction.

[0100] As shown, the mounting bracket 20 extends laterally and can have a plurality of laterally spaced apart apertures 21 arranged between right and left sides of the mounting bracket 20. At least one fixation member, generally referred to by callout 25, such as bolts, pins or rods, can extend longitudinally through a corresponding aperture 21 and can extend into the chin support 15 to terminate in the chin support 15 and but do not directly contact the patient.

[0101] As also shown, there are a plurality of fixation members 25 including a first fixation member 40 configured to control the longitudinal position of the chin support 15 and first and second secondary (side) fixation members 50i, 502, positioned on opposing sides of the first fixation member 40. The first fixation member 40 can be a center fixation member 40. Alternatively, this first fixation member 40 can be provided as a pair of cooperating fixation members (not shown) on opposing sides of the laterally central location of the mounting bracket 20 and chin support 15. The first fixation member 40 can have a larger outer diameter than the secondary, side fixation members 50i, 502. The side fixation members 50i, 502 can provide increased stability relative to the use of a single fixation member 40 but are not required.

[0102] The first fixation member 40 can comprise color coding 42 with at least two different colors positioned along first and second thread portions that are axially spaced apart for providing visual distance indicators of position of the chin support 15 relative to the mounting bracket 20, to a user. The first fixation member 40 can be configured to threadably engage the mounting bracket 20 and chin support 15 and a head portion 40h can be rotatably moved to translate the chin support 15 in a longitudinal direction between engaged and released positions.

[0103] As also shown, the support members 30i, 302 project outwardly above a head rest 80 with a first end portion 30f of a respective support member above the second bottom end portion 30b. In some embodiments, the first end portion 30f can be configured to reside above the chin support 15 and the opposing second, lower end or bottom portion 30b can be configured to reside below the chin support 15. One support member 30i is attached to a first side portion (e.g., the right-side portion) of the mounting bracket 20 and the other support member 302 is mounted to the laterally spaced apart opposing side portion (e.g., the left-side portion) of the mounting bracket 20.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0104] Still referring to FIG. 1, the support members 30i, 302 can comprise sleeves 30s that can be configured to slidably receive respective posts 70i, 702 of a head rest 80. During use, a face mask 90 can be placed over a face of a patient and coupled to the head rest 80 and the chin support 15 can clamp against a chin portion 90c of the face mask 90 and the chin of a patient to help secure the head of the patient and / or the face mask 90 in position for a therapy session.

[0105] Turning now to FIGS. 2-7, an example support system 12 of the surgical chin support assembly 10 is shown. As shown, the sleeves 30s of the support members 30i, 302 each comprise an open channel 30c (FIG. 6) that slidably receive the corresponding post 70i, 702 (FIG. 1) of the head rest 80.

[0106] The mounting bracket 20 can be configured to releasably engage the support members 30i, 302. The mounting bracket 20 can be configured to releasably interlock to the support members 30i, 302 in two orientations, a first upright position and a reverse second position. In the first position, as shown in FIGS. 2-7, a plurality of positional indicators 22, shown as three numbers 1, 3, 5 are upright 22u and a plurality of other positional indicators 22, shown as three even numbers 2, 4, 6 are in an orientation perpendicular to the upright 22u indicators, e.g., upside down positional indicators 22r. While numbers are shown for the positional indicators 22, it is noted that other or additional alphanumeric indicia, marker features or shapes and / or color-coded features can be used to designate the different height positions.

[0107] The mounting bracket 20 can be configured to provide some of the apertures 21 arranged as a plurality of aligned, vertically stacked and / or vertically spaced apart first apertures 140 positioned at different height positions, shown as at three different height positions H1-H3 (FIGS. 4, 5) when the mounting bracket 20 is in an upright orientation and three different height positions H4-H6 relative to the sleeves when in the mounting bracket 20 is flipped (FIG. 10) and a user can select which one of the first apertures 140 to use for a particular patient. The distance DI that a top aperture of the first apertures 140 resides from the bottom 30b of the sleeves 30 in the upright position can be greater than the distance D2 that the top aperture of the first apertures 140 resides from the bottom 30b of the sleeves 30 in the reverse orientation (FIG. 10).

