CN200945174Y

CN200945174Y - Styloid process excising device

Info

Publication number: CN200945174Y
Application number: CN 200620096996
Authority: CN
Inventors: 王志斌
Original assignee: Tongji Medical College of Huazhong University of Science and Technology
Current assignee: Tongji Medical College of Huazhong University of Science and Technology
Priority date: 2006-05-31
Filing date: 2006-05-31
Publication date: 2007-09-12
Anticipated expiration: 2016-05-31

Abstract

A styloid process excider which comprises a holding structure and an exciding structure si provided. The holding structure is in a forceps shape structure, between whose front and back hand knobs a reposition spring sheet is arranged. The top of the front and back hand knobs is provided with a screwed hole arranged separately. The exciding structure has a tubular bushing, whose front end is connected to a clamping claw sleeve in an arc connection shape. The back end of the tubular bushing is provided with an external threads section. An elastic steel wire is arranged through the tubular bushing; a pair of clamping claws connected on the connection plate by a hinge pin is arranged in the clamping claw bushing; a supporting spring sheet is set up between the pair of clamping claws, which is in opening status in still conditions. The front end of the elastic steel wire is connected to the connection plate; extended out at the back end of the elastic wire is a tubular bushing, which goes through the top screwed holes of the front and back hand knobs, and finally is matched and connected with a thrust nut; the top screwed hole of the front hand knob is connected to the external threads of the back end of the tubular bushing. The excider is simple in structure and easy to operate, suitable for removing a plurality of styloid process at different lengths and irregular positions with less damage to tissue.

Description

The belemnoid resectoscope

Technical field

This utility model relates to the operating theater instruments for the treatment of elongation of styloid process, refers to a kind of belemnoid resectoscope particularly.

Background technology

Elongation of styloid process claims belemnoid syndrome or Eagle syndrome again.Belemnoid truncate operation is the main mode of this disease of healing, and operation must be excised the elongated styloid process part, and guarantees that the belemnoid knochenbruch takes out smoothly, avoids damaging belemnoid neighbouring blood vessel and nerve simultaneously.Because the length of belemnoid and angle variation are very big, the neighbouring relationship complexity of important structure around the belemnoid, important structure such as belemnoid root and stylomastoid foramen, jugular foramen, external opening of carotid canal are in close relations, and therefore, it is meticulous, accurate that operation must be operated, and avoids complication.Yet, influenced by the pharyngeal confined space and tongue body, operation technique is very thorny.Too shorten the belemnoid stub, can increase the risk of important blood vessels or neural tissue injury, and excision belemnoid length is not enough, then can not eliminate symptom fully.

Traditional belemnoid operation method lacks special equipment, mainly relies on bone shears, bone forceps or rongeur and makes to substitute utensil.The knochenbruch in the necessary gap, full alert deep of osteotomy need be repaired the remaining pointed stake of belemnoid sometimes from the slippage of clamping apparatus.In case the knochenbruch slippage is difficult to knochenbruch is taken out from the gap, deep, retains knochenbruch condition of illness is increased the weight of, and damages important blood vessels or nerve easily and insist on seeking knochenbruch, causes serious consequence.Postoperative complication comprises cervical region subcutaneous emphysema and lower jaw part hematoma, and internal carotid artery thrombosis, facial paralysis etc. are put down in writing by document.

In order to prevent the knochenbruch slippage, the domestic people of having reports and utilizes fixedly belemnoid amputation section of tonsil snare recently.Abroad the someone adopts the uterine curet of different model to separate the belemnoid periosteum, be intended to improve surgical field of view, but two methods is still continued to use the traditional instruments osteotomy, operation inconvenience.

The inventor once made out a kind of belemnoid cutting device, as long as the amputation section and the claw axle of belemnoid are in linear relation, this device just can be cut off belemnoid smoothly and avoid the knochenbruch slippage.Yet because the length of belemnoid and orientation variation are greatly, this installs only suitable some cases.In addition, needing both hands while control instrument also is a big drawback.

Summary of the invention

The purpose of this utility model is exactly that unusual belemnoid in a kind of features simple structure, easy operating, suitable excision all lengths and orientation and the belemnoid resectoscope little to tissue injury will be provided.

