WO2018188747A1

WO2018188747A1 - Headrest-unit

Info

Publication number: WO2018188747A1
Application number: PCT/EP2017/058896
Authority: WO
Inventors: Kajetan Berlinger; Merle STRUTZ
Original assignee: Brainlab Ag
Priority date: 2017-04-13
Filing date: 2017-04-13
Publication date: 2018-10-18

Abstract

The present invention relates to a headrest-unit for supporting a patient's head during a medical procedure, wherein the headrest-unit (1) comprises: -a bolster-section (2) providing a supporting surface (3) for at least one of a back of the patient's head and a patient's neck; -a frame-section (4) attached to the bolster-section (3), which holds a display (5) at a predetermined position with respect to the bolster-section (2). The present invention further relates to a method of providing support to a patient's head during a medical procedure involving the headrest-unit (1).

Description

HEADREST-UNIT

TECHNICAL FIELD

The present invention relates to a headrest-unit which is utilized to support the head of a patient lying in a supine position during a medical procedure that may involve acquiring patient images or radiation therapy.

SUMMARY

In general terms, the present invention relates to a head support used during medical procedures that require the patient to lie on a medical patient support couch while an image acquiring device such as a CT-imaging device, or a treatment beam generating device used for radio therapy is directed towards anatomical structures of the patient, images of which are to be acquired, or which are to be treated by ionizing radiation.

The treatment of breast cancer represents a specific application of the inventive headrest-unit, which in most cases starts with a resection of the tumor, and is followed by radiation therapy. Clinical studies have shown that radiating the tumor bed reduces the risk of recurrence dramatically. A negative side-effect however is that the heart, particularly the RIVA (Ramus Interventricularis Anterior), a coronary vessel, is very sensitive to radiation and thus the treatment may yield in the long term to heart diseases. Especially regarding treatments of the left breast the problem arises, because in this case the spatial distance between the target to be radiated and the heart which is to be avoided is comparatively small. Thus, most hospitals plan and perform these treatments in state of a deep inspiration breath-hold (DIBH). During inspiration the heart moves away from the area to be treated in an inferior and a posterior direction, such that the heart is eventually moved out of the radiation beam's path. Prior to acquiring CT-scans and performing radiation therapy, the patient is coached to perform a deep inspiration breath hold. Then, a CT-scan is acquired while the patient performs the DIBH as trained in theory. It is desired that the patient performs the DIBH during the subsequent treatment in the same manner so as to reproduce the DIBH that was existent during the CT-scan.

Studies have shown that feedback systems help the patient to reproduce a certain breath-hold. A known approach is to record a breathing signal that is displayed to the patient on a screen that may be mounted in the vicinity of the patient support couch . The breathing signal itself can be recorded by, for example, an infrared camera that follows reflective markers, a chest-belt or a surface camera.

Known systems for providing the patient with the recorded breathing signal include spectacles with integrated displays, which are worn by the user, or to a separate screen that is held in front of the patient by an adjustable support structure. However, a whole range of drawbacks come with the known systems. For example, the spectacles are cumbersome and lack wearing comfort and even reports about patients exists that suffered from claustrophobia while wearing such spectacles. On the other hand, the displays provided separately for this application are held in place by means of flexible or articulated support arms, wherein the displays are often positioned in such a manner that the patient has to turn the head for reading the screen. While this is already uncomfortable for the patient, the more serious problem is that this may even cause changes in the patient's position, thereby compromising the procedures outcome.

US 2014/0005463 A1 suggests breath holding means as discussed above, including visualization means that visualize a moving target. US 2006/0074305 A1 discloses an apparatus for prompting a patient via a screen. US 4,986,261 discloses a walking exercise device comprising an overhead monitor.

It is an object of the present invention to overcome the aforementioned drawbacks. This object is solved by the inventive headrest-unit including a display in accordance with independent claim 1 , and by the corresponding method according to independent claim 15. The inventive headrest-unit is adapted to support a patient's head during a medical procedure, wherein the headrest-unit comprises:

- a bolster-section providing a supporting surface for at least one of a back of the patient's head and a patient's neck;

- a frame-section attached to the bolster-section, which holds a display at a predetermined position with respect to the bolster-section.

In other words, the inventive headrest-unit includes a bolster-section that is placed between the patient's head and a patient support couch and may even extend in a caudal direction to support the patient's neck, as well. Preferably, the bolster-section comprises an upper surface that is formed to adapt to the patient's anatomy so as to provide a comfortable "cushion", while the bottom surface thereof is substantially flat as it comes to rest on the flat upper surface of the patient support couch. A frame- section forms the second major component of the inventive headrest-unit. As the frame-section is attached to the bolster-section and holds a display at a predetermined spatial position, the relative spatial position between the display and the bolster-section and therefore also to the patient's face is defined by the frame- section. Thus, the display can be held by the frame-section in front of the patient's face at the most comfortable "reading/viewing-distance", without forcing the patient to turn the head in order to look at the display.