[0108] A nut insert 142 can be positioned in each of the first apertures 140 providing threads to threadably engage a first fixation member 40. The threads of the first apertures may be directly formed in the first apertures 140 or otherwise provided. In other embodiments, threads are not required and the first fixation member 40 can be configured toPCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO frictionally engage the mounting bracket 20 and chin support 15 and a locking member can be used to lock the chin support in a desired position (not shown).

[0109] The mounting bracket 20 can also be configured to provide other of the apertures 21 as a plurality of vertically stacked side apertures 150i, 1502 selectable as the aperture to use for the side fixation members 50i, 502. The side apertures 150i, 1502 can be devoid of threads.

[0110] Each center aperture 140 can be associated with two positional indicators 22, both an upright positional indicator 22u and an upside-down positional indicator 22r. That is, a different positional indicator can be positioned on each outer side of each center aperture 140. Thus, as shown in FIGS. 7 and 10, there are six indexed (numbered) positions of six different heights that can be used for the first fixation member 40, depending on the orientation of the mounting bracket 20, allowing for patient specific geometry / size / shape.

[0111] The positional (height) indicators 22 may reside only on an outer facing surface 20f of the mounting bracket 20 which can be referred to as a “front” surface that faces away from the patient allowing a user easy visual access to the positional indicators. The opposing / rear surface 20r (the surface facing the patient) of the mounting bracket 20 can be devoid of any positional indicators 22, including those adjacent the center apertures 140. Alternatively, the positional indicators 22 may be provide on each of the front and rear surfaces 20f, 20r, respectively, of the mounting bracket 20.

[0112] In some embodiments, the mounting bracket 20 can have right and left side end portions 120 that extend rearwardly from the primary body 20p, perpendicular to the primary body 20p. The right and left side portions 120 can releasably interlock with interlock interfaces 130 provided by the corresponding support members 30i, 302.

[0113] Referring to FIGS. 2-7 and 8, 9A, 9B, the interlocking engagement of the mounting bracket 20 with the support members 30i, 302 allows the mounting bracket 20 to be released while in a first upright orientation (FIG. 2) and reassembled in an upside-down orientation (FIG. 8), reverse from the first upright orientation, thereby allowing for an increased number of height positions for the first fixation member 40 using a selected one of the apertures 140.

[0114] FIGS. 10A-10C show the mounting bracket 20 can be provided as a first mounting bracket 20U configured for as an “upright” configuration for use in a single orientation. FIGS. 10D-10E show the mounting bracket 20 can be provided as a second mounting bracket 20D configured for a “downward” configuration for use in a single orientation. The positional indicators 22 can be provided as a single set in a first set ofPCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO numerical increments, e.g., “1, 3, 5”, for the upright configuration 20U and a second single set of numerical increments, e.g., “2, 4, 6”, for the downward configuration 20D. The first and second mounting brackets 20U, 20D can provide the same different height positions for the apertures 140 of the single, flappable, mounting bracket 20 shown in FIGS. 8, 9A, 9B.

[0115] The right and left side end portions 120 can be shaped to matably, releasably engage a respective mounting channel 130c in the corresponding support member 30i, 302. In some embodiments, the reverse configuration can be used, e.g., the support members 30i, 302 can have the shaped interlocking end and the mounting bracket 20 can have the matably shaped channel (not shown).

[0116] A lock member 125 can be coupled to a sleeve 30s of a respective support member 30i, 302 and be configured to pivot between first and second positions to controllably release and lock to the support member 30i, 302 to a corresponding post 70i, 702.

[0117] The sleeve 30s of the support members 30i, 302 can be configured so that the channel 30c has a radius of curvature R, when viewed from the side (FIG. 4), that corresponds to / matches that of the posts 70i, 702.

[0118] As discussed above, the mounting bracket 20 can be configured to be used in first and second orientations with the bottom 20b of one orientation (FIG. 2) at the top in the other orientation: compare, FIG. 2 with FIG. 8, for example. One end 20e, shown as the bottom end in FIGS. 2, 5, can have a straight configuration across an entire lateral extent while the opposing end can have a curvilinear configuration comprising a straight segment 27 that merges into outer side segments 28 with a reduced height toward the support members 30i, 302 (FIGS. 2, 5) which can provide a sight path for fiducial markers such as optical reflectors (95, FIG. 24A) of the radiosurgery system.

