RU2468751C2 - Method of positioning and bringing positioner - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and can be used in positioning patients when carrying out X-ray dental examination. Method lies in the following; height of panoramic apparatus for X-ray examination is regulated by means of column switch up/down, providing support for patient's chin on the apparatus chin, patient's cervical spine must be straight and vertical. Vertical laser beam of the apparatus is pointed at the centre of patient's occipital bone, patient's head is immobilised by the apparatus head fixer. Horizontal laser beam of the apparatus chin is adjusted until it corresponds to patient's occlusion plane. Patient preliminarily sits down on the seat of bringing positioner, places the chin on the apparatus chin and holds the handle of bringing positioner with lowered hands. Patient's shoulders are brought medially under the impact of bringing positioner with patient's chest remaining immobile and tightly pressed to vertical bar of bringing positioner, which switches on the seat with control unit and tumbler. The seat is provided with vertical bar, engine and reductor, covered with case with hole, into which kinematically shortened flexible cable with triangular handle is passed, are fixed under it.

EFFECT: application of invention makes it possible to optimise mechanical part of examination.

2 cl, 3 dwg

Description

The invention relates to medicine, namely to dentistry, and can be used in the process of positioning patients in panoramic X-ray machines and computed tomographs, for example PaX-Reve3D, and during X-ray studies, with the exception of studies in cephalometric mode.

PaX-Reve3D panoramic x-ray machine with 3D reconstruction function is designed to carry out the entire possible range of x-ray studies possible in dentistry.

One of the most important points during the study is the correct positioning of the patient. Inaccurate positioning is the cause of the distortion of the desired data and re-diagnosis, i.e. unreasonable radiation exposure.

In view of this aspect, patient immobilization with correctly performed positioning is of particular relevance. Immobilization of patients - a sequence of actions that prevents the movement of patients with external force. This component is one of the most important when conducting x-ray studies. Minimal patient movements significantly reduce the quality of diagnosis.

When performing X-ray diagnostic studies on panoramic X-ray machines or a computer tomograph, a bite block, a set of chins, head fixators, and also handles located on the console below the chin are used for high-quality immobilization. These devices help the patient to remain motionless after completing positioning, during the start of exposure and the start of image capture. This algorithm starts to run after pressing the “Ready” button. Following the command, the rotating part will begin moving around the shoulder girdle of the subject and will occupy the position necessary for a particular type of study.

The positioning technique used for computed tomography on PaX-Reve3D devices [User Manual PaX-Reve3D instruction] was selected for the prototype. Other types of studies differ from those described by modeling the parameters of the exposure and projection of vertical and horizontal laser beams, which regulates only the nature of the emission of the electron beam.

The study is carried out as follows: after the procedure, which ensures that the grip parameters take effect, the patient is installed as close to the device as possible, puts his legs a little forward, and grabs hold of the handles, orienting the chin to the line of the chin; the height of the apparatus is adjusted by the column switch up / down, ensuring that the patient’s chin rests on the chin, the patient’s shoulders are even, the cervical spine is straight and vertical, the vertical laser beam is placed in the center of the occipital bone; the patient’s head is immobilized with a head clamp; the horizontal beam is brought out by the height of the chin using the LCD panel up / down control button and corresponds to the patient's occlusion plane, the patient's tongue is brought to the sky, lips are compressed; after which the “Ready” button is pressed, and the study is conducted in a standard form.

Figure 1 shows the situation in which the distance between the heads of the right and left humerus of the patient is greater than the distance from the x-ray tube to the x-ray sensor module. Active reduction of the bones of the shoulder girdle by the patient does not guarantee the immobility of the latter during the study.

The disadvantage of positioning methods is: the impossibility of conducting research on persons with a distance between the heads of the right and left humerus (taking into account soft tissues, clothing) equal to or greater than the distance from the x-ray tube to the x-ray sensor module. In this case, two options are possible:

- the rotating part of the apparatus stops (the mechanical power of the apparatus is less than the patient's stability), the study is interrupted;

- the patient is “shifted” by the device (the mechanical power of the device is greater than the patient's stability). Passive movements of the patient lead to a change in the positioning and not informativeness of the study.

The closest to the achieved result is a positioner for a panoramic apparatus for x-ray research according to patent US 3521057, published July 21, 1970, including a seat with a control unit and a toggle switch. The disadvantage of this device is that relative to the source of x-ray radiation, only the patient’s head is positioned, and if necessary, the influence of the positioner cannot change the anatomical characteristics of the shoulder girdle of the studied biological prototype.

The objective of the invention is to optimize the mechanical part of the study - the movement of the rotating part of the apparatus around the patient’s shoulder girdle, the creation of positioning conditions that reduce the distance between the heads of the humerus by mechanically-static impact on the musculoskeletal system of the shoulder girdle with a fixed position of the spine and bones of the facial skeleton.

