Abstract:
A unitary support for holding and cushioning the head and face of a surgical patient has a resilient body of molded foam. The resilient body has a cavity formed in the upper face for receiving and cushioning the head and face of a patient. The resilient body has access openings therein for additional apparatus, such as an endotracheal tube, and to permit viewing of the patient&#39;s face during surgery. The resilient body has stiffening structure to prevent constriction of the openings during use and to prevent constriction of an endotracheal tube or similar apparatus.

Description:
BACKGROUND OF THE INVENTION 
   1. Field of the Invention 
   The present invention relates to a head rest for supporting the head of an anesthetized patient in prone position during surgery. 
   2. Brief Description of the Prior Art 
   Some surgical procedures are performed on an anesthetized patient in a face down, prone, position with breathing supported by an endotracheal tube placed in the patient&#39;s mouth. In this position much of the weight of the patient&#39;s head must be supported on the soft tissue of the face. The art has provided a number of structures to support a patient&#39;s head in this position. These structures, however, either obstruct much of the view of the patient&#39;s face making it more difficult to monitor the patient or limit access to the endotracheal tube which may make the condition of the endotracheal tube more difficult to watch. 
   In addition, the supporting structure typically used for head rests is made of a cushioning material or includes a cushioning material. Since the cushioning material is soft, it collapses or partially collapses under the weight of the patient&#39;s head. The change of shape of the supporting structure may further block the view of the patient&#39;s face or pinch off the endotracheal tube. 
   U.S. Pat. Nos. D 271,834, D 298,992, D 337,914, D 414,974, D 456,516, 2,688,142, 3,366,104, 3,694,831, 4,752,064, 5,269,035, 5,613,501, 5,960,494, 6,374,441, 6,427,272, and 6,490,737 are incorporated by reference herein. 
   BRIEF SUMMARY OF THE INVENTION 
   The present invention provides an inexpensive structure for supporting the head of a patient during surgery. The structure is unitary and freestanding. The structure may be formed of inexpensive materials, such as a molded foam. The support structure is suited for single use application, which reduces the chance of infection. 
   The head rest provides a cushioning support which minimizes stress on the head of the patient. The cushioning movement of the head rest under the weight of the patient&#39;s head is controlled by the structure of the head rest in a manner that the view of the patient&#39;s face remains unobstructed and the head rest does not interfere with the endotracheal tube or such other apparatus that may be attached to the patient. 
   It is thus an object of the present invention to provide a unitary head rest which provides a cushioning support for a patient&#39;s head during surgery. It is a further object to provide a head rest that does not obscure the view of the patient&#39;s face or pinch off the breathing support. Another object is to provide a single use, inexpensive head rest for use in surgery. 
   These and other objects will be apparent from the Drawings and from the following Description of the Drawings and the Description of the Preferred Embodiments. 

   
     BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING 
     In the accompanying drawings, in which one of various possible embodiments of the invention are illustrated, corresponding reference characters refer to corresponding parts throughout the several views of the drawings in which: 
       FIG. 1  is a perspective view of the device of the invention supporting the head of a patient; 
       FIG. 2  is a left side view of  FIG. 1  in partial cross-section; 
       FIG. 3  is a perspective view of the device of the invention; 
       FIG. 4  is a top plan view of the device of the invention; 
       FIG. 5  is a left side view of the device of the invention; 
       FIG. 6  is a cross-sectional view of the device of the invention taken along the plane  6 — 6  in  FIG. 4 ; and, 
       FIG. 7  is a bottom view of the device of the invention. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   Referring to  FIG. 1 , a cushioning device of the invention  10  is shown supporting a head  12  of a patient. The patient is in the face down, prone position, as shown. Cushioning device  10  is placed over a mirror  14 , which permits a face  16  of the patient to be observed as a reflection  18 . 
