CN210962183U - Percutaneous perforation temporal styloid process truncates device - Google Patents
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- CN210962183U CN210962183U CN201920951977.XU CN201920951977U CN210962183U CN 210962183 U CN210962183 U CN 210962183U CN 201920951977 U CN201920951977 U CN 201920951977U CN 210962183 U CN210962183 U CN 210962183U
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Abstract
The utility model discloses a percutaneous perforation temporal bone styloid process truncates device, including the sleeve pipe and with the percutaneous perforating device that the sleeve pipe cooperation was punched, truncate the cutting device of styloid process. Compared with the traditional operation mode of external incision of the neck and fracture of the external diameter of the neck, the system adopts the mode of punching and cutting, has small operation wound, quick recovery and short operation time, reduces the operation difficulty of an operator, and provides good wound area illumination. And has little damage to surrounding tissues and few complications.
Description
Technical Field
The utility model relates to a device for temporal bone styloid process is truncated.
Background
The temporal styloid process is a thin and long bony prominence protruding forward and downward from the lower part of the temporal bone, normally ranging from several millimeters to 2.5cm, and is located below the ear. The styloid process syndrome is also called as excessive styloid process, Eagle syndrome and styloid neuralgia. The styloid process syndrome is a general term for symptoms such as foreign body sensation in pharynx, pharyngalgia, reflex otodynia, pain in head and neck, salivary glands, etc. caused by overlong styloid process (more than 2.5cm) or abnormal orientation and morphology of styloid process, which stimulate adjacent vascular nerves. Is commonly found in adults. The disease is slow in onset, the disease history is different, the tonsil region and the tongue root region are often painful, the pain is usually unilateral, the pain is usually not acute, the pain can be radiated to the ear or the neck, and the pain is aggravated when the patient swallows the medicine. Foreign body sensation or obstruction sensation in throat is common, mostly one side, and is more obvious when swallowing, sometimes aggravated when speaking, turning head or at night. It can also cause coughing, pain radiating upwardly from the angle of one jaw to the neck or face when the carotid artery is compressed or abraded. There may be symptoms of neurasthenia such as tinnitus, salivation, insomnia, etc.
For patients with the styloid process syndrome with obvious symptoms and signs, the operation truncates the styloid process as the only treatment mode. The operation method comprises 1, a transoral throat tonsil route 2 and a transcervical route. The problem of the tonsil route through oropharynx lies in that firstly tonsil of a patient needs to be removed, secondly, the operation bleeding amount is large, the tissue damage of the patient is heavy, the complications such as postoperative bleeding and severe sore throat are many, and the operation is difficult to operate due to the narrow and small oral cavity, so that the effective shortening of the styloid process cannot be achieved. The external cervical approach is a commonly used operation mode at present, a patient is subjected to general anesthesia in a supine position, an incision with the length of 4-6 cm is made on the front edge of sternocleidomastoid muscle at the distance of 2cm from the lower jaw edge of the neck, subcutaneous tissue is spread by using a curved forceps, a styloid process is found in gap tissues at the lower edge of the parotid gland and the upper edge of the back abdomen of the digastric muscle, muscle tissues attached to the styloid process are stripped by a stripper, and the styloid process is broken by clamping the root of the styloid process by a needle holder. The problem of the external diameter of the neck is that 1, the incision is long and is positioned on the neck, which affects the beauty of the patient. 2. Because the position of the styloid process is deep, the shadowless lamp in the operating room can not achieve effective lighting conditions at present, the lighting direction and the body position need to be changed repeatedly, 3, the styloid process can be achieved through neck separation, important tissues such as parotid gland, internal carotid artery, facial nerve and the like need to pass through, if the neck anatomical structure is not familiar, the important tissues are easy to damage in the styloid process, serious complications are caused 4, special instruments are not available at present, muscle tissues 5 attached to the styloid process can be quickly and effectively stripped, peripheral blood vessels and nerves are easy to stab when the styloid process is broken by a needle holder, and serious complications are caused 6, the requirement of the existing operation mode on an operator is high, and a multi-user cooperative operation is needed.
SUMMERY OF THE UTILITY MODEL
In view of this, the utility model provides a percutaneous perforation temporal bone styloid process truncates device cuts the styloid process after carrying out percutaneous perforation.