The bolster-section may be attached to the frame-section in that it is put into or onto the frame-section and may be easily removed therefrom again. It is also conceivable that the bolster-section is releasably fixed to the frame-section, for example via Velcro^®-fasteners or by snap-fasteners, so as to prevent the bolster-section together with the patient's head to slip out of position with respect to the frame-section.

While the bolster-section may provide a supporting surface only for the back of the patient's head, it may as well provide a supporting surface only for the patient's neck. According to a preferred embodiment, the bolster-section provides a supporting surface exclusively for the back of the patient's head and the patient's neck. According to another embodiment of the present invention, the headrest-unit is a self- contained unit adapted to be freely handled and/or moved in its entirety. This enables the headrest-unit to be used on a plurality of patient couches by carrying it from one patient couch to another. Further, this allows to use one headrest-unit for one specific patient during a plurality of subsequent procedures.

As already set out further above, the inventive headrest-unit is preferably adapted to rest on a medical patient support couch and is in particular adapted to be placed on the upper surface of the medical patient support couch. Consequently, the bottom surface of the headrest-unit is substantially flat to conform with the upper surface of patient support couches which are generally flat. However, the bottom surface may take any other shape to fit to a corresponding patient support couch and may even comprise means for releasably fixing the headrest-unit to a patient support couch at a, for example, predetermined and reproducible position, such as Velcro^®-fasteners or snap-fasteners.

Further, the frame-section may adjustably hold the display at a predetermined position with respect to the bolster-section and the patient's head that rests on the bolster-section. In other words, the relative location and/or orientation of the display held by the frame-section can be adjusted so as to conform to the patient's individual reading distance and/or anatomy. For doing so, the frame-section may be adjusted in accordance with the patient's preferences in predefined steps or continuously.

Specifically, the frame-section may allow to adjust the distance between the display and the bolster-section (and therefore the patient's head) in a direction substantially perpendicular to a front-plane of the display held via the frame-section. On the other hand, at least part of the frame-section that holds the display may be movably attached to the bolster-section in at least one of a translational and a rotational manner. This not only enables adjusting the headrest-unit to the anatomy and the preferences of a specific patient, but also enables the frame section to "swing open" or "slide open" for placement of the patient's head on the headrest-unit. It should be noted that the patient's head has to be placed between the upper surface of the bolster-section and the display, such that the headrest-unit at least partially encompasses the patient's head, which may make placement of the patient's head more difficult. Considering this, placing the patient's head on the headrest-unit may be more convenient with a headrest-unit which can be "opened" in one of the above described manners. While it is generally conceivable that the display may form an integrated part of the frame-section, the frame-section may also be adapted to releasably hold a separate display. In this context, the frame-section may comprise an adaptor, for example a snap-in-fastener, which enables attaching and removing an external display to and from the frame-section. In a specific embodiment which will also be described further below, the frame-section may comprise an adapter that releasably holds a mobile device such as a smartphone or a tablet computer, enabling a fast and easy replacement of the display for cleaning or replacement.

As already described further above, some medical devices for imaging or radiation therapy are calibrated with respect to the patient by optically measuring the patient's skin surface. Such approaches may involve projecting a predetermined optical pattern onto the patient's skin, wherein the pattern reflected from the individually formed surface of the patient's skin is measured. From the recorded deformation of the initially known pattern the actual form of the skin's surface is then calculated. As visible light may be used, these approaches often dazzle and blind the patient and are therefore often described as uncomfortable.

The present invention takes into account this problem, as well, by providing a headrest-unit that comprises a visor adapted to shield the patient's eyes, particularly to at least partially shield the patient's face from light or even also other kinds of electromagnetic radiation. Since the frame-section is adapted to hold a display in front of the patient's face, it is useful that such visor is integrally formed with the frame-section. In particular, the part of the frame-section at which the display is attached may itself form the described visor and may therefore include a flat section having two opposite surfaces, wherein the display is arranged at the surface which faces towards the bolster-section and the patient's face.

