Fabrication of customized tongue-displacing stents Considerations for use in patients receiving head and neck radiotherapy

Background. Conformal or intensity-modulated radiation therapy can be improved by using a customized tongue-displacing (CTD) stent. These stents are designed to either move healthy oral tissues out of the path of the radiation beam or stabilize mobile tissues to allow more precise field control. Methods. The authors describe CTD stent construction for both tongue-deviating and tongue-depressing applications. Results. CTD stents enable clinicians to achieve more predictable and consistent radiation dosimetry planning while sparing greater volumes of healthy tissue from damage. They have been well tolerated by patients. Conclusions. Use of CTD stents results in increased oral mucosal sparing, ensures reproducible immobilization and is incorporated readily into the clinical practice of radiation oncology. Practical Implications. Clinicians can reduce or avoid significant morbidity to healthy oral tissues by using CTD stents. This can lead to better outcomes and improved quality of life for patients receiving head and neck radiation therapy.