For solving the above technical problem, the technical scheme of the utility model is that: a percutaneous perforation temporalis styloid process truncating device comprises a sleeve, a percutaneous perforation device and a cutting device, wherein the percutaneous perforation device is matched with the sleeve to perforate, and the cutting device is used for truncating styloid process.
As an improvement, the two ends of the sleeve are open, and the front end of the sleeve is provided with an inclined plane; an internal thread sleeve coaxial with the sleeve is fixedly arranged in the sleeve. The cannula firstly serves as a passage for the entry and exit of other devices and secondly protects other tissues from damage during the cutting operation. In addition, the bevel at the front end of the sleeve is used for inserting neck tissues more smoothly and peeling off tissues attached to the styloid process preliminarily.
As an improvement, the percutaneous perforating device comprises a sharp puncture head, and a threaded column is arranged behind the puncture head and is matched and connected with an internal threaded sleeve in the sleeve. The puncture head is used for puncturing neck tissues, so that the tissues are prevented from being embedded into the hollow sleeve, and the sleeve is guided to be in place.
As an improvement, the cutting device comprises an external thread sleeve which is matched with the internal thread sleeve of the sleeve and is provided with two openings at two ends; a rotary sleeve is arranged in the external thread sleeve, and a plurality of telescopic cutting blades are arranged on the inner annular surface of the rotary sleeve; the lower end of the external thread sleeve is provided with a positioning baffle table. The blade has the function of cutting the styloid process in the radial direction, and can be kept to be always tightly attached to the styloid process because of the telescopic shape of the blade. The external thread sleeve and the internal thread sleeve are matched for positioning and used for determining the cutting position.
As an improvement, the cutting blade comprises a blade and a telescopic rod arranged at the tail end of the blade; the telescopic rod comprises an inner sleeve and an outer sleeve which are sleeved with each other, the tail end of the outer sleeve is fixed on the inner annular surface of the rotary sleeve, and a pre-tightening spring is arranged at the rear end, located in the inner sleeve, of the outer sleeve. The pre-tightening spring pushes the inner sleeve to extend out, so that the blade keeps clinging to the styloid process.
Preferably, the cutting blade comprises a blade, and a connecting rod is fixedly connected to the tail end of the blade; the mounting seat is fixed on the inner ring surface of the rotating sleeve, and the front end of the mounting seat is provided with a small hole; the connecting rod extends into the mounting seat through the small hole, and a part of the connecting rod, which is positioned in the mounting seat, is sleeved with a pre-tightening spring; and spring seats are arranged on the inner walls of the connecting rods and the mounting seat. The pre-tightening spring pushes the inner sleeve to extend out, so that the blade keeps clinging to the styloid process.
As an improvement, the number of the cutting blades is three, and the cutting blades are uniformly distributed along the circumference and are provided with inner arc-shaped cutting edges; or the number of the cutting blades is 4 which are uniformly distributed along the circumference, and the cutting blades are provided with sharp working parts. The contact area between the inner arc-shaped cutting edge and the styloid process is large, and the cutting speed is high. While the sharp working portion cuts more thoroughly. The two cutting edges can be selected according to requirements and can also be matched for use.
As an improvement, a cross beam is arranged at the upper end of the rotary sleeve, and a driving rod which is vertically arranged is connected onto the cross beam. The driving rod is connected with a power device to drive the rotary sleeve to rotate for cutting.
As an improvement, the tissue stripping device also comprises a tissue stripping device, wherein the tissue stripping device comprises an external thread sleeve which is matched with the internal thread sleeve of the sleeve and is provided with two open ends; a sliding sleeve capable of sliding up and down along the inner cavity of the external thread sleeve is arranged in the external thread sleeve, a steel rope used for stripping tissues attached to the styloid process is arranged in the sliding sleeve, one end of the steel rope is a fixed end connected to the inner annular surface of the sliding sleeve, and the other end of the steel rope is a movable end extending out of the sleeve; the middle part of the steel rope is folded and is bound by a rope buckle to form a rope loop, and the movable end can be pulled to control the size of the rope loop; still have a plurality of stay cords even on the sliding sleeve inner ring surface, the stay cord rear end is connected with sliding sleeve inner ring surface, and the front end is connected on the rope circle. The tissue stripping device carries out secondary fine stripping on the tissue attached to the styloid process, the loop formed by utilizing the steel rope loop is sleeved into the styloid process from top to bottom, and the tissue attached to the styloid process is completely stripped naturally, so that convenience is provided for later-stage truncation.
