[Noninvasive head fixation for external irradiation of tumors of the head-neck area].

PURPOSE To fully utilize the technical capabilities of radiation diagnostics and planning, a precise and reproducible method of head fixation is a prerequisite. METHOD We have adapted the Vogele-Bale-Hohner (VBH) head holder (Wellhofer Dosimetrie, Schwarzenbruck, Germany), originally designed for frameless stereotactic operations, to the requirements of external beam radiotherapy. A precise and reproducible head fixation is attained by an individualized vacuum upper-dental cast which is connected over 2 hydraulic arms to an adjustable head- and rigid base-plate. Radiation field and patient alignment lasers are marked on a relocatable clear PVC localization box. RESULTS The possibility of craniocaudal adjustment of the head plate on the base plate allows the system to adapt to the actual position of the patient on the radiotherapy couch granting tensionless repositioning. The VBH head holder has proven itself to be a precise yet practicable method of head fixation. Duration of mouthpiece production and daily repositioning is comparable to that of the thermoplastic mask. CONCLUSION The new head holder is in routine use at our hospital and quite suitable for external beam radiation of patients with tumors of the head and neck.