[0119] It is noted that the height positions of the apertures 140 can be provided in other ways not requiring inversion of the mounting bracket 20 or used with the reversible orientation of the mounting bracket 20. For example, the height adjustment can be provided by providing different height engaging positions in the support member interlock interface 130’ for the side portions 120 of the mounting bracket 20. That is, the side portions 120 of the mounting bracket 20 can be slid into a desired “shelf’ location 130a, 130b, 130d provided by a respective support member 30’ to provide defined selectable support positions Pl, P2, P3 as shown in FIG. 11 A. By way of another example, as shown in FIG. 11B, the interlocking segment and / or interlocking interface 130” of the support members 30” and / or the side portions 120 of the mounting bracket 20 can be configured to telescopingly extend and retract relative to a bottom 30b of the sleeve to provide the height adjustment for thePCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO mounting bracket 20 and thus for the chin support 15. In the example embodiment shown in FIG. 11B, the interlock interface 130” can be slidably mounted on rails 130r to extend and retract and can be configured to lock into a desired height position.

[0120] Turning now to FIGS. 12A and 12B, a surgical chin support assembly 10 is shown with the support system 12 adjustably coupled to the chin support 15. In this embodiment, the chin support 15 can have a curved surface 15c (FIG. 13) configured to face the chin of a patient for comfort. The radius of curvature R (FIG. 17) can be in a range of about 50 mm to about 120 mm, such as, for example, about 52 mm in some embodiments. The chin support 15 can have a maximum lateral extent (width) in a range of 70 mm to 100 mm, typically about 80 mm. The chin support 15 can have a maximum longitudinal extent (thickness) that is in a range of 15-20 mm, such as about 17.5 mm. The thickness of the chin support 15 may vary across its width / lateral extent so that it increases in thickness at outer edges by about 50% or greater. In some embodiments, the thickness at the center can be about 10 mm and this thickness can increase to about 17.5 mm at the outer edges, for example.

[0121] FIGS. 13 and 14 show the first fixation member 40 threadably coupled to a first aperture 140 at a medial height location associated with positional indicator 22 at position “3”. The secondary fixation members 50i, 502 can be positioned in respective apertures 1501, 1502 to provide side to side stability of the chin support 15. The secondary fixation members 50i, 502 may be positioned at a common height position as the first fixation member 40.

[0122] FIGS. 15-18 illustrate one example embodiment of a chin support 15 with the curved surface 15c. The chin support 15 can comprise a plurality of laterally spaced apart apertures 200, 2501, 2502 that can extend longitudinally a partial distance through a portion of the chin support 15. No threads are required in any of the apertures 200, 2501, 2502. The first fixation member 40 is configured to be received in the aperture 200 while the secondary fixation members 50i, 502 (FIG. 13) are configured to be received in the respective apertures 2501, 2502. The apertures 2501, 2502 can have a diameter or maximum lateral extent that is less than the diameter or maximum lateral extent of the first aperture 200 by about 30-50%, e.g., about 8 mm for the first aperture and about 4.5 mm for the secondary / side apertures 2501, 2502. The apertures 200, 2501, 2502 can have any suitable shape and are not required to be circular. The fixation members 40, 50i, 502, can also have any suitable shape and are not required to be circular.PCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO

[0123] FIGS. 19A and 19B illustrate another example embodiment of a chin support 15’ similar to that shown in FIGS. 15-18 but with a different configuration comprising a different perimeter shape (rectangular versus oval). Other chin support configurations may be used.

[0124] FIGS. 19B, 21A also illustrate that the chin support 15 can comprise a pressure sensor 275 that can be used to confirm sufficient contact force with the chin of the patient and / or be used to identify any reduction in force during a therapy session. The pressure sensor 275 can be a single pressure sensor or a plurality of pressure sensors for different contact locations. The chin support 15 can comprise a pressure sensor channel 1275 sized and configured to receive the pressure sensor 275. The pressure sensor 275 can be electrically connected to a display to provide an audiovisual output. The pressure sensor 275 can be hard-wired or be wirelessly configured to communicate with a user interface such as a pressure gauge module with a display (FIG. 30A).

[0125] FIG. 21A shows a first example channel 1275 holding a pressure sensor 275. FIG. 21B shows a second example channel 1275 for the pressure sensor 275.

