DK170062B1

DK170062B1 - tracheal cannula

Info

Publication number: DK170062B1
Application number: DK61092A
Authority: DK
Inventors: Finn Jeppesen
Original assignee: Finn Jeppesen
Priority date: 1992-05-11
Filing date: 1992-05-11
Publication date: 1995-05-15
Also published as: DK61092D0; WO1993023103A1; DK61092A

Description

i DK 170062 B1in DK 170062 B1

Den foreliggende opfindelse angår en tracheal kanyle omfattende et holdeelement samt en yder- og en inderkanyle, der begge er forsynet med en krave, og hvor holdeelementet fastholdes til halsen ved hjælp af bånd eller lignende og er forsynet med en central åbning omkring en 5 indføringsåbning, der er beliggende i et fritlagt område, og som er beregnet til indføring af yderkanylen, der fastholdes til halsregionen ved hjælp af holdeelementet, og hvor yderkanylen endvidere er forsynet med låseorganer til fastholdelse af inderkanylen, og hvor inderkanylen valgfrit er forsynet med dele til fastholdelse af en taleventil.The present invention relates to a tracheal cannula comprising a retaining member as well as an outer and an inner cannula, both of which are provided with a collar, and wherein the retaining member is secured to the neck by means of ribbons or the like and is provided with a central aperture about an insertion opening. located in a exposed area intended for insertion of the outer cannula, which is retained to the neck region by the holding member, and wherein the outer cannula is further provided with locking means for retaining the inner cannula and wherein the inner cannula is optionally provided with parts for retaining the a voice valve.

1010

For at yderkanylen ikke skal forskydes ud af hals- og struberegionen, for eksempel i forbindelse med hosteanfald, eller når patienten sover, er det nødvendigt, at yderkanylen fastholdes til halsen.In order for the outer cannula not to be moved out of the throat and larynx region, for example in connection with cough attacks, or when the patient is asleep, it is necessary that the outer cannula is held to the neck.

15 US patentskrift nr. 3.088.466 og US patentskrift nr. 3.688.774 beskriver begge en tracheal kanyle bestående af en yder- og en inderkanyle, der kan adskilles, og hvor begge kanyledele har en krave.U.S. Patent No. 3,088,466 and U.S. Patent No. 3,688,774 both disclose a tracheal cannula consisting of a separable outer and inner cannula, wherein both cannula portions have a collar.

I US patent nr. 3.088.466 er yderkanylens krave forsynet med udspa-20 ringer til anbringelse af bånd eller lignende til fastholdelse af kanylen til halsen. I US patent nr. 3.688.774 indføres både yder- og inderkanylen gennem et snævