Tuesday, August 01, 2006

A method to immobilize patients without the chin cup

Diane from Yamamoto Radiography in Beverly Hills felt the chin cup did not work adequately for the 40 second scan i-CAT patients so she devised an alternate method that turns out to be very fast, simple to use and works every time.

Diane purchased a two inch wide Velcro strap (available from any home center) and wraps it very snugly around the patient's symphysis (see photo). A second strap (provided by ISI) stabilizes the forehead of the patient. Combined, the two straps virtually eliminates any patient movement. The added benefit is that the straps work on any size patient and is very fast to use.

This method is quick, easy to use and works so efficiently that we have implemented Diane's method in our own office.

Notice the straps are covered with blue Allrap for simple infection control.


Blogger Chester Wang said...

Very interesting, Diane and Eric! The only comment I'd add: please not do this for orthodontic and orthognathic surgery patients, for this technique (due to the strap around the jaw) has a great potential of altering the patient's normal jaw position and bite.

8:54 PM  
Blogger Matt Kroona said...

I am still a bit confused on the actual value of the 40 sec scan. Considering what you have to do to help immobilize the patient, and realizing that you are doubling the radiation (equivilent to 8-12 panoramics - how many of you would consent to TWELVE panormics on yourself?) PLUS if you are scanning at .2 or .25mm you cannot reconstruct to .4mm so your data will not be usable in many 3rd party software applications...is the additional information from a 40 sec scan significantly better?

9:38 AM  
Blogger Craig Dial said...

I like the idea of immobilizing the patient; movement (as most of you know) is one of the biggest problems with CBCT. If we can control patent movement, then the scans will be much better in quality. I do think there may be a problem using this technique for orthodontic and TKJ cases were soft tissue and bites are very important, but for other cases like impactions and implants, it is a very good idea.

We use similar strategies to immobilize the patient. We have an elastic Velcro piece for the head, and we use a modified chin cup, plus a few more velcro sponges to help with stabilization.

7:32 AM  
Blogger Eric Iwamoto said...

This method was devised to eliminate the chin cup - which is not used for orthodontic or orthognathic patients. The chin strap or chin cup should not be used when the soft tissue is to be taken into consideration.

9:12 AM  
Blogger Craig Dial said...

I think that the head/chin holder is a very innovative idea. It is great that people are coming up with ways to control movement.

When I use other CBCT units in the supine position (Newtom) I have more control of patient movement because the patient is lying flat, and we use a CT pillow/foam head holder with a velco strap that squeezes the head in the foam pad and therefore we achieve very little movement. This technique works for all our Newtom cases since the pressure is on the back of the head, and on the for head with the velcro strap. I have been thinking of how I can incorporate this into the I-CAT somehow………

10:45 AM  

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