[0126] The pressure sensor 275 can be releasably insertable into the channel 1275 or integrated into the chin support 15. The pressure sensor channel 1275 can be medially laterally centered as shown in FIGS. 19B, 19C, 21A.

[0127] The pressure sensor 275 can comprise or be a thin-film pressure sensor.

[0128] FIGS. 22A, 22B show that the chin support 15 can have a maximum longitudinal extent (thickness “Th” or “TH”) that is in a range of 15-20 mm, such as about 17.5 mm. The apertures 2501, 2502 can reside on opposing sides of the pressure sensor channel 1275 as shown in FIGS. 19C, 21A, 21B. The fixation aperture 200 for the first fixation member 40 can reside behind the pressure sensor 275 and channel 1275 (FIGS. 21A, 21B) with the pressure sensor channel 1275 closer to the curved surface 15c of the chin support 15 than the first aperture 200 in the use position (FIG. 12A).

[0129] FIGS. 23A and 23B illustrate sets 40s of first fixation members 40 that may be provided, optionally in a kit for use. The sets 40s provide the first fixation members 40 in different maximal lengths L1-L3, in a range of about 50 mm to about 85.5 mm. LI can be about 50 mm, L2 can be about 65.5 mm and L3 can be about 85.5 mm, for example. The fixation members 40 can be configured with a first portion 41 having threads 41t and which can be colored in discrete adjacent segments, such as every 1-5 mm, in different colors 42 to facilitate reproducible, efficient set-up. The fixation members 40 may be partially threaded so that a segment 44 is devoid of threads for easier assembly to the chin support 15. ThePCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO segment 40 that is devoid of threads can have a different distance “d” for each different length fixation member 40, with longer fixation members having longer segments 44. The head 40h may be sufficiently wide to allow for ease of rotation by a user.

[0130] Components of the surgical chin support assembly 10 may be formed in any suitable manner including, for example, 3-D printing, molding, machining and the like. Components may be reusable or single-use disposable. The chin support 15 may be formed of thermoplastic material and be moldable to a patient specific anatomical chin shape or may have a preformed shape suitable for use for most patients. Different size and shaped chin supports 15 may be used along with different length fixation members 40 (FIG. 23A) for gender and age, such as pediatric, adult and / or male, female.

[0131] Turning now to FIGS. 24A, 24B, an example head rest 80 is shown adjacent a bore 100b of a radiosurgery system 100. The head rest 80 is coupled to a table 101. The posts 70i, 702 can comprise fiducial makers 95 such as optical reflectors that can be used to identify patient position. The posts 70i, 702 can each comprise a recess 73 on a rearward facing surface. The recess 73 can extend up and down a partial distance of the posts 70i, 702. The head rest 80 can comprise short posts and apertures on each side thereof.

[0132] Referring to FIGS. 25, 26A and 26B, the surgical chin support assembly 10 can be coupled to the posts 70i, 702. The lock member 125 can be pivoted upward above pivot axis A-A to slide the sleeve 30i down over the post 70i. The lock member 125 can pivot downward to lock into the recess 73 (FIG. 26B) and lock the support member 30i in position. The chin support assembly 10 does not visually block the fiducial markers 95 present on the posts of the head rest 80.

[0133] FIG. 27 shows the chin support assembly 10 coupled to the posts 70i, 702 with the mounting bracket 20 in a first upright orientation 20a and FIG. 28 shows the surgical chin support assembly 10 coupled to the posts 70i, 702 with the mounting bracket 20 in the second reverse orientation 20b. This versatility provides double the indexed height positions available for the fixation member 40 that controls the longitudinal position of the chin support 15 relative to a single orientation configuration. As shown the two orientations provides for three different height positions for the fixation member 40 using three apertures 140 at different height positions thereby providing six different indexed positions of height for the chin support 15. More or less such height positions can be provided by using additional apertures 140 or less apertures 140 or by configuring the mounting bracket for a single use orientation. In some embodiments, an elongate vertical slot that is narrower than the apertures 140 but slightly larger than the shaft of the fixation member can be providedPCT / US25 / 51811 21 October 2025 (21.10.2025)Attorney Docket No. 1184.283. WO which merges into different aperture positions at different heights providing selectable aperture positions (not shown). A simulation set-up can be used prior to an actual therapy session and the color segments 42 of the fixation member 40 along with the indexed heigh position can facilitate duplication and speed of an actual set-up for the therapy session.

