Methodology & Findings
Based off initial research available we planned to use its findings to iterate on a prototype to help find a solution that matched Marilyn's needs. In addition to our prototype we researched C-PAP masks to help identify user issue trends and current adaptations for some of those issues. Our findings showed that individuals who use a ventilation mask lose oxygen due to slack jaw, loose fitting masks, and air blow back.
The initial research provided was materials and documentation on initial adaptations for Marilyn's full-face mask. The prototypes in the initial research were unsuccessful in preventing air leakage. Based on their adaptations we wanted to look for alternative methods in preventing air leakage by looking into mask sealant for scuba gear, 3-D printing and face-scanning, hospital methods for addressing mask fit issues, and speaking with
Our goal was to discuss some of the issues nurses experienced with ventilation marks in the pediatric unit and how they went about solving them. The nurses issues resonated some of the earlier points we discovered in our research. According to the nurse, most of the issues they encountered had to do with fit and masks sliding up on their patients face. This commonly led to bruising of the nose and discomfort. The nurse highlighted their adaptive solutions using Mepilex and a Cavilon seal on the skin to prevent bruising and a better fit to prevent air loss.
In another interview we spoke with a Prosthodontist from NYU’s Oral Health Center for People with Disabilities. Our hope was to brainstorm and potentially fabricate some kind of prosthetic, mouth guard or custom mask fit for Marilyn. We believed that one of these ideas may be a solution to any potential jaw slack during sleep. Since Marilyn prefers to use her lip seal mask over her full-face mask we wanted to explore alternative options around this model with the Prosthodontist. She mentioned to us that her current lip seal is an older model and is no longer being sold.
As we spoke to the Prosthodontist, he mentioned a Canadian company that does a mouth guard for sleep apnea that would help with any jaw slack Marilyn was experiencing when she sleeps. It would keep her bite engaged just enough without keeping her mouth locked closed so that if she needed help at night, she could still call for an aide. The doctor was able to provide us two different solutions a long term and a short term solution.
Marilyn's Lip Seal Mask
Short Term Temporary Solution
The Prosthodontist suggested using two sets of orthodontic buttons (1 set on each side, one on the bottom and one on top) that have hooks for rubber bands. Marilyn could have the aides hook the bands (just like the one braces use) on low tension braces and rubber bands to close her bite. The low tension and night time only usage won’t cause teeth to move, but will help keep her bite closed and allow for a more consistent seal. Marilyn, her aide and our advisor all agreed that it seemed like a simple elegant solution for the short term. Marilyn wanted to give it a try and then test out the setup with her respiratory therapist.
Long Term Solution
The Prosthodontist proceeded with an assessment and felt her occlusion was potentially a large factor of potential mask fit issues, especially when using a mouth seal or a nasal only mask, which are the main masks available in the market. He also noted that she may need some potential dental work done and heavily recommended the dental work to be done first (to save Marilyn from paying for a second mouth guard post dental work). However since her levels have been so low (recently in mid 50s one night and had to go to ER) we asked if there were any temporary solutions he could think of until the dental work was done.