CN203944037U - Upper and lower separation type support for the radiotherapy of oral cavity - Google Patents
Upper and lower separation type support for the radiotherapy of oral cavity Download PDFInfo
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- CN203944037U CN203944037U CN201420364059.4U CN201420364059U CN203944037U CN 203944037 U CN203944037 U CN 203944037U CN 201420364059 U CN201420364059 U CN 201420364059U CN 203944037 U CN203944037 U CN 203944037U
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- type support
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Abstract
The utility model discloses upper and lower separation type support for the radiotherapy of a kind of oral cavity, comprise rack body, this rack body is a hollow shell, and oral cavity intracavity shape when its external shape and people dehisce is coincide; The front portion of rack body is standing part, is respectively equipped with denture impression groove and mandibular dentition impression groove on the upper surface housing of standing part and lower surface housing; The rear portion of rack body is a bulging tongue portion, and the upper surface of a bulging tongue portion is support palatal surface, and the lower surface of a bulging tongue portion is support lingual surface; Between standing part and a bulging tongue portion, with gas-permeable channels, connect.Dental stent of the present utility model is applicable to oral and maxillofacial surgery tumor radiotherapy, can stablize and effectively reduce the radioactive dose that jeopardizes organ, thereby reduce oral mucosa damage and sense of taste damage in oral and maxillofacial surgery tumor radiotherapy process, improve compliance and life quality that sufferer is accepted radiotherapy.
Description
Technical field
This utility model belongs to tumor of head and neck radiation therapy technology field, relates in particular to a kind of dental stent of separation type up and down using in oral and maxillofacial surgery tumor radiotherapy process.
Background technology
Radiotherapy or radiotherapy are that main Comprehensive Treatment is the basic principle of in current medical domain, tumor of head and neck being treated, and more than 70% head-neck malignant tumor all needs radiocurable intervention in its therapeutic process.But all the time, the function of parotid damage that radiotherapy causes, oral mucosa damage and sense of taste damage etc., the xerostomia causing therefrom and oral disease, it is modal complication in head-neck malignant tumor radiotherapy always, these complication have a strong impact on patient's life quality, sometimes even cause having to suspend radiotherapy, thereby reduced the Partial controll to tumor.
The incidence rate of radioactivity oral mucosa damage and sense of taste damage and the order of severity are closely related with oral mucosa and the irradiated dosage of tongue and volume respectively.At present, for reducing tongue and the radioactive dose of oral mucosa in Patients During Radiotherapy, domestic frequent use cork, disposable syringe etc. push away target area by tongue and part oral mucosa, but the method mainly exist press tongue effect uncertainly, position poor repeatability, can not individuation shortcoming.
Utility model content
The support of separation type up and down that provides a kind of oral cavity radiotherapy to use is provided the purpose of this utility model, contributes to reduce the radioactive dose, the raising field dose that jeopardize organ, contributes to applying electronic Real time portal imaging (EPID) to improve radiotherapy position accuracy.
For solving the problems of the technologies described above, this utility model provides upper and lower separation type support for the radiotherapy of a kind of oral cavity, comprises rack body, and this rack body is a hollow shell, and oral cavity intracavity shape when its external shape and people dehisce is coincide; The front portion of this rack body is standing part, is respectively equipped with denture impression groove and mandibular dentition impression groove on the upper surface housing of standing part and lower surface housing; The rear portion of this rack body is a bulging tongue portion, and the upper surface of a bulging tongue portion is support palatal surface, and the lower surface of a bulging tongue portion is support lingual surface;
In addition, between above-mentioned standing part and a bulging tongue portion, with gas-permeable channels, connect, the two ends of this gas-permeable channels are respectively the first air-vent being opened in rack body front end shell and are opened in the second air-vent on rack body end housing.