[0134] FIG. 29 schematically illustrates an example radiosurgery system 100 with the bore 100b and table 101 in communication with a computer system 500 can be used with the surgical chin support assembly 10, the head rest 80 and face mask 90 such as shown in FIG.1. The fiducial markers (e.g., optical reflectors) 95 are not visually occluded from one or more detectors 195 when the surgical chin support assembly 10 is used. The one or more detector 195 can be in communication with the computer system 500 which may be provided onboard the radiosurgery system or distributed in a LAN, WAN or CLOUD based systems.

[0135] FIGS. 30A and 30B show an example pressure sensor 275 coupled to a pressure gauge module 277 comprising a display 277d for providing a measurement of the pressure sensed at the chin support 15 according to embodiments of the present invention. As stated hereinabove, the pressure sensor 275 can be a thin-film force sensor / gauge of various types and from various manufacturers. On example, is a thin-film pressure sensor and display module by Qinlorgo (P / N 74byh2r9p61900), available through Amazon.com and other sources.

[0136] The foregoing is illustrative of the present invention and is not to be construed as limiting thereof. Although a few exemplary embodiments of this invention have been described, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the claims. The invention is defined by the following claims, with equivalents of the claims to be included therein.

Claims

Attorney Docket No. 1184.

283. WOTHAT WHICH IS CLAIMED IS:

1. A surgical chin support assembly comprising: a mounting bracket comprising at least one through aperture; a chin support comprising an aperture facing the mounting bracket; and a fixation member configured to extend through one of the at least one through aperture of the mounting bracket and into the aperture of the chin support, wherein the fixation member is configured to be controllably translated in a longitudinal direction between extended and retracted positions whereby in the extended position the chin support is positionable against a chin of a patient.

2. The surgical chin support assembly of Claim 1, wherein the at least one through aperture of the mounting bracket comprises a plurality of vertically spaced apart through apertures aligned along a transverse center of the mounting bracket.

3. The surgical chin support assembly of Claim 1, wherein the mounting bracket is configured to be releasably attached to first and second support members that are laterally spaced apart.

4. The surgical chin support assembly of Claim 2, wherein the mounting bracket is configured to be interchangeably releasably attached to the first and second support members in a first orientation and a in second orientation reversed to be upside down of the first orientation, with the first and second orientations providing the plurality of vertically spaced apart through apertures at different height positions relative to a bottom of the support members.

5. The surgical chin support assembly of Claim 1, further comprising first and second positional indicators positioned adjacent the at least one through aperture whereby two different height positions are correlated to a single one of the at least one through aperture.

6. The surgical chin support assembly of Claim 1, wherein the at least one through aperture comprises a plurality of vertically spaced apart through apertures, and wherein the positional indicators comprise a plurality of different numbers arranged along a side of the vertically spaced apart through apertures.Attorney Docket No. 1184.

283. WO7. The surgical chin support assembly of Claim 1, further comprising first and second sleeves releasably attached to the mounting bracket, wherein the first and second sleeves each comprise a curved channel configured to receive a post of a head rest, and wherein the first and second sleeves each comprise a lock member configured to lock a respective sleeve against a corresponding post.

8. The surgical chin support assembly of Claim 1, wherein the fixation member comprises a plurality of neighboring segments in different colors.

9. The surgical chin support assembly of Claim 1, wherein the fixation member comprises a shaft with threads, and wherein the threads are configured to threadably engage threads in a selected aperture of the at least one through aperture whereby rotation of the fixation member in a first rotational direction extends the chin support toward the patient and rotation of the fixation member in a second rotational direction retracts the chin support away from the patient.

10. The surgical chin support assembly of Claim 9, wherein the shaft of the fixation member comprises a segment devoid of threads configured to couple to the aperture of the chin support.

11. The surgical chin support assembly of Claim 1, wherein the fixation member is provided as a set of fixation members, each having a different length thereby providing different longitudinal positional adjustability for the chin support relative to the mounting bracket.

