A new, simple maxillary-sparing tongue depressor for external mandibular radiotherapy: A case report

Background. In external radiotherapy, the use ofleaded intraoral devices to shield adjacent tissues is welldescribed, but stabilization of the mandible is often realizedwith standard bite blocks, which do not allow a good stabiliza-tion of the mandible.Methods and Results. A 40-year-old patient presentingwith a local recurrence of a tumor of the floor of the mouthunderwent external radiotherapy. To shield the maxilla duringmandibular irradiation and to ensure mandible and tongueimmobility during external radiotherapy, a custom-made devicewas realized. The apparatus consists of a polymethylmethacry-late resin plate and 2 wedges. Only 2 steps are needed.Conclusion. The realization is simple and cheap, the appa-ratus is comfortable, and modifications are easy. It can beused in all patients, except in patients with totally mandibularedentulous with severe bone resorption. VV C 2009 WileyPeriodicals, Inc. Head Neck 31: 1528–1530, 2009Keywords: external radiotherapy; maxilla; reproducibility;tongue-shielding; spacer