Specifically: dental stent of the present utility model is that personalization is made, its external shape is carried out the oral cavity intracavity shape customization of radiocurable sufferer while dehiscing according to need.The front portion of this dental stent is standing part, and rear portion is a bulging tongue portion.Standing part at this dental stent, on upper and lower surperficial housing, be respectively equipped with denture impression groove and mandibular dentition impression groove, and upper and lower denture impression groove is all darker, avoid this dental stent to wear to situation about being moved after sufferer oral area, guaranteed this dental stent and the good position repeatability of upper mandibular bone in radiation therapy process.The effect of this bulging tongue portion, is separated upper mandibular bone and supporting role on the one hand, makes to jeopardize organ and is fixed on beyond high dose area, reduces radioactive dose; Be that tongue is fixed on to bottom, oral cavity on the other hand, guarantee the repeatability of the position of tongue in radiation therapy process.Finally, between the standing part of this dental stent and a bulging tongue portion, with gas-permeable channels, connect, the two ends of this gas-permeable channels are respectively the first air-vent being opened in rack body front end shell and are opened in the second air-vent on rack body end housing; Airway patency when being conducive to keep sufferer to wear this dental stent and carrying out radiotherapy with the dental stent of gas-permeable channels, this advantage seems particularly important for oral and maxillofacial surgery tumor radiotherapy patient, because the situation of edema of throat airway narrows in its Patients During Radiotherapy happens occasionally; The gas-permeable channels connecting before and after being provided with in dental stent of the present utility model, with to sufferer, use stopper etc. to suck thing when the radiotherapy clinically at present to compare, can effectively prevent respiratory distress, respiratory movement degree to increase and cause target area displacement error to increase, thereby having avoided most possibly the generation of the contingencies such as patient suffocates.
Preferably, in dental stent of the present utility model, support palatal surface is a shape and the people identical curved surface of oral cavity palatal surface shape while dehiscing, and support lingual surface is a shape and the people identical curved surface of oral cavity lingual surface shape while dehiscing.A bulging tongue portion at this dental stent, the identical support lingual surface of oral cavity lingual surface shape when the support palatal surface that oral cavity palatal surface shape when comprising shape and people and dehiscing is identical and shape and people dehisce, its medium-height trestle lingual surface must with tongue close contact, simultaneously again to the reserved certain space of tongue, both avoided pressing tongue tension to cause discomfort, tongue can not passed backward and caused glossoptosis again, cause patient to suffocate.
Preferably, in oral cavity of the present utility model radiotherapy, with in upper and lower separation type support, the cross section of gas-permeable channels is circular, and the diameter of the cross section of this gas-permeable channels is 1～1.5cm.In theory, the gas-permeable channels that cross section is any shape all can play the unobstructed effect of above-mentioned maintenance patient airway; Preferably, the shape of cross section of gas-permeable channels is made as to circle, and the diameter of the cross section of this gas-permeable channels is made as 1～1.5cm, in the situation that bottom surface maximum diameter is restricted, circular maximum compared with other shape floor space such as rectangle, square, thus guarantee that the ventilation of cylinder gas-permeable channels is maximum.
Preferably, in oral cavity of the present utility model radiotherapy with in upper and lower separation type support, vertical dimension between mandibular dentition impression groove and rack body end is 4.5～5cm, both can guarantee the pressure tongue effect of determining, in the time of can avoiding again dental stent long, stimulate wearer's pars oralis pharyngis to cause that the situation of pharynx rear wall reflection occurs.
Further, in oral cavity of the present utility model radiotherapy with in upper and lower separation type support, surrounding at the first air-vent is provided with more than three index aperture, index aperture is also opened in rack body front end shell, and extend different depth in rack body, in index aperture, place non-coplanar metal marker thing, this metal marker thing is preferably the stainless steel ball of diameter 3mm.MV level x-ray be take Compton scattering as main, Gu Yu soft-tissue image resolution is low, anatomical structure shows owes clearly, put three the above non-coplanar metal marker things clearly that develop, can improve precision and the speed of launched field image and reference picture (DRR image) registration, contribute to apply the termed image-guided radiotherapy (IGRT) that EPID carries out incidence.In addition, because upper jaw bone and skull link by sutura, cranium jaw face organ moves very little, can suppose that whole head is 1 rigidity structure.In head, the coordinate of any point will change along with the variation of 3 above non-coplanar label coordinates like this.Owing to there being the function that can carry out image registration based on metal marker, the range of application of dental stent of the present utility model is further expanded, except being suitable for oral and maxillofacial surgery tumor radiotherapy, be also very suitable for being applied in head and neck tumor radiotherapy process.
In theory, more than 3 or 3 non-coplanar metal marker things all can be realized above-mentioned purpose, but label number too much can increase the difficulty of registration, so the number of index aperture and label is preferably 3.In addition, the metal object that all size is suitable all can be used as metal marker thing and realizes above-mentioned purpose, but wherein with stainless steel ball economy, easily purchases, therefore be preferred.Unclear through experimental studies have found that the development of diameter 1mm, 2mm steel ball, it is heavier that diameter is greater than the stainless steel ball artifact of 5mm, is therefore preferably the stainless steel ball of diameter 3mm, can meet best clinical practice demand.