   Cushioning device  10  has a body  20  formed of a resilient cushioning material, as described herein. Cushioning device  10  has a central cavity  22  in an upper face  23  of body  20  as shown in  FIGS. 2 through 7 . Head  12  is received in central cavity  22  and supported by cushioning device  10  along the patient&#39;s forehead, as shown. Body  20  of cushioning device  10  also has a longitudinally spaced cavity  24 , as shown in  FIGS. 2 ,  3 ,  4 ,  6  and  7 , for support of the patient&#39;s cheeks and chin. A slot  25 , into which the nose of the patient is received, joins longitudinally spaced cavity  24  with central cavity  22 . 
   Cushioning device  10  also has a plurality of transverse passages  26 ,  28 ,  30  and  32  in a lower face  33  of body  20 . Transverse passages  26  and  28  communicate with the central cavity  22  and allow face  16  of the patient to be observed in mirror  14 . Transverse passages  30  and  32  communicate with longitudinally spaced cavity  24  and allow an endotracheal tube  34  to be monitored. 
   Transverse passages  26  and  28  are positioned near a transverse axis of body  20 , as shown. Transverse passages  26  and  28  are preferable formed as tapered arches and extend from lower face  33  of body  20  to near upper face  23  of body  20 . The height and shape of transverse passages  26  and  28  form hinge points  40  and  42  in body  20  of cushioning device  10 , as described herein. 
   Transverse passages  30  and  32  are positioned between the transverse passages  26  and  28  and a proximal end  44  of body  20  of cushioning device  10 . Transverse passages  30  and  32  are also preferably formed as tapered arches and extend toward the upper face  23  of body  20 . Transverse passages  30  and  32  terminate at a greater distance from upper face  23  of body  20  than transverse passages  26  and  28 , leaving a greater volume of material between the termination points of transverse passages  30  and  32  and upper face  23  of body  20  than transverse passages  26  and  28 . The greater volume of material created makes this portion of cushioning device stiffer than hinge points  40  and  42  formed by transverse passages  26  and  28 . If desired, hinge points  40  and  42  may be made even more flexible by forming relieved areas  41  and  43  adjacent hinge points  40  and  42 , as shown. 
   A distal end  46  of body  20  is formed with a volume of increased material or bulge  48 , as shown, with a squared foot  49 . Bulge  48  may extend around distal end  46  of body  20  in a curve, as shown and may terminate above bottom face  33  of body  20 , also as shown. The increased material of bulge  48   i  increases the stiffness of body  20  at its distal end  46 , as described herein. 
   Bottom face  33  of body  20  has a plurality of support surfaces  50 ,  52 ,  54  and  56 , as shown in FIG.  7 . Support surfaces  50 ,  52 ,  54  and  56  contact mirror  14 , as shown in  FIG. 1 , or any other supporting structure. Support surface  50  is at distal end  46  of body  20  and support surface  52  is at proximal end  44  of body  20 . 
   Support surfaces  54  and  56  are positioned centrally in body  20 , as shown. Support surfaces  54  and  56  separate transverse passages  26  and  28  from transverse passages  30  and  32 . Support surfaces  54  and  56  are separated by slot  25  and form elongated pillars  58  and  60 , as shown in  FIGS. 1 and 5 . Separated pillars  58  and  60  act as independent spring supports which may add to the stability of cushioning device  10 . 
   Cushioning device  10  of the invention is unitary and free standing. Cushioning device  10  of the invention does not require an additional case or support. Cushioning device  10  of the invention is preferably made of an expanded polymer foam, for example, a polyurethane foam. It will be appreciated that other polymer foams may also be used, such as polyether foams, polyester foams, and the like. A blown polyurethane foam having an open cell structure is most preferred. The hardness of the foam is preferably between about 20 to 40 Shore 000 durometer. The optimum durometer is believed to be about 35 Shore 000. This hardness provides optimum support for the head of a patient. The cushioning device  10  is sufficiently stiff that pressure points on a patient&#39;s face are minimized, but the cushioning device  10  is sufficiently stiff that the weight of a patient&#39;s head does not collapse cushioning device  10  to the point of constricting endotracheal tube  34 . 
