Vacuum-assisted fixation apparatus

• US 5,730,745 A
• Filed: 06/07/1995
• Issued: 03/24/1998
• Est. Priority Date: 11/02/1993
• Status: Expired due to Term

• Current Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Original Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Inventors: Schulte, Reinhard W., Nethery, Winston J., Meinass, Helmut J., Wicks, William J.
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US08/481,794
• Time in Patent Office: 1,021 Days
• Field of Search: 606/1, 606/130, 128/846, 128/859-862, 294/64.1, 294/64.3, 294/65, 601/23, 601/24, 601/139
• US Class Current: 606/130
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61B 90/16 Bite blocks
• CPC Class Codes: A61N 2005/1097 Means for immobilizing the patient

Abstract

A stereotactic fixation apparatus provides for accurate and reproducible positioning of a patient'"'"'s skull during medical diagnostic and treatment procedures. The stereotactic fixation apparatus includes a mouthpiece having a bite block formed as an impression of the patient'"'"'s upper teeth and hard palate. The mouthpiece is connected to a stereotactic frame, which in turn is releasable connected to an adaptor board on which the patient rests. Vacuum pressure is used to draw the bite block firmly against the patient'"'"'s hard palate. Vacuum pressure is also used to hold the stereotactic frame on the adaptor board. The stereotactic fixation apparatus additionally includes a patient-activated safety release mechanism which allows the patient to disconnect the vacuum pressure and to dislodge the restraints of the mouthpiece and frame, as well as to disable the medical equipment used with the medical diagnostic or treatment procedure.

Claims

1. A stereotactic fixation apparatus comprising a stereotactic frame, a mouthpiece attached to said stereotactic frame, said mouthpiece having a surface for contacting a patient'"'"'s hard palate, said surface having an aperture therein, and a vacuum source connected to said mouthpiece, such that a vacuum is applied at said aperture, whereby said hard palate is drawn toward said mouthpiece.

2. A stereotactic fixation apparatus as in claim 1, wherein said surface is shaped to conform to the hard palate of the patient.

3. A stereotactic fixation apparatus as in claim 1, wherein said mouthpiece comprises a port to which said vacuum source is coupled, said port being spaced from said surface.

4. A stereotactic fixation apparatus as in claim 3, wherein said mouthpiece defines a fluidic path between said port and said aperture of said surface.

5. A stereotactic fixation apparatus as in claim 4, wherein said mouthpiece additionally comprises a normally closed, one-directional flow valve in communication with the fluidic path provided between the port and the aperture of the mouthpiece.

6. A stereotactic fixation apparatus as in claim 5, wherein said valve covers said aperture in said surface.

7. A stereotactic fixation apparatus as in claim 1, wherein said mouthpiece comprises an impression of a cast formed to replicate the patient'"'"'s upper teeth and hard palate, said surface forming a portion of said impression.

8. A stereotactic fixation apparatus as in claim 7, wherein said mouthpiece additionally comprises a tray onto which said impression is mounted.

9. A stereotactic fixation apparatus as in claim 8, wherein said tray includes a port positioned on an external portion of said mouthpiece tray, said port being adapted to receive a tube connected to said vacuum source.

10. A stereotactic fixation apparatus as in claim 9, wherein a coupling connects said tube to said stereotactic frame.

11. A stereotactic fixation apparatus as in claim 10, wherein said coupling is configured to provide at least 3 degrees of rotational movement of said tube relative to said stereotactic frame, and at least 2 degrees of linear movement of said tube relative to said stereotactic frame.

12. The stereotactic fixation apparatus of claim 11, wherein said coupling is removably attached to said stereotactic frame.

13. The stereotactic fixation apparatus of claim 11, wherein said coupling includes a locking mechanism which prevents said tube from moving in reference to said stereotactic frame.

14. The stereotactic fixation apparatus of claim 13, wherein said coupling comprises a plurality of discs having a central bore formed through the center of the discs along a common axis, a first of said disks having a first bore positioned generally normal to said central bore and being positioned in said first disc so as not to intersect with said central bore, a second of said discs having at least a portion of a second bore positioned generally normal to said central bore and being positioned in said second disc so as not to intersect with said central bore, and a fastener having a shaft which passes through said central bore to join said discs together, said fastener having a first unlocked position in which said first and second discs are rotatable about the fastener shaft, and a second locked position in which said first and second discs are non-rotatable about said fastener shaft, said tube extending through said first bore of said first disc with said first disc being adapted to permit the tube to rotate about a vertical axis of the tube when the fastener is in said unlocked position, and to prevent the tube from rotating about the vertical axis of the tube when the fastener is in the locked position, and a rod adapted to attach to said stereotactic frame, said rod extending through said second bore of said second disc, said second disc being adapted to permit said second disc to rotate about a longitudinal axis of said rod when said fastener is in said unlocked position, and to prevent said second disc from rotating about said longitudinal axis of said rod when said fastener is in said locked position.

15. A stereotactic fixation apparatus as in claim 14, wherein a self-locating coupling mechanism secures said rod to said stereotactic frame.

16. A stereotactic fixation apparatus as in claim 15, wherein said self-locating coupling mechanism comprises a V-shaped tang and a corresponding V-shaped groove.

17. A stereotactic fixation apparatus as in claim 16, wherein said rod is connected to a block in which said V-shaped groove is formed.

18. A stereotactic fixation apparatus as in claim 17, wherein said block includes a threaded hole and said stereotactic frame includes a rotatable threaded shank about which said V-shaped tang is located, said threaded shank being adapted to engage said threaded hole of said block with said V-shaped tang and corresponding V-shaped groove.

19. A stereotactic fixation apparatus as in claim 1, additionally comprising a vacuum control system configured to selectively place said vacuum source in communication with said mouthpiece.

20. A stereotactic fixation apparatus as in claim 19, wherein said vacuum control system comprises a remote patient-activated switch which is configured to be held by a patient and which controls a valve that is positioned in fluidic communication with said mouthpiece and said vacuum source so as to control the fluidic communications between said mouthpiece and said vacuum source.