The utility model discloses an useful part lies in:
compared with the traditional operation mode of external incision of the neck and fracture of the external diameter of the neck, the system adopts the mode of punching and cutting, has small operation wound, quick recovery and short operation time, reduces the operation difficulty of an operator, and provides good wound area illumination.
1. Because the wound is on the neck, the scar of the wound area is small after the minimally invasive punching operation, and the beauty effect is greatly improved.
2. The sleeve is arranged to avoid unnecessary damage to peripheral tissues caused by operation of an operator, primary stripping of tissues attached to the styloid process is realized by sleeving the styloid into the sleeve, and then secondary fine stripping is carried out by using the tissue stripping device. The tissue obstruction in the operation process is avoided, and the accidental injury is avoided.
3. The whole process of punching, puncturing and sleeving can be guided by the B ultra-precision, so that invalid styloid search of a conventional path is avoided, and damages to blood vessels, nerves and muscles in the searching process are avoided
4. The cutting device is operated in the sleeve, so that the styloid process can be efficiently shortened and timely discharged, the damage probability of facial nerves and neck blood vessels in the conventional styloid process of breaking is avoided, and the occurrence of operation complications is effectively avoided.
5. The operation difficulty of an operator is reduced, and the traditional mode needs three persons to perform cooperative operation; after the shortening system provided by the utility model is adopted, the whole operation only needs one-man operation, the operation time can be greatly shortened after skilled operation, and the operation labor load of the operator is reduced.
Drawings
Fig. 1 is a schematic structural view of a sleeve and a cutting device.
FIG. 2 is a schematic view of the sleeve and the tissue dissecting device.
Fig. 3 is a schematic view of a cutting blade in example 1.
Fig. 4 is a schematic view of a cutting blade in example 2.
FIG. 5 is a top view of the tissue dissecting device.
Fig. 6 is a schematic view of the piercing head.
Fig. 7 is a schematic diagram of cutting.
FIG. 8 is a schematic view of tissue dissection.
The labels in the figure are: 1 sleeve, 2 internal thread sleeves, 3 external thread sleeves, 4 rotating sleeves, 5 cutting blades, 6 driving rods, 7 supporting sleeves, 8 sliding sleeves, 9 steel ropes and 10 styloid processes.
11 blades, 12 inner sleeves, 13 outer sleeves and 14 pre-tightening springs.
21 blades, 22 mounting seats, 23 connecting rods and 24 pre-tightening springs.
31 fixed end, 32 movable end, 33 rope buckle, 34 pull rope and 35 connecting rod.
41 piercing head, 42 threaded post
Detailed Description
In order to make those skilled in the art better understand the technical solution of the present invention, the present invention will be further described in detail with reference to the specific embodiments.
Example 1 as shown in figures 1-8, it comprises a cannula 1 and a transcutaneous punch means cooperating with the cannula 1 for punching, a cutting means for truncating the styloid process and a tissue stripping means for stripping the adherent tissue from the styloid process.
The two ends of the sleeve 1 are open, and the front end of the sleeve is provided with an inclined plane; the inclined plane is gentle, and the angle between the inclined plane and the axis is 80-85 degrees. The sleeve pipe 1 internal fixation is provided with rather than coaxial internal thread cover 2, and internal thread cover 2 also can be connected with sleeve pipe 1 through the mode of external screw thread, is more convenient for like this change. The cannula 1 not only serves as a passage for other devices to enter and exit the body, but also serves as a barrier to prevent damage to blood vessels and nerves outside the styloid process 10. In addition, the cannula 1 can also perform a preliminary peeling of the tissue attached to the styloid process 10 during the sheathing of the styloid process 10.
