A Pivoting Appliance for Intracavitary Brachytherapy in Patients with Reduced Mouth Opening

Purpose: The risks of radiotherapy to normal tissues are well known. In many cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. Afterloading devices allow the position of radiating materials near the site for treatment exactly according to three-dimensional treatment planning. This report shows the technical procedure for the fabrication of an intracavitary afterloading radiation device. Materials and Methods: A 48-year-old woman who had received neutron radiotherapy and tumor surgery for adenoid cystic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axis for a pivoting appliance. Results: Two years after reradiation, the patient was free of relapse symptoms, although an increased limitation of mouth opening was recorded. Conclusion: Even if the mouth opening is severely limited after tumor surgery and/or radiation, intracavitary brachytherapy still can be performed in edentulous patients using a pivoting device.