   Cushioning device  10  of the invention may be made by conventional molding techniques using molds which form a pattern for cushioning device  10 , as is known in the art. The molds may be heated to form an integral skin on the outer surface of the cushioning device  10 , also as is known in the art, but it is preferred to leave the cushioning device  10  unskinned as the unskinned cushioning device  10  is softer and more comfortable for the face of a patient. As shown in  FIGS. 4 and 5 , for example, cushioning device  10  is formed with smooth, rounded contours. The rounded contours provide a smoother cushioning to face  16  of a patient and facilitate the removal of cushioning device  10  from a mold, as is known in the art. Cushioning device  10 , as so formed, is an inexpensive item which may be disposed of after a single use. Device  10  is easily sterilized and as a single use item assists in maintaining a clean environment for surgery. 
   As noted above, cushioning device  10  is stable and self supporting. No additional structure is required to assist in supporting head  12  of a patient and as a result, there is a softer support for the patient&#39;s head  12 . A patient&#39;s face  16  is highly vascularized and is usually not weight bearing. The softer support provided by cushioning device  10  results in less bruising and other trauma to the patient&#39;s head  12 , as may result during a long surgery. 
   The structure of cushioning device  10  maintains the stability of the supported head  12  of a patient. When cushioning device  10  is compressed by the weight of patient&#39;s head  12 , the access to endotracheal tube  34  remains uncompressed. In particular, the stiff support provided by distal end  46  and proximal end  44  in combination with the softer hinge points  40  and  42  provide a controlled cushioning which results in a neutral or outward pivoting force at the base of transverse passages  26  and  28  and counteracts any tendency to constrict transverse passages  26  and  28 . Cushioning device  10  may also be used with a variety of surgical mirrors; no special cooperation between the surgical mirror and cushioning device  10  is required. With any mirror, the view of patient&#39;s face  16 , and reflection  18  in mirror  14 , remain unobstructed. Cushioning device  10  and endotracheal tube  34  are installed before surgery. Cushioning device  10  facilitates the transfer of the patient from a gurney, where the patient is back down, to the face down position for surgery. Mirror  14  can be installed under cushioning device  10  as the patient is turned. 
   Further, the support provided by proximal end  44  and pillars  58  and  60  resists any tendency to constrict longitudinally extending cavity  24  and transverse passages  30  and  32  or to pinch off endotracheal tube  34  installed therein. The separation of pillars  58  and  60  allows the nose of the patient to clear central cavity  22  and longitudinally extending cavity  24 . The wide supporting surfaces  54  and  56  allow pillars  58  and  60  to independently support face  16  of a patient providing additional support and comfort for the patient. 
   The structure of cushioning device  10  of the invention also provides additional stability in that the cushioning effect is uniform. That is, the compressing motion of patient&#39;s head  12  is essentially uniformly vertical. Stiff bulge structure  48  functions to prevent distal end  46  of cushioning device  10  from rolling forward or compressing downward to a greater degree than the central portion or proximal end  44  of body  20 , i.e. bulge  48  prevents distal end  46  from buckling forward. This feature helps cushioning device  10  maintain transverse passages  26 ,  28 ,  30  and  32  open and unobstructed. The view of patient&#39;s face  16  is unobstructed and binding of endotracheal tube  34  is prevented. By preventing binding of endotracheal tube  34  cushioning device  10  prevents chaffing of the patient&#39;s mouth from torque being applied to endotracheal tube  34 . 
   It will be appreciated by those skilled in the art that the embodiments disclosed herein are illustrative. The invention disclosed may be modified further without departing from the spirit of the invention. The invention is not to be restricted to the specifics of the structure disclosed herein, but is to be limited only by the scope of the appended claims and their equivalents.