Bionix for H&N RT

[medgator]

Wasn't sure where to post this, anyone heard of this device to reduce h&n toxicity. Was being pushed by a local "oncology" focused dentist

Bionix

Bionix is a quality driven, service oriented multi-national company committed to acquiring, developing, manufacturing and marketing innovative single-patient use medical products that help people.

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[OTN]

Wasn't sure where to post this, anyone heard of this device to reduce h&n toxicity. Was being pushed by a local "oncology" focused dentist

Bionix

Bionix is a quality driven, service oriented multi-national company committed to acquiring, developing, manufacturing and marketing innovative single-patient use medical products that help people.

bionix.com

I just have my therapists create a device on their own to separate the tongue from the roof of the mouth, which costs $0. I was having a dentist make stuff like this for me, but it introduced delays into the process and seemed needlessly complicated. Helps reduce dose to the soft and hard palate when treating the oral tongue.

 

[taserlaser]

yeah we have some of our own lying around. I think our machine shop 3-D printed something and then we just coated it.

 

[grenz]

Wasn't sure where to post this, anyone heard of this device to reduce h&n toxicity. Was being pushed by a local "oncology" focused dentist

Bionix

Bionix is a quality driven, service oriented multi-national company committed to acquiring, developing, manufacturing and marketing innovative single-patient use medical products that help people.

bionix.com

Whether they’re helpful or not depends on the treatment site. The custom oral stents we’ve hade made in the past worked remarkably well when treating the nasal cavity or hard palate. Minimal tongue mucositis for those cases. Off the shelf products would be more convenient.

 

[metallica81788]

I just have my therapists create a device on their own to separate the tongue from the roof of the mouth, which costs $0. I was having a dentist make stuff like this for me, but it introduced delays into the process and seemed needlessly complicated. Helps reduce dose to the soft and hard palate when treating the oral tongue.

Tongue depressors stacked together and taped work pretty well. Just saying.

 

[medgator]

I just have my therapists create a device on their own to separate the tongue from the roof of the mouth, which costs $0. I was having a dentist make stuff like this for me, but it introduced delays into the process and seemed needlessly complicated. Helps reduce dose to the soft and hard palate when treating the oral tongue.

yeah we have some of our own lying around. I think our machine shop 3-D printed something and then we just coated it.

Tongue depressors stacked together and taped work pretty well. Just saying.

Physics previously had concerns with us trying to use devices to get the palate out of the way in terms of daily reproducibility with an IMRT plan.

No issues with that?

 

[TheWallnerus]

Tongue depressors stacked together and taped work pretty well. Just saying.

I incorporate them into the mask using wax creating one solid hybrid mask/tongue depressor thing. I cut the middle finger of a latex glove each day to stretch over the depressors to keep things more pleasant and sanitary for the patient. Day to day reproducibility is excellent. I enjoy going into the CT sim for my arts&crafts time.

 

[Palex80]

Physics previously had concerns with us trying to use devices to get the palate out of the way in terms of daily reproducibility with an IMRT plan.

No issues with that?

Of course I have issues with physics. Physics were made to make our life more difficult.

 

[deleted1111261]

no

Physics previously had concerns with us trying to use devices to get the palate out of the way in terms of daily reproducibility with an IMRT plan.

No issues with that?

No. people been doing for decades
Anderson has written it up.

Have done it, but I don’t feel it is dramatic improvement

 

[elementaryschooleconomics]

 

[Mandelin Rain]

Used something that looks a lot like that yesterday. It was less bulky though. My (and patients') main complaint with all these products are they are incredibly bulky. Any trismus, forget about it. They start gagging with the mask on and refuse it, now you have to replan. It sucks.

Wrap a tongue depressor with several sheets of dental wax and have them make bite marks so you get it in the same spot each day. Works fine.

 

[medgator]

no

No. people been doing for decades
Anderson has written it up.

Have done it, but I don’t feel it is dramatic improvement

Yeah i can't find much evidence at all, and it is bad enough trying to immobilize pts with a h&n mask to begin with.

 

[communitydoc13]

Used something that looks a lot like that yesterday. It was less bulky though. My (and patients') main complaint with all these products are they are incredibly bulky. Any trismus, forget about it. They start gagging with the mask on and refuse it, now you have to replan. It sucks.

Wrap a tongue depressor with several sheets of dental wax and have them make bite marks so you get it in the same spot each day. Works fine.

Ditto.

 

[Burt Radnolds]

When I want to get the tongue away from the hard palate we use the Civco moutbites with a built in plate and they work perfectly. Any reason any of these other solutions is any better or more hassle free?

I think it makes a huge difference in appropriately selected patients. Just had a sinonasal tumor I treated and patient can still taste shortly after treatment completion. Guarantee it would be a different story with neutral tongue position.

You have to be careful though, it shoves the tongue backwards and inferior, and if you are pushing dose in that area for whatever reason your anterior tongue dose can actually be much worse as it has been displaced towards a target volume.

 

[deleted1111261]

When I want to get the tongue away from the hard palate we use the Civco moutbites with a built in plate and they work perfectly. Any reason any of these other solutions is any better or more hassle free?

I think it makes a huge difference in appropriately selected patients. Just had a sinonasal tumor I treated and patient can still taste shortly after treatment completion. Guarantee it would be a different story with neutral tongue position.

You have to be careful though, it shoves the tongue backwards and inferior, and if you are pushing dose in that area for whatever reason your anterior tongue dose can actually be much worse as it has been displaced towards a target volume.

View attachment 359726

super important.
tongue has to go up not back
i have definitely had to re-sim

 

[evilbooyaa]

Wasn't sure where to post this, anyone heard of this device to reduce h&n toxicity. Was being pushed by a local "oncology" focused dentist

Bionix

Bionix is a quality driven, service oriented multi-national company committed to acquiring, developing, manufacturing and marketing innovative single-patient use medical products that help people.

bionix.com

The correct answer about something completely unrelated to SpaceOAR or their complications should be posted is.... a new thread.

Moved it to a new thread for the 'new' OP.

 

[evilbooyaa]

Not sure why this is significantly better than commercially available mouth guards. A million ways to d oit.... now there's a million and one days to separate the sensitive oral cavity structure from the tumor that is getting RT. I also use it for all BoT tumors to prevent excessive motion a la Dave Fuller's previous pubs.

 

[thecarbonionangle]

I have made custom oral stents with limited success. Resim rate with them can be high. Some patients really do not like them and a common complaint is the secretions pool and they feel they are “choking”. Another thing is it can involve delays in treatment to make them. Overall i tend to not use these devices. I have used the mouthguards with also mixed success, overall do not like.

 

[medgator]

I have made custom oral stents with limited success. Resim rate with them can be high. Some patients really do not like them and a common complaint is the secretions pool and they feel they are “choking”. Another thing is it can involve delays in treatment to make them. Overall i tend to not use these devices. I have used the mouthguards with also mixed success, overall do not like.

Plus physics doesn't like.

Honestly, i would be more sold if there was some solid data to back it up