The percutaneous perforating device comprises a sharp puncturing head 41, a threaded column 42 is arranged behind the puncturing head 41, and the threaded column 42 is connected with the internal threaded sleeve 2 in the sleeve 1 in a matching manner. When the percutaneous perforation is carried out, if bleeding occurs, the electric coagulation gun is required to stop bleeding. The electrocoagulation gun comprises a cylindrical working electrode and a cylindrical return circuit electrode which are used for electrifying and stopping bleeding. A high-frequency current flows between the working machine and the return pole. Because the tissue has certain impedance, the high-frequency current can generate heat when flowing through the tissue, and the heat can cause the tissue spiral protein to shrink and dehydrate, so that the blood vessel is closed, thereby realizing the function of hemostasis. Since electrocoagulation guns are prior art, no further description is provided in this application.
The tissue stripping device comprises an external thread sleeve 3 which is matched with the internal thread 2 of the sleeve 1 and is provided with openings at two ends; a sliding sleeve 8 capable of sliding up and down along the inner cavity of the external thread sleeve 3 is arranged in the external thread sleeve 3, a steel rope 9 used for stripping tissues attached to the styloid process is arranged in the sliding sleeve 8, one end of the steel rope 9 is a fixed end 31 connected to the inner annular surface of the sliding sleeve 8, and the other end of the steel rope is a movable end 32 extending out of the sleeve 1; the middle part of the steel rope 9 is folded and is bound by a rope buckle 33 to form a rope loop, and the movable end 32 can be pulled to control the size of the rope loop; still have a plurality of stay cords 34 even on the sliding sleeve 8 inner annular surface, stay cord 34 rear end is connected with sliding sleeve 8 inner annular surface, and the front end is connected on the rope circle. The upper end face of the sliding sleeve 8 is fixed with a connecting rod 35, and the movable end of the steel rope can extend out of the sleeve 1 through the hollow connecting rod 35. The rope buckle 33 is provided with a small hole, and the fixed end 31 and the movable end 32 of the steel rope 9 respectively penetrate through the small hole to form a rope loop.
The cutting device comprises an external thread sleeve 3 (which can be used with the external thread sleeve 3 of the tissue stripping device) which is matched with the internal thread 2 of the sleeve 1 and is provided with openings at two ends; a rotary sleeve 4 is arranged in the external thread sleeve 3, and a plurality of telescopic cutting blades 5 are arranged on the inner annular surface of the rotary sleeve 4; the lower end of the external thread 3 sleeve is provided with a positioning baffle table. The positioning block table is used for positioning and preventing the rotating sleeve 4 from slipping. The upper end of the rotary sleeve 4 is provided with a beam, and the beam is connected with a vertically arranged driving rod 6.
The actuating lever 6 is used for connecting the rotatory cover of drive arrangement drive 4 and rotates, and drive arrangement can select manually, also can select electronically, the utility model discloses do not do the restriction. In order to drive the driving rod 6 to move radially, a supporting sleeve 7 can be sleeved on the driving rod 6, and the outer diameter of the supporting sleeve 7 is consistent with the inner diameter of the sleeve 1.
Example 1 as shown in fig. 3, the number of the cutting blades 5 is three, and the cutting blades 5 are provided with an inner arc-shaped cutting edge. The cutting blade comprises a blade 11 and a telescopic rod arranged at the tail end of the blade 11; the telescopic rod comprises an inner sleeve 12 and an outer sleeve 13 which are sleeved with each other, the tail end of the outer sleeve 13 is fixed on the inner annular surface of the rotary sleeve 4, and a pre-tightening spring 14 is arranged at the rear end of the inner sleeve 12 in the outer sleeve 13. The cutting blade 5 of the structure has strong cutting capability and high cutting speed.
Example 2 as shown in fig. 4, the number of the cutting blades 5 is 4 which are uniformly distributed along the circumference, and the cutting blades 5 have a sharp working portion. The cutting blade 5 comprises a blade 21, and a connecting rod 23 is fixedly connected to the tail end of the blade 21; the device also comprises a mounting seat 22 fixed on the inner annular surface of the rotary sleeve 4, and the front end of the mounting seat 22 is provided with a small hole; the connecting rod 23 extends into the mounting seat 22 through a small hole, and a part of the connecting rod 23 positioned in the mounting seat is sleeved with a pre-tightening spring 24; spring seats are arranged on the inner walls of the connecting rod 23 and the mounting seat 22. The cutting blade 5 of the above structure cuts more thoroughly since the blade 21 can extend to the center of the rotary sleeve 4.