With the display already being provided in front of the patient's face, the inventive headrest-unit may also comprise at least one sensor facing towards the bolster- section and the patient's face, wherein the sensor is particularly arranged at the visor. Such sensor may be utilized to determine the state of the patient, particularly considering the patient's comfort. The at least one sensor may be selected from the group consisting of an optical camera sensitive for optical light, an infrared camera or a microphone. For example, using an optical camera may involve face recognition and/or detecting facial expressions of the patient. Facial features like eyes, nose, mouth, eyebrows as well as artificial features like spectacles may be extracted from a pre-acquired image and may be compared to an image taken with the camera of the inventive headrest-unit. By doing so, it can be determined whether or not the person placed on the headrest-unit is the expected patient. In the affirmative, the planned procedure could be commenced, elsewise a warning signal may be output and the procedure may be stopped. In case of the patient is afraid or is in pain, detecting facial expressions via the sensor of the headrest-unit may help in detecting such situations. Characteristics of the patient's facial expression may be extracted from an image taken with the camera of the headrest-unit, on the basis of which the current facial expression of the patient can be determined. Further, the patient may communicate and express oneself via a microphone with personnel attending the performed medical procedure. For example, the patient may express discomfort or pain and may call for aid or help via the microphone.

On the other hand, the inventive headrest-unit may comprise a loudspeaker, which may be in particular arranged at the visor, as well, allowing personnel attending the procedure to communicate with the patient. Further, the patient may even be provided with acoustic information supplementing or even partially replacing the optical information provided via the display. For example, the level of the breath-hold may be output to the patient optically and/or acoustically.

As already indicated further above, the at least one sensor and/or the loudspeaker may be assigned to the display, particularly wherein the display, the at least one sensor and/or the loudspeaker are part of an integrated device such as a smartphone or tablet-computer detachably attached to the frame-section. This embodiment encompasses the delicate electronic appliances in one single integrated device that may be easily detached from the remaining hardware of the headrest-unit for easy cleaning or replacement. A further aspect of the present invention relates to a corresponding method of providing support to a patient's head during a medical procedure, the method comprising the steps of:

- providing a headrest-unit according to one of the embodiments described above;

- monitoring the patient's face via the at least one sensor while the patient's head is supported by said headrest-unit; and

- detecting, via face and/or facial expression recognition, whether the medical procedure as planned to be performed on the correct patient and/or whether the patient feels uncomfortable while being placed on said headrest-unit; and/or

- communicating with the patient via the loudspeaker and the microphone. The present invention may be in particular utilized in connection with ExacTrac^®, a Brainlab^®-product.

BRIEF DESCRIPTION OF THE DRAWINGS

In the following, the invention is described with reference to the enclosed figures which represent preferred embodiments of the invention. The scope of the invention is however not limited to the specific features disclosed in the figures, which show:

Figure 1 a first embodiment of the inventive headrest-unit;

Figure 2 a second embodiment of the inventive headrest-unit;

Figure 3 a third embodiment of the inventive headrest-unit;

Figure 4 a flow-chart including the basic steps of the inventive method.

DETAILED DESCRIPTION

Figure 1 schematically shows a first embodiment of the inventive headrest-unit 1 that includes a bolster-section 2 (separately shown in the left drawing of Figure 1 ), a frame-section 4 (separately shown in the middle drawing of Figure 1 ), which are combined to a headrest-unit 1 (shown in the right drawing of Figure 1 ). The bolster- section 2 features a flat bottom surface (not shown) and a curved top-surface that is anatomically formed so as to provide a comfortable support for the back of the patient's head and the patient's neck. In order to set up the inventive headrest-unit 1 , the bolster-section 2 is put onto or into the frame-section 4 that comprises an "arc- shaped" section that encompasses the bolster-section 2 and carries a display 5 which further comprises a sensor 10 for monitoring the face of a patient's head resting on the top-surface 3 of the bolster-section. It can be seen form Figure 1 that the display 5 is held at a predetermined spatial position (location and orientation) with respect to the bolster-section 2 and therefore also to the patient's eyes. Thus, the display 5 can be positioned with respect to the patient's eyes in a most comfortable and reproducible position, such that the patient does not need to turn the head for looking at the display 10. While Figure 1 (and also Figures 2 and 3) show an "arc- shaped" frame for holding the display 10 in place, the frame may also have a cantilever-form that runs around the patient's head only on one side, which, due to the "open shape", may significantly decrease the risk of claustrophobia.

