Kenneth Wong1, Justine Cheng2, Kristine Bowlin3, Arthur Olch4. 1. Radiation Oncology Program, Division of Hematology Oncology, Children's Hospital Los Angeles, Los Angeles, California; Department of Radiation Oncology, University of Southern California, Los Angeles, California. Electronic address: kewong@chla.usc.edu. 2. Massachusetts Institute of Technology, Cambridge, Massachusetts. 3. Radiation Oncology Program, Division of Hematology Oncology, Children's Hospital Los Angeles, Los Angeles, California. 4. Radiation Oncology Program, Division of Hematology Oncology, Children's Hospital Los Angeles, Los Angeles, California; Department of Radiation Oncology, University of Southern California, Los Angeles, California.
Abstract
PURPOSE: Our purpose was to describe an adaptation of a commercially available mouthpiece for vacuum-assisted mouthpiece immobilization for radiation therapy in infants. METHODS AND MATERIALS: An infant diagnosed with a brain tumor required radiation therapy. After reviewing dental literature about obturators, we designed a modification for the smallest commercially available mouthpiece tray. RESULTS: The patient was simulated with the adapted mouthpiece tray. We achieved excellent immobilization and had small daily image guided treatment position shifts. Our patient tolerated treatment well without injury to oral cavity or mucosa. CONCLUSIONS: Head immobilization with a vacuum-assisted modified mouthpiece has not been described in infants. Our modification is a novel and safe and permits effective and accurate immobilization for infants for radiation therapy. New manufacturing technologies may allow creation of individualized mouthpieces.
PURPOSE: Our purpose was to describe an adaptation of a commercially available mouthpiece for vacuum-assisted mouthpiece immobilization for radiation therapy in infants. METHODS AND MATERIALS: An infant diagnosed with a brain tumor required radiation therapy. After reviewing dental literature about obturators, we designed a modification for the smallest commercially available mouthpiece tray. RESULTS: The patient was simulated with the adapted mouthpiece tray. We achieved excellent immobilization and had small daily image guided treatment position shifts. Our patient tolerated treatment well without injury to oral cavity or mucosa. CONCLUSIONS: Head immobilization with a vacuum-assisted modified mouthpiece has not been described in infants. Our modification is a novel and safe and permits effective and accurate immobilization for infants for radiation therapy. New manufacturing technologies may allow creation of individualized mouthpieces.
Authors: Kenneth Wong; Anthony B Opimo; Arthur J Olch; Sean All; Jonathan F Waxer; Desirae Clark; Justine Cheng; Alisha Chlebik; Anat Erdreich-Epstein; Mark D Krieger; Benita Tamrazi; Girish Dhall; Jonathan L Finlay; Eric L Chang Journal: Cureus Date: 2016-04-25