The technical result consists in the fact that the proposed algorithm for conducting x-ray studies, by means of the declared converging positioner, reduces the distance between the heads of the right and left humerus, which allows the mechanical part of the x-ray apparatus to mix freely around the patient, i.e. the distance between the heads of the right and left humerus of the patient is passively reduced to values smaller than the distance from the x-ray tube to the x-ray sensor module, and the patient is guaranteed to be stationary during the study.

The problem is solved by the proposed positioning method, namely, that the height of the panoramic apparatus for x-ray studies is controlled by the column up / down switch to ensure that the patient’s chin is fixed on the apparatus’s chin, while the cervical spine of the patient must be straight and vertical, and the apparatus’s vertical laser beam to the center of the occipital bone of the patient, the patient’s head is immobilized by the apparatus head retainer, and the horizontal laser beam of the chin app rata outputted to patient compliance with the plane of occlusion. To implement the method, the patient pre-sits on the seat of the reducing positioner, which is installed with the possibility of placing the chin on the chin of the apparatus, and with his hands down, holds the handle of the reducing positioner, after which the patient’s shoulders are brought medially under the action of the reducing positioner, and the patient’s chest remains motionless and tightly pressed to the vertical level of the converging positioner.

To achieve the technical result, a converging positioner is proposed that includes a seat with a control unit and a toggle switch, the seat being equipped with a vertical bar and a motor and gearbox are rigidly fixed under it, sheathed with a housing with an opening through which a kinematically shortened flexible wire with a triangular handle is passed, connecting motor, gearbox and handle for converging positioner.

The method is as follows. The patient first sits on the seat of the reducing positioner installed at the point that determines the corresponding (along the line) chin placement on the chin. He puts his hands down and holds the handle of the reducing positioner firmly. Adjust the height of the apparatus by turning the column up / down switch, ensuring that the patient’s chin rests on the chin. The patient’s shoulders under the action of the converging positioner, without encountering the counteraction of the vertical bar of the converging positioner, are medially brought, while the patient’s chest remains motionless and tightly pressed to the vertical bar of the converging positioner, and the cervical spine of the patient should be straight and vertical. A vertical laser beam is placed in the center of the occipital bone. The patient's head is immobilized with a head retainer. A horizontal beam is output with the height of the chin using the LCD panel up / down button so that it corresponds to the patient's occlusion plane. The patient brings his tongue to the sky and tightens his lips. The study is conducted in a standard form.

Figure 2 shows a situation in which the distance between the heads of the right and left humerus of the patient, by the kinematic effect of the converging positioner, is passively reduced to values smaller than the distance from the x-ray tube to the x-ray sensor module, which ensures the patient is immobilized during the study.

Figure 3 shows a side view of the converging positioner.

The reducing positioner contains a seat 1 with a vertical bar 2, under which the motor 3 and the gearbox 4 are rigidly fixed, covered by a housing 5 with an opening (not shown). A kinematically shortened flexible wire 6 with a triangular handle 7 is passed into the hole, in addition, the reducing positioner is equipped with a control unit 8 with a toggle switch “on” - “off” 9.

The device is used as follows: the patient, wearing a lead apron, sits on the seat 1 of the reducing positioner installed at the point that determines the corresponding chin placement on the chin of the used X-ray machine; puts her hands down and holds the handle 7 of the converging positioner tightly. By moving the toggle switch 9 to the “on” position of the control unit 8, the flexible wire 6 connecting the motor 3 and the gearbox 4 and the handle 7 of the converging positioner is shortened. At the same time, the patient’s chest remains motionless and tightly pressed to the vertical bar 2 of the reducing positioner; the patient's shoulders under mechanical stress, not encountering the counteraction of the vertical bar 2 of the reducing positioner, are given medially. Upon reaching sufficient information of the bones of the shoulder skeleton, the toggle switch 9 is switched to the off state.

Claims (2)

1. The method of positioning, which consists in adjusting the height of the panoramic apparatus for x-ray studies with the column switch up / down to ensure that the patient’s chin rests on the apparatus’s chin, while the cervical spine of the patient must be straight and vertical, and the vertical laser beam of the apparatus is placed in the center the occipital bone of the patient, the patient’s head is immobilized by the apparatus head retainer, and the horizontal laser beam of the apparatus’s chin is brought out to match the plane o patient’s occlusion, characterized in that the patient previously sits on the seat of the reducing positioner according to claim 2, adopted with the possibility of placing the chin on the chin of the apparatus and with downcast hands holds the handle of the reducing positioner, after which the patient’s shoulders are brought medially, and the patient’s chest remains stationary and tightly pressed to the vertical bar of the reducing positioner. 2. A converging positioner, including a seat with a control unit and a toggle switch, characterized in that the seat is provided with a vertical bar and the motor and gearbox are rigidly fixed under it, covered with a hole with a kinematically shortened flexible wire with a triangular handle that connects the motor , gearbox and knob for reducing positioner.

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