Tongue stabilisation during CT simulation in radiotherapy using a customised dental biomaterial appliance: a case report.

Abstract

Introduction: Precise tongue stabilisation is essential during radiotherapy (RT) planning to ensure accurate target delineation in patients with squamous cell carcinoma of the tongue. Conventional tongue- depressing techniques can be difficult to apply in completely edentulous patients due to the absence of dentition and limited tongue control. This report aims to present a simple prosthodontic solution for effective tongue stabilisation during RT planning in an edentulous patient.

Patients: A 72-year-old completely edentulous woman diagnosed with stage III (T3N0M0) well-differentiated squamous cell carcinoma of the left side of the tongue was scheduled for definitive RT. Conventional tongue stabilisation methods failed during computed tomography (CT) simulation. A custom-designed clear acrylic resin intraoral appliance was fabricated to maintain a constant 1.5 cm distance between the tongue and the palate and to achieve reproducible tongue depression. Repeated CT simulations were performed to assess the consistency of tongue positioning.

Results: The custom intraoral appliance provided stable and repeatable tongue positioning, allowing improved visualisation of the target volume and facilitating accurate RT planning. Consistent tongue depression was confirmed across repeated CT simulations.

Conclusion: The proposed low-cost, custom-made prosthodontic appliance is an effective method for tongue stabilisation in edentulous patients undergoing head and neck RT. Its use can enhance treatment planning accuracy and may be beneficial in similar clinical situations.