How to Choose the Right Head Support for your Patient?

Radiotherapy Immobilization Using High Precision Head Supports and Blocks and Wedges

The importance of choosing an appropriate head support is twofold:

  • To ensure optimal reproducibility and minimize set-up errors.
  • To rest the patient’s head comfortably and help them keep the same position during the treatment.

Blocks and wedges are helpful when you must position the head in different degrees of flexion or extension. In addition, if a head support alone is not sufficient to achieve the correct positioning, we also recommend using a block or wedge combination.

Orfit head supports, blocks and wedges come in a variety of different shapes. This allows you to perfectly adapt each immobilization set-up to the patient’s anatomy and the requirements of the treatment.

Radiotherapy patient immobilized with a thermoplastic mask and head support


Head Supports

Orfit head supports come in six different shapes that can accommodate a variety of neck and head sizes. They help to comfortably cradle the patient’s head while the cranial stop allows a correct and reproducible position. The head supports are combined with Orfit Blocks and Wedges to allow high precision positioning.

Orfit 3D head rests for head and neck positioning and immobilization in radiotherapy

All six head rests come in a regular (blue) and low (gray) density version that can be used for both simulation and treatment. The extra soft (pink) head supports are ideal for treatments that require high comfort, e.g. on the Cyberknife or when the patient is in severe discomfort.

Choosing the correct head support

When choosing an appropriate head rest, verify the contact made with the cranial backstop and the neck to determine if it is a suitable size for the patient. If there are any gaps or if a head support is too small, try another one or introduce some of the blocks and wedges (go straight to Blocks and Wedges).

Make sure to ask the patient if they are comfortable and in a secure position. If the patient feels comfortable, they will be able to stay in the position for a longer period of time.

A very helpful tool to choose the correct head support is the Head Support Finder. Follow the questions on the decision tree and you will be sure to find a suitable option for your patient:


Prone Head Support

When treating patients in prone position, such as for pelvis or Craniospinal (CSI) treatment, the Prone Head Support offers the possibility to position the patient’s head in a stable, reproducible way.

The head support is adjustable to make it fit for both adult and pediatric patients. It has enough open space to allow comfortable breathing and the use of anesthetic tubes.


Prone head supports for radiotherapy immobilization

There are two types of prone head supports available:

  • With a moveable head cushion (32393 and 38226)
  • With a moveable chin cushion (32380)

Just like the regular head supports, you can use the prone head support in combination with the blocks and wedges to adjust the height or angle.

Positioning the head support

The positioning of the prone head support is different from the standard headrests. Before fixing it to the base plate, you should first fit the prone head support to the patient’s face.

Move the head or chin cushion, depending on the type of support you are using, in the right position to accommodate the unique anatomy of the patient. Once you have established an appropriate position, fix the head support in the base plate. Position the patient on the head support, verify the position and adjust the moveable cushion if necessary.

Detailed instructions can be found in the Instructions for Use: 32393, 38226 and 32380


Blocks and Wedges

Blocks and wedges allow you to position the patient’s head at different heights and to place the head in different degrees of flexion or extension.

We offer two blocks (2 cm and 4 cm height) and three wedges (9°, 13.5° and 18°). You can position the wedges in two directions, to create either flexion or extension.

Orfit Blocks and Wedges lined up

Thanks to the straightforward click system, you can easily stack the blocks and wedges on top of each other. If possible use no more than two blocks or wedges to ensure optimal stability.

The blocks and wedges come in a low density and high density version that can be used during both simulation and treatment. A separate set of blocks and wedges (white set) is suitable for MRI simulation.

Choosing the correct block or wedge

Verify the contact of the head support with the patient’s neck and the contact with the cranial backstop. Check whether the patient is in a comfortable position. If the positioning is not yet appropriate, you can adjust with a block or wedge.

Radiotherapy immobilization setup with a head support and wedges.

The 2 cm block and the 9° wedge are ideal to adjust the fit of the head rest. Try out different combinations to find the perfect set-up for your patient. As mentioned before, the Head Support Finder is a great tool to help you verify the patient’s position and choose the correct combination of head supports and blocks and wedges.

If the patient’s head should be placed in extension or flexion, test different combinations of blocks and wedges to obtain the angle and position you need.


Next time you are in doubt of which head support, block or wedge to choose, refer to this overview to find the most suitable immobilization devices to fit your patient’s needs.


Contact us for more product information or find your local distributor here.


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