The cutting blades in example 1 and example 2 can be used alone or in combination. Namely, the cutting blade 5 with the inner arc-shaped cutting edge is used for preliminary cutting, and then the sharp cutting blade 5 is used for complete cutting. Giving consideration to both efficiency and effectiveness.
For further facilitate the use, this application still includes a fixing device, and this fixing device is provided with the arm including being used for fixing the base on the operation table on the base, and the arm has a plurality of sections, utilizes the universal joint to connect between every section. The front end of the mechanical arm is provided with a hoop, and positioning is completed through a hoop clamping sleeve. The robotic arm may be bolted down for positioning. Thus, one person can complete the operation without holding the sleeve by extra hands.
In use, the percutaneous perforation device is first mounted on the sleeve 1. The method is that the screw column 42 is directly screwed into the internal thread sleeve 2, and the puncture head 41 extends out of the sleeve 1. The length of the extension can be adjusted according to actual conditions. Under the guidance of B-ultrasonic, the cervical tissue is punctured by the puncturing head 41 to reach the position right above the styloid process 10. The percutaneous perforation device is then removed. For easy assembly and disassembly, the rear end of the threaded post 42 may also be provided with a connecting rod for driving the threaded post 42 to rotate.
After the percutaneous perforating device is taken out, the sleeve 1 is pushed to continue to go deep to completely sleeve the styloid process 10 in the sleeve 1. The bevel at the front end of the sleeve 1 is used for stripping off the human tissue attached to the styloid process 10. After the styloid process 10 is completely sleeved in the sleeve 1, the styloid process is completely isolated from the external tissues, and the operation is convenient.
If bleeding occurs, the electric coagulation gun can be used for stopping bleeding. After hemostasis is finished, the external thread sleeve 3 is screwed into the internal thread sleeve 2. The connecting rod 35 is then used to insert the tissue dissecting device into the external thread sleeve 3, and the movable end 32 of the steel cable 9 is pulled to tighten the rope loop before insertion. During the exploration, the styloid process 10 is sleeved in the rope loop, and the rope loop is unfolded by utilizing the diameter change of the styloid process 10. The sliding sleeve 8 slides to the bottom (the position of the stopping table), and the tissues on the styloid process 10 can be peeled off. Once the tissue is peeled off incompletely, the sliding sleeve 8 can be pulled out, the rope loop is tightened again, and the direction is changed to be inserted again until the tissue is peeled off completely. The pull cord 34 maintains the loop balance and prevents the loop from being pulled off the cord lock 33 when the movable end 32 is pulled.
After the tissue is stripped, the position of the external thread sleeve 3 can be adjusted, the screwing-in depth can be determined according to the cutting position, namely, the positioning baffle table at the lower end of the external thread sleeve 3 is arranged slightly below the cutting position, and the operation is guided by the visual operation of an endoscope system. Then the rotating sleeve 4 is placed into the external thread sleeve 3, and the cutting blade is spread by the styloid process 10 in the placing process. The driving rod 6 is used for driving the rotary sleeve 4 to rotate, so that the cutting blade 5 is driven to cut the styloid process 10. The effect of the two cutting blades 5 is better when used together. The cut stem falls above the cutting blade 5, which is convenient to take out directly and avoids remaining in the body.
The method has the advantages that the temporal bone styloid process is truncated by cutting off the styloid process instead of the existing breaking mode, the wound is small, and the truncated length is more controllable. For protection of the sleeve, the surrounding tissue may also be protected from unnecessary damage. The whole operation process is greatly simplified, and the number of the participated operators is reduced from three to one.
The above is only a preferred embodiment of the present invention, and it should be noted that the above preferred embodiment should not be considered as limiting the present invention, and the protection scope of the present invention should be subject to the scope defined by the claims. It will be apparent to those skilled in the art that various modifications and enhancements can be made without departing from the spirit and scope of the invention, and such modifications and enhancements are intended to be within the scope of the invention.
Claims (9)
1. A percutaneous perforation temporal bone styloid process truncates device which characterized in that: comprises a sleeve, a percutaneous perforating device which is matched with the sleeve for perforation, and a cutting device for cutting the styloid process.