12. The surgical chin support assembly of Claim 1, wherein the fixation member is a center fixation member, the surgical chin support assembly further comprising side fixation members, one on each side of the center fixation member and each extending through a respective aperture in the mounting bracket and a corresponding receiving aperture in the chin support to thereby provide lateral stability to the chin support.

13. The surgical chin support assembly of Claim 1, further comprising first and second sleeves with interlocking interface segments coupled to respective first and second end portions of the mounting bracket, wherein the mounting bracket has a lateral length sufficientAttorney Docket No. 1184.

283. WO to extend across a head rest, and wherein the chin support is configured to clamp a face mask against a chain of a patient while the patient head is in the head rest and the face mask is coupled to the head rest.

14. A radiosurgery system comprising: a radiation system comprising a bore, a table longitudinally translatable into and out of the bore, a head rest coupled to the table with first and second posts on opposing lateral sides of the table; and a chin support assembly coupled to the first and second posts of the head rest.

15. The radiosurgery system of Claim 14, wherein the chin support assembly comprises: a mounting bracket comprising at least one through aperture; a chin support comprising an aperture facing the mounting bracket; and a fixation member configured to extend through one of the at least one through aperture of the mounting bracket and into the aperture of the chin support, wherein the fixation member is configured to be controllably translated in a longitudinal direction between extended and retracted positions whereby in the extended position the chin support is positionable against a chin of a patient.

16. The radiosurgery system of Claim 15, wherein the at least one through aperture of the mounting bracket comprises a plurality of vertically stacked through apertures aligned along a transverse center of the mounting bracket.

17. The radiosurgery system of Claim 16, wherein the chin support assembly further comprises a first support member coupled to the first post and a second support member coupled to the second post, wherein the mounting bracket is configured to be interchangeably, releasably attached to the first and second support members in a first orientation and in a second orientation reversed to be upside down of the first orientation, with the first and second orientations providing the plurality of vertically stacked through apertures at different height positions relative to a bottom of the support members.

18. The radiosurgery system of Claim 15, further comprising first and second positional indicators positioned adjacent the at least one through aperture whereby two different height positions are correlated to a single one of the at least one through aperture.Attorney Docket No. 1184.

283. WO19. The radiosurgery system of Claim 16, wherein the mounting bracket further comprises positional indicators arranged adjacent the plurality of vertically stacked through apertures.

20. The radiosurgery system of Claim 19, wherein the positional indicators comprise odd numbers arranged along one side of the vertically stacked through apertures21. The radiosurgery system of Claim 19, wherein the positional indicators comprise even numbers arranged along one side of the vertically stacked through apertures.

22. The radiosurgery system of Claim 19, wherein the positional indicator comprise odd numbers arranged along one side of the vertically stacked apart through apertures and even numbers arranged along an opposing side of the vertically stacked through apertures.

23. The radiosurgery system of Claim 15, further comprising first and second sleeves releasably attached to the mounting bracket, wherein the first and second sleeves each comprise a curved channel configured to receive a respective post, and wherein the first and second sleeves each comprise a lock member configured to lock a respective sleeve against the respective post.

24. The radiosurgery system of Claim 16, wherein the fixation member comprises a shaft with threads, wherein the threads are configured to threadably engage threads in a selected aperture of the plurality of vertically stacked through apertures whereby rotation of the fixation member in a first rotational direction extends the chin support toward the patient and rotation of the fixation member in a second rotational direction retracts the chin support away from the patient, and wherein the threads of the fixation member comprises a plurality of neighboring segments in different colors.

25. The radiosurgery system of Claim 15, further comprising a face mask coupled to the head rest, wherein the mounting bracket has a lateral length sufficient to extend across the head rest, and wherein the chin support is configured to clamp the face mask against a chain of a patient while the patient head is in the head rest and the face mask is coupled to the head rest.Attorney Docket No. 1184.

283. WO26. The radiosurgery system of Claim 14, wherein the radiosurgery system is a gamma knife radiosurgery system.

27. The assembly of Claim 1 or the radiosurgery system of Claim 15, wherein the chin support comprises a pressure sensor held therein.

28. The assembly of Claim 1 or the radiosurgery system of Claim 15, wherein the chin support comprises a curved surface configured to abut a chin of a patient, and wherein the chin support comprises a pressure sensor channel in the chin support behind the curved surface and in front of the aperture facing the mounting bracket.

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