Further, in oral cavity of the present utility model radiotherapy, with in upper and lower separation type support, the thickness of shell of rack body is 2～10mm, and preferably the thickness of shell of rack body is 5～10mm.In general, the thickness of shell of dental stent is at least 2mm.When tumor is carried out to radiotherapy apart from the nearer sufferer of mucomembranous surface, this utility model is increased to 5～10mm by the thickness of shell of dental stent, and fit tightly with mucosal surface, thereby make tumor outside built-up areas, make it to play tissue equivalent's implant (Bolus) effect.In clinical radiotherapy irradiation process, the patient that some skins or mucosal surface are invaded, Xu Yong tissue equivalent packing material by buildup depth in advance to improve field dose.Dental stent housing of the present utility model only need be selected even density, CT value with soft tissue is close, can fit tightly with mucosal surface, the material of the satisfied requirement as Bolus is made when making, and can play tissue equivalent's implant (Bolus) and act on.
Accompanying drawing explanation
Fig. 1 is the left view of upper and lower separation type support for the radiotherapy of oral cavity of the present utility model;
Fig. 2 is the top view of upper and lower separation type support for the radiotherapy of oral cavity of the present utility model;
Fig. 3 is the upward view of upper and lower separation type support for the radiotherapy of oral cavity of the present utility model;
Fig. 4 is the front view of upper and lower separation type support for the radiotherapy of oral cavity of the present utility model;
Fig. 5 is the rearview of upper and lower separation type support for the radiotherapy of oral cavity of the present utility model.
The specific embodiment
For making the purpose of this utility model, technical scheme and advantage clearer, below in conjunction with accompanying drawing, each embodiment of the present utility model is explained in detail.Yet, persons of ordinary skill in the art may appreciate that in each embodiment of this utility model, in order to make reader understand the application better, many ins and outs have been proposed.But, even without these ins and outs and the many variations based on following embodiment and modification, also can realize each claim of the application technical scheme required for protection.
The first embodiment of the present utility model relates to upper and lower separation type support for the radiotherapy of a kind of oral cavity, comprise rack body 1, this rack body 1 is a hollow shell, oral cavity intracavity shape when its external shape and people dehisce is coincide, oral cavity intracavity shape personalized customization while dehiscing according to the sufferer of wearing this dental stent forms, and the thickness of shell of rack body 1 is 3mm.
The front portion of this rack body 1 is standing part, on the upper surface housing of standing part and lower surface housing, be respectively equipped with denture impression groove 2 and mandibular dentition impression groove 3, on this, the distance of denture impression groove 2 and mandibular dentition impression groove 3 is to form according to the mouth opening personalized customization of sufferer, in general, between upper and lower denture impression groove, distance is 2cm, the width of standing part is also adjusted according to the denture concrete condition of sufferer, is 3.5cm.In addition, the vertical dimension between mandibular dentition impression groove 3 and rack body 1 end is 4.5cm; In the dental stent of present embodiment, upper denture impression groove 2 and mandibular dentition impression groove 3 impressions are all darker, when sufferer is worn this dental stent, on this, denture impression groove 2 and mandibular dentition impression groove 3 can play good fixation, avoid dental stent after wearing, to be moved, to guarantee this dental stent and the good position repeatability of upper mandibular bone in radiation therapy process.
The rear portion of this rack body 1 is a bulging tongue portion, the upper surface that props up bulging tongue portion is support palatal surface 4, support palatal surface 4 is the curved surface that a shape and the people oral cavity palatal surface shape while dehiscing matches, the lower surface of bulging tongue portion is support lingual surface 5, and support lingual surface 5 is the curved surface that a shape and the people oral cavity lingual surface shape while dehiscing matches; The effect of this bulging tongue portion, is separated upper mandibular bone and supporting role on the one hand, makes to jeopardize organ and is fixed on beyond high dose area, reduces radioactive dose; Be that tongue is fixed on to bottom, oral cavity on the other hand, guarantee the repeatability of the position of tongue in radiation therapy process.The shape of above-mentioned support palatal surface and support lingual surface is all to carry out intraoral palatal surface and the personalized customization of lingual surface shape while dehiscing of radiocurable sufferer according to need, in general, mandibular dentition impression backward 0.5～1cm place is gone up backward about diagonal 1cm and is formed support lingual surface leading edge, and support lingual surface approximately to the 3 that extend back ground one's teeth in sleep.Support lingual surface in present embodiment must with tongue close contact, simultaneously, again to the reserved certain space of tongue, both avoided pressing tongue tension to cause discomfort, tongue can not passed backward and is caused glossoptosis again, cause patient to suffocate.