2. The percutaneous perforated temporal styloid process truncation device of claim 1, wherein: the two ends of the sleeve are open, and the front end of the sleeve is provided with an inclined plane; an internal thread sleeve coaxial with the sleeve is fixedly arranged in the sleeve.
3. The percutaneous perforated temporal styloid process truncation device of claim 2, wherein: the percutaneous perforating device comprises a sharp piercing head, a threaded column is arranged behind the piercing head, and the threaded column is matched and connected with an internal thread sleeve in the sleeve.
4. The percutaneous perforated temporal styloid process truncation device of claim 2, wherein: the cutting device comprises an external thread sleeve which is matched with the internal thread sleeve of the sleeve and is provided with openings at two ends; a rotary sleeve is arranged in the external thread sleeve, and a plurality of telescopic cutting blades are arranged on the inner annular surface of the rotary sleeve; the lower end of the external thread sleeve is provided with a positioning baffle table.
5. The percutaneous perforated temporal styloid process truncation device of claim 4, wherein: the cutting blade comprises a blade and a telescopic rod arranged at the tail end of the blade; the telescopic rod comprises an inner sleeve and an outer sleeve which are sleeved with each other, the tail end of the outer sleeve is fixed on the inner annular surface of the rotary sleeve, and a pre-tightening spring is arranged at the rear end, located in the inner sleeve, of the outer sleeve.
6. The percutaneous perforated temporal styloid process truncation device of claim 4, wherein: the cutting blade comprises a blade, and the tail end of the blade is fixedly connected with a connecting rod; the mounting seat is fixed on the inner ring surface of the rotating sleeve, and the front end of the mounting seat is provided with a small hole; the connecting rod extends into the mounting seat through the small hole, and a part of the connecting rod, which is positioned in the mounting seat, is sleeved with a pre-tightening spring; and spring seats are arranged on the inner walls of the connecting rods and the mounting seat.
7. The percutaneous perforated temporal styloid process truncation device of claim 4, wherein: the cutting blades are uniformly distributed along the circumference, and the cutting blades are provided with inner arc-shaped cutting edges; or the number of the cutting blades is 4 which are uniformly distributed along the circumference, and the cutting blades are provided with sharp working parts.
8. The percutaneous perforated temporal styloid process truncation device of claim 4, wherein: the upper end of the rotary sleeve is provided with a cross beam, and the cross beam is connected with a vertically arranged driving rod.
9. The percutaneous perforated temporal styloid process truncation device of claim 2, wherein: the tissue stripping device comprises an external thread sleeve which is matched with the internal thread sleeve of the sleeve and is provided with openings at two ends; a sliding sleeve capable of sliding up and down along the inner cavity of the external thread sleeve is arranged in the external thread sleeve, and a rope sleeve for stripping tissues attached to the styloid process is arranged in the sliding sleeve; the rope sleeve comprises a steel rope, one end of the steel rope is a fixed end connected to the inner ring surface of the sliding sleeve, and the other end of the steel rope is a movable end extending out of the sleeve; the middle part of the steel rope is folded and is bound by a rope buckle to form a rope loop, and the movable end can be pulled to control the size of the rope loop; still have a plurality of stay cords even on the sliding sleeve inner ring surface, the stay cord rear end is connected with sliding sleeve inner ring surface, and the front end is connected on the rope circle.
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| CN201920951977.XU CN210962183U (en) | 2019-06-24 | 2019-06-24 | Percutaneous perforation temporal styloid process truncates device |
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| CN201920951977.XU CN210962183U (en) | 2019-06-24 | 2019-06-24 | Percutaneous perforation temporal styloid process truncates device |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110537953A (en) * | 2019-06-24 | 2019-12-06 | 自贡市第一人民医院 | Percutaneous perforation temporal styloid process truncates device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110537953A (en) * | 2019-06-24 | 2019-12-06 | 自贡市第一人民医院 | Percutaneous perforation temporal styloid process truncates device |
| CN110537953B (en) * | 2019-06-24 | 2024-07-23 | 自贡市第一人民医院 | Percutaneous punching temporal bone styloid process shortening device |
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