The bolster-section may be a soft structure and therefore may comprise a core made from a formed material placed inside a coating that can be easily cleaned. Figure 2 shows a second embodiment of the inventive headrest-unit 1 , differing from the embodiment of Figure 1 only in that the frame 4 comprises a visor 8 that is integrally formed with the frame-section 4. While Figure 2 schematically shows the form of the visor 8 as being set up by rectangles, the visor 8 may take any desired shape so as to optimally shield the patient's eyes or even at least partially the patient's face from light so as to prevent blinding or dazzling of the patient by light projections generated for measuring the shape of the patient's skin. The display 5 along with the sensor 10 is provided at the surface of the visor 8, which faces towards the bolster-section 2 and the patient's face. As the bottom right drawing of Figure 2 shows, the visor 8 shields the patient's face from a light beam 9, while at the same time allowing the patient to view content displayed on the screen 5.

Figure 3 shows a third embodiment of the inventive headrest-unit, wherein the frame- section 4 can be "opened" by rotating the visor 8 with respect to the remaining frame- section 4 as indicated by an arrow. After the patient has lied down on the patient couch 6, with his head resting on the bolster-section 2, the visor 8 can be rotated upwards again, thereby bringing the display 5 into the optimal position in front of the patient's face. As further shown in Figure 3, the headrest-unit can be placed on the upper surface 7 of a patient couch 6. Further, the display 5 and the sensor 10 are integrated within a tablet-computer that is releasably attached to the visor 8. It is to be noted that interfaces provided by integrated devices such as smartphones or tablet computers may allow to connect further sensors (which are usually not part of the integrated device, such as infrared cameras), such that those sensors may also be utilized to monitor the patient's face.

Claims

Attorney's File: 61 716 P WO XV Applicant: Brainlab AG Claims

1 . Headrest-unit for supporting a patient's head during a medical procedure, wherein the headrest-unit (1 ) comprises:

- a bolster-section (2) providing a supporting surface (3) for at least one of a back of the patient's head and a patient's neck;

- a frame-section (4) attached to the bolster-section (3), which holds a display (5) at a predetermined position with respect to the bolster-section (2).

2. Headrest-unit according to claim 1 , wherein the bolster-section (2) provides a supporting surface (2) exclusively for at least one of the back of the patient's head and the patient's neck.

3. Headrest-unit according to any one of claims 1 or 2, wherein the headrest-unit (1 ) is a self-contained unit adapted to be freely handled and/or moved in its entirety.

4. Headrest-unit according to any one of claims 1 to 3, wherein the headrest-unit (1 ) is adapted to rest on a medical patient support couch (6), and is in particular adapted to be placed on the upper surface (7) of the medical patient support couch (6).

5. Headrest-unit according to any one of claims 1 or 4, wherein the frame-section (4) adjustably holds the display (5) at a predetermined position with respect to the bolster-section (2).

6. Headrest-unit according to claim 5, wherein the frame-section (4) allows to adjust the distance between the display (5) and the bolster-section (2) in a direction substantially perpendicular to a front-plane of the display (5).

7. Headrest-unit according to any one of claims 5 or 6, wherein at least a part of the frame-section (4) is movably attached to the bolster-section (2) in at least one of a translational and a rotational manner.

8. Headrest-unit according to any one of claims 1 to 7, wherein the frame-section (4) detachably holds the display (5).

9. Headrest-unit according to any one of claims 1 to 8, wherein the headrest-unit (1 ) further comprises a visor (8) adapted to shield the patient's eyes, particularly to at least partially shield the patient's face from electromagnetic radiation (9).

10. Headrest-unit according to claim 9, wherein the visor (8) is integrally formed with the frame-section (4).

1 1 . Headrest-unit according to any one of claims 1 to 10, further comprising at least one sensor (10) facing towards the frontal face of the patient's head, which is particularly arranged at the visor (8).

12. Headrest-unit according to claim 1 1 , wherein the at least one sensor (10) is selected from the group consisting of:

- an optical camera,

- an infrared camera,

- a microphone.

13. Headrest-unit according to any one of claims 1 to 12, further comprising a loudspeaker, which is particularly arranged at the visor (8).

14. Headrest-unit according to any one of claims 8 and 1 1 to 13, wherein the at least one sensor (10) and/or the loudspeaker are assigned to the display (5), particularly wherein the display (5), the at least one sensor (10) and/or the loudspeaker are part of an integrated device such as a smartphone or tablet- computer detachably attached to the frame-section (4).

15. Method of providing support to a patient's head during a medical procedure, the method comprising the steps of:

- providing a headrest-unit (1 ) according to any one of claims 1 1 to 14;

- monitoring the patient's face via the at least one sensor (10) while the patient's head is supported by said headrest-unit (1 ); and

- detecting, via face and/or facial expression recognition, whether the medical procedure is planned to be performed on the correct patient, and/or whether the patient feels uncomfortable while being placed on said headrest-unit (1 ); and/or

- communicating with the patient via the loudspeaker and the microphone.