Between above-mentioned standing part and a bulging tongue portion, with gas-permeable channels 6, connect, the cross section of this gas-permeable channels can be the circle of diameter 1cm, the two ends of this gas-permeable channels 6 are respectively and are opened in circular the first air-vent 61 in rack body 1 front end shell and are opened in the second circular air-vent 62 on rack body 1 end housing, the airway patency when being conducive to keep sufferer to wear this dental stent and carrying out radiotherapy with the dental stent of gas-permeable channels 6.
What deserves to be explained is, the number of the gas-permeable channels 6 in present embodiment also can be for over one, this gas-permeable channels is except can be for circular cross section, also can be the cross section of ellipse, other shapes such as square, can reach equally the effect that keeps sufferer airway unobstructed.
The dental stent of present embodiment is applicable to tumor of head and neck radiotherapy, be particularly suitable for using in oral and maxillofacial surgery tumor radiotherapy process, oral cavity intracavity shape customization when it is dehisced according to sufferer forms, and is fixed, with support palatal surface and support lingual surface, supports and press tongue with upper and lower dentition impression groove.Sucking thing with the stopper using in Patients During Radiotherapy clinically at present etc. compares, its comfortableness and position repeatability all have a very significant increase, can stablize, effectively in tumor of head and neck radiotherapy, reduce the radioactive dose that jeopardizes organ, reduce thus salivary gland function damage in radiotherapy, oral mucosa damage and sense of taste damage, improve the life quality of sufferer; And in dental stent, set up the gas-permeable channels that runs through rack body front and back end, can guarantee airway patency, further reduced the sense of discomfort of sufferer in accepting radiation therapy process, can improve compliance and the satisfaction of sufferer.
The upper and lower separation type support for the radiotherapy of oral cavity that the second embodiment of the present utility model is related, the dental stent of its structure and the first embodiment is basic identical, and its further improvement is: the thickness of shell of rack body 1 is increased to 10mm.
The dental stent of present embodiment, is particularly suitable for tumor apart from the nearer sufferer of mucomembranous surface.What the dental stent housing in present embodiment was selected is polylactic acid (PLA) material that 3D prints, even density, and CT value and soft tissue are close, can fit tightly with mucosal surface, meet the requirement as tissue equivalent's implant (Bolus).Thickness of shell is increased to the dental stent of 10mm, makes tumor outside built-up areas, plays tissue equivalent's implant (Bolus) effect.Compare with the first embodiment, the dental stent in present embodiment improved field dose, improved plan conformal degree and uniformity, reduced total jumping figure and jeopardized the radioactive dose of organ.
The upper and lower separation type support for the radiotherapy of oral cavity that the 3rd embodiment of the present utility model is related, the dental stent of its structure and first, second embodiment is basic identical, its further improvement is: the surrounding at described the first air-vent 61 is provided with three index aperture 7, index aperture 7 is also opened in rack body 1 front end shell and to the interior extension different depth of rack body 1, the non-coplanar metal marker thing of the interior placement of this index aperture 7.
Present embodiment can be at the metal marker thing of index aperture 7 interior placements the rustless steel steel ball that diameter is 3mm, MV level x-ray be take Compton scattering as main, Gu Yu soft-tissue image resolution is low, anatomical structure shows owes clearly, put three the non-coplanar metal marker things clearly that develop, can improve precision and the speed of launched field image and reference picture (DRR image) registration, contribute to apply the termed image-guided radiotherapy (IGRT) that EPID carries out incidence.In addition, because upper jaw bone and skull link by sutura, cranium jaw face organ moves very little, can suppose that whole head is 1 rigidity structure.In head, the coordinate of any point will change along with the variation of 3 label coordinates like this.
Above-mentioned technique effect confirms by radiotherapy clinical trial: the image registration of carrying out based on non-coplanar metal marker thing is compared with traditional image registration based on anatomical structure, and registration error, in 1mm, has improved registration speed, meets clinical instructions for use.Owing to there being the function that can carry out image registration based on metal marker, the range of application of dental stent of the present utility model is further expanded, except being suitable for oral and maxillofacial surgery tumor radiotherapy, be also very suitable for being applied in head and neck tumor radiotherapy process.
Persons of ordinary skill in the art may appreciate that the respective embodiments described above are to realize specific embodiment of the utility model, and in actual applications, can to it, do various changes in the form and details, and do not depart from spirit and scope of the present utility model.
Claims (10)
1. a upper and lower separation type support for the radiotherapy of oral cavity, is characterized in that, comprises rack body (1), and described rack body (1) is a hollow shell, and oral cavity intracavity shape when its external shape and people dehisce is coincide;
The front portion of described rack body (1) is standing part, is respectively equipped with denture impression groove (2) and mandibular dentition impression groove (3) on the upper surface housing of described standing part and lower surface housing; The rear portion of described rack body (1) is a bulging tongue portion, and the upper surface of described bulging tongue portion is support palatal surface (4), and the lower surface of described bulging tongue portion is support lingual surface (5);
Between described standing part and a bulging tongue portion, with gas-permeable channels (6), connect, the two ends of described gas-permeable channels (6) are respectively and are opened in the first air-vent (61) in rack body (1) front end shell and are opened in the second air-vent (62) on rack body (1) end housing.
2. upper and lower separation type support for the radiotherapy of oral cavity according to claim 1, it is characterized in that, described support palatal surface (4) is a shape and the people identical curved surface of oral cavity palatal surface shape while dehiscing, and described support lingual surface (5) is a shape and the people identical curved surface of oral cavity lingual surface shape while dehiscing.
3. upper and lower separation type support for the radiotherapy of oral cavity according to claim 1, is characterized in that, the cross section of described gas-permeable channels (6) is preferably the circle of diameter 1～1.5cm.
4. upper and lower separation type support for the radiotherapy of oral cavity according to claim 1, is characterized in that, the vertical dimension between described mandibular dentition impression groove (3) and described rack body (1) end is 4.5～5cm.
5. according to upper and lower separation type support for the oral cavity radiotherapy described in claim 1 to 4 any one, it is characterized in that, surrounding at described the first air-vent (61) is provided with more than 3 index aperture (7), and described index aperture (7) is also opened in the front end shell of rack body (1) and in rack body (1) extends different depth.
6. upper and lower separation type support for the radiotherapy of oral cavity according to claim 5, is characterized in that, the number of described index aperture (7) is preferably 3.
7. upper and lower separation type support for the radiotherapy of oral cavity according to claim 5, is characterized in that, places non-coplanar metal marker thing in described index aperture (7).
8. upper and lower separation type support for the radiotherapy of oral cavity according to claim 7, is characterized in that, described metal marker thing is preferably the stainless steel ball of diameter 3mm.
9. upper and lower separation type support for the radiotherapy of oral cavity according to claim 8, is characterized in that, the thickness of shell of described rack body (1) is 2～10mm.
10. upper and lower separation type support for the radiotherapy of oral cavity according to claim 9, is characterized in that, the thickness of shell of described rack body (1) is 5～10mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420364059.4U CN203944037U (en) | 2014-07-02 | 2014-07-02 | Upper and lower separation type support for the radiotherapy of oral cavity |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201420364059.4U CN203944037U (en) | 2014-07-02 | 2014-07-02 | Upper and lower separation type support for the radiotherapy of oral cavity |
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| Publication Number | Publication Date |
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| CN203944037U true CN203944037U (en) | 2014-11-19 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201420364059.4U Withdrawn - After Issue CN203944037U (en) | 2014-07-02 | 2014-07-02 | Upper and lower separation type support for the radiotherapy of oral cavity |
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| CN (1) | CN203944037U (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104043205A (en) * | 2014-07-02 | 2014-09-17 | 上海交通大学医学院附属第九人民医院 | Vertically-separated support for oral cavity radiotherapy and manufacturing method thereof |
| CN109125950A (en) * | 2018-06-29 | 2019-01-04 | 哈尔滨医科大学 | A kind of oral cavity radiotherapy mouth containing device bracket and production method |
-
2014
- 2014-07-02 CN CN201420364059.4U patent/CN203944037U/en not_active Withdrawn - After Issue
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104043205A (en) * | 2014-07-02 | 2014-09-17 | 上海交通大学医学院附属第九人民医院 | Vertically-separated support for oral cavity radiotherapy and manufacturing method thereof |
| CN104043205B (en) * | 2014-07-02 | 2017-02-15 | 上海交通大学医学院附属第九人民医院 | Vertically-separated support for oral cavity radiotherapy and manufacturing method thereof |
| CN109125950A (en) * | 2018-06-29 | 2019-01-04 | 哈尔滨医科大学 | A kind of oral cavity radiotherapy mouth containing device bracket and production method |
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| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| AV01 | Patent right actively abandoned |
Granted publication date: 20141119 Effective date of abandoning: 20170215 |
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| AV01 | Patent right actively abandoned |
Granted publication date: 20141119 Effective date of abandoning: 20170215 |
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| AV01 | Patent right actively abandoned | ||
| AV01 | Patent right actively abandoned |