For realizing this purpose, the belemnoid resectoscope that this utility model is designed comprises holding mechanism and excision mechanism two parts:

Described holding mechanism is pincerlike structure, the forward and backward arm of this pincer structure is connected as a single entity with the forward and backward handle of homonymy respectively, hinged between the junction of preceding arm and front hand grip and the junction of back arm and back handle by the pincers axle, the top of forward and backward arm is respectively equipped with screwed hole, is provided with reseting leaf between the forward and backward handle.

Described excision mechanism has a jacket tube, and the front end arc of jacket tube is connected with catch jacket, and the rear end of jacket tube is provided with external thread section, is interspersed with an elasticity cable wire in the jacket tube.Be provided with in the catch jacket by bearing pin and be hinged on a pair of claw on the connecting block, this is to being provided with supporting spring between the claw, under static state the opening-like attitude of two claws.The front end of elasticity cable wire links to each other with connecting block, and the rear portion of elasticity cable wire is stretched out jacket tube, and passed the screw top hole of forward and backward arm successively, matches with Thrust nut and be connected again.The screw top hole of preceding arm links to each other with the rear end external thread section of jacket tube.

Operation principle of the present utility model is: hold forward and backward handle, two handle relative motioies produce moment, and forward and backward arm is that hinged support produces reverse movement with the pincers axle, expands outwardly.Because the rear end screw thread of preceding arm and jacket tube is connected as a single entity, the Thrust nut that back arm is installed in elasticity cable wire rear portion stops, forward and backward like this arm produces thrust and pulling force respectively, preceding arm props up jacket tube, back arm is that fulcrum pulling elasticity cable wire moves with the Thrust nut, and coupled a pair of claw is bounced back in catch jacket.Under the effect of catch jacket, this jaw to claw begins to close, and is locked by catch jacket until two claw lobes, and this moment, the jaw of claw can THE ADIABATIC SHEAR IN belemnoid sclerotin.Unclamp forward and backward handle, forward and backward arm returns to original state under the effect of reseting leaf, and a pair of claw stretches out in catch jacket, and opens automatically under the effect of supporting spring, and the belemnoid knochenbruch can safety take out from the claw lobe of opening-like attitude.

Advantage of the present utility model is: designed resectoscope adopts handle as power source, it is simple in structure, easy to operate, no matter practise strong hand or non-habit strong hand, one hand is managed this device just can shorten belemnoid, the abecedarian is easy to grasp, and can be used for route surgical shortening of the elongated styloid processes in the general anesthesia per os, can excise the unusual belemnoid in all lengths and orientation.And this apparatus combines together with belemnoid " cut-out " with from two kinds of operating procedures of deep tissue gap safety " taking-up ", has both eliminated the anxiety of belemnoid knochenbruch slippage, and it is tired to have exempted finishing belemnoid stub again.Simultaneously, this resectoscope is little to tissue injury, can not injure important blood vessels and nerve.If the patient can be cooperated under the local anaesthesia, and patient's belemnoid touched easily, and this apparatus also can use when local anaesthesia is performed the operation.

Description of drawings

Fig. 1 is a kind of assembly structure sketch map of belemnoid resectoscope;

Fig. 2 is an A portion structure for amplifying sketch map among Fig. 1;

Fig. 3 is a B portion structure for amplifying sketch map among Fig. 1.

The specific embodiment

Below in conjunction with the drawings and specific embodiments this utility model is described in further detail:

Belemnoid resectoscope shown in the figure is made of holding mechanism and excision mechanism two parts.Holding mechanism is pincerlike structure, its forward and backward

arm

5,6 is connected as a single entity with the forward and backward

handle

13,11 of homonymy respectively, hinged between the junction of preceding arm 5 and front hand grip 13 and the junction of back arm 6 and back handle 11 by pincers axle 10, have screwed hole on the same horizontal line in top of forward and backward

arm

5,6, the reseting leaf 12 of arranged crosswise is installed between the forward and backward

handle

13,11.

Excision mechanism has a jacket tube 3, and the front end arc of jacket tube 3 is connected with catch jacket 2, and the rear end of jacket tube 3 is provided with external thread section, is interspersed with an elasticity cable wire 8 in the jacket tube 3.Catch jacket 2 is generally 120 °～165 ° with the transition arc angle that is connected between the jacket tube 3, and can adapt to the needs of most corrective surgery work angles in this scope.Be mounted with in the catch jacket 2 by bearing pin 15 and be hinged on a pair of claw 1 on the cylindrical connecting block 16.Catch jacket 2 is the loudspeaker tubular, so that a pair of claw 1 is successfully inside and outside flexible along catch jacket 2.This forms the jaw of the long belemnoid of excision to the front end pointed tooth of claw 1.This is to being provided with simple and practical U-shaped supporting spring 14, to guarantee the original open state of two claw lobes between the claw 1.

The two ends of elasticity cable wire 8 are provided with screw thread.The front end screw thread of elasticity cable wire 8 links to each other with the screwed hole of connecting block 16, can dismantle easily and change.Stretch out, also pass the screw top hole of forward and backward

arm

5,6 successively, be threaded with Thrust nut 7 again from the rear end external thread section of jacket tube 3 in the rear portion of elasticity cable wire 8.The longitudinal section of Thrust nut 7 is step, which is provided with the external thread section that matches with the screw top hole of back arm 6, when the external thread section of Thrust nut 7 screws in the screw top hole of back arm 6, can limit the position of Thrust nut 7, elasticity cable wire 8 and back arm 6 simultaneously, make the stretching motion of elasticity cable wire 8 drive claws 1 more reliable and more stable.The rearmost end screw thread of elasticity cable wire 8 links to each other with a Safety nut 9, can avoid end and other article hooks of elasticity cable wire 8, and is safe and reliable when guaranteeing operation technique.

The screw top hole of preceding arm 5 links to each other with the rear end external thread section of jacket tube 3.Also be provided with a location nut 4 on the rear end external thread section of jacket tube 3, after arm 5 was tightened before setscrew nut 4 was close to, can limit jacket tube 3 rotates with respect to preceding arm 5, thereby can regulate direction with stationary jaw cover 2, and then the jaw direction of stationary jaw 1, to adapt to the needs of patient present position.

The size design of this belemnoid resectoscope critical piece is as follows: tonsillectomy 40 examples are as the experimenter under the general anesthesia of selecting at random to be grown up, and the patient lays the Dai Weishi gag in Trendelenburg's position, measure oral cavity and pars oralis pharyngis related data after the removal of tonsils; Belemnoid according to design is positioned at tonsillar fossa partition method, and the catch jacket 2 and the jacket tube 3 of the suitable radian of appliance configuration is optimized selection.

Measure the ccavum oropharygeum data: [1] cutting spacing up and down; [2] cutting is to the distance at tonsil center under; [3] the tonsil semilunar fold is to the distance of triangle pleat; [4] palate hangs down to the height of back; [5] spacing of bilateral amygdala nest mid point.Determine the actual size of the catch jacket 2 of excision elongated styloid process part and claw 1 and jacket tube 3 prove-in length according to measurement result at ccavum oropharygeum.The measurement result of ccavum oropharygeum: cutting spacing up and down: 4.25 ± 0.25cm; Following cutting is to the degree of depth at tonsil center: 7.18 ± 0.46cm; The tonsil semilunar fold is to the distance of triangle pleat: 4.4 ± 0.33cm; Palate hangs down to the vertical height of spatula: 4.3 ± 0.38cm; The spacing of bilateral amygdala nest mid point: 5.82 ± 0.44cm.Determine the dimensional parameters of belemnoid resectoscope thus: setting can be held the catch jacket 2 of belemnoid knochenbruch of long 3.5cm and the physical length of claw 1 is 4.0cm; Catch jacket 2 is 165 °, 150 °, 135 ° and 120 ° with the transition arc angle that is connected between the jacket tube 3, and jacket tube 3 is respectively 1.5cm, 2.0cm and 2.5cm and 3.0cm with the actual height of claw 1 binding clip; Catch jacket 2 is 8.0cm with jacket tube 3 in the length of pars oralis pharyngis.

Make the combination that the transition arc angle is respectively the four kinds of catch jackets 2 and the jacket tube 3 of 165 °, 150 °, 135 ° and 120 °, every kind respectively to the contact of 5 subregions fixed points of 40 experimenter's tonsillar fossas, writes down qualified frequency respectively.When a kind of distal end of combination contacts a tonsillar fossa partition position, if catch jacket 2 and jacket tube 3 stage casings are not against upper and lower cutting, then point out apparatus can distinguish set belemnoid therewith and constitute linear overlapping relation, write down qualified radian 1 time with the configuration of this combination.Accumulative total every kind of combination qualified frequency, obtain qualified frequency maximum as best allocation.Experiment shows: the transition arc angle of 150 ° and 135 ° all can 40 experimenters' tonsillar fossa center, interior on, interior down, outer on and outside following 5 zones and the para-position of set belemnoid end, promptly these two kinds of combinations are best allocation.Because catch jacket 2 is bigger with the radian of jacket tube 3, the frictional resistance that produces when elasticity cable wire 8 interacts within it is littler, so with 150 ° the combination first-selection as clinical practice.

When this utility model used: operator was positioned at patient's head during general anesthesia, and claw 1 jaw down; Operator is positioned at the patient opposite during local anaesthesia, and claw 1 jaw up.Can rotate jacket tube 3 according to the operator present position, and regulate the jaw directions by setscrew nut 4.At first go the tonsil enucleation, touch the position of the clear and definite belemnoid end of tonsillar fossa according to a conventional method with forefinger.Separate after the surrounding soft tissue that is attached to belemnoid excision section, a hand-held ethmoid curet is enclosed within styloid tip, pushes to the belemnoid foundation, expose belemnoid excision section, needn't withdraw from curet this moment, and the forward and backward

handle

13,11 of another hand-held this device stretches into pharyngeal cavity with the binding clip of claw 1.If palatoglossal arch blocks exposed belemnoid, binding clip can be pushed it open.Claw 1 is approached the belemnoid end of exposure, gradually belemnoid excision section is inserted in the pawl groove of claw 1.Hold handle then, the audible and the deep sound show that jaw cuts off belemnoid rapidly this moment, and knochenbruch is stranded in the pawl groove.Device distal end release handle not when gap, patient deep is withdrawn, knochenbruch can withdraw from the oral cavity in the lump in company with device.

Claims

1. a belemnoid resectoscope comprises holding mechanism and excision mechanism two parts, it is characterized in that:

Described holding mechanism is pincerlike structure, the forward and backward arm of this pincer structure (5,6) is connected as a single entity with the forward and backward handle (13,11) of homonymy respectively, hinged between the junction of preceding arm (5) and front hand grip (13) and the junction of back arm (6) and back handle (11) by pincers axles (10), the top of forward and backward arm (5,6) is respectively equipped with screwed hole, and forward and backward handle is provided with reseting leaf (12) between (13,11);

Described excision mechanism has a jacket tube (3), and the front end arc of jacket tube (3) is connected with catch jacket (2), and the rear end of jacket tube (3) is provided with external thread section, is interspersed with an elasticity cable wire (8) in the jacket tube (3); Be provided with in the catch jacket (2) by bearing pin (15) and be hinged on a pair of claw (1) on the connecting block (16), this is to being provided with supporting spring (14) between the claw (1); The front end of elasticity cable wire (8) links to each other with connecting block (16), and the rear portion of elasticity cable wire (8) is stretched out jacket tube (3), and passed the screw top hole of forward and backward arm (5,6) successively, matches with Thrust nut (7) and be connected again; The screw top hole of preceding arm (5) links to each other with the rear end external thread section of jacket tube (3).

2. belemnoid resectoscope according to claim 1 is characterized in that: the setscrew nut (4) that also is provided with the preceding arm (5) of next-door neighbour on the rear end external thread section of said jacket tube (3).

3. belemnoid resectoscope according to claim 1 and 2 is characterized in that: also be provided with the external thread section that matches with the screw top hole of back arm (6) on the said Thrust nut (7).

4. belemnoid resectoscope according to claim 1 and 2 is characterized in that: the front end screw thread of said elasticity cable wire (8) links to each other with the screwed hole of connecting block (16).

5. belemnoid resectoscope according to claim 1 and 2 is characterized in that: the rear end screw thread of said elasticity cable wire (8) links to each other with a Safety nut (9).

6. belemnoid resectoscope according to claim 1 and 2 is characterized in that: said catch jacket (2) is the loudspeaker tubular.

7. belemnoid resectoscope according to claim 1 and 2 is characterized in that: said catch jacket (2) is 120 °～165 ° with the transition arc angle that is connected between the jacket tube (3).

8. belemnoid resectoscope according to claim 1 and 2 is characterized in that: said catch jacket (2) is 135 ° or 150 ° with the transition arc angle that is connected between the jacket tube (3).

9. belemnoid resectoscope according to claim 1 and 2 is characterized in that: said supporting spring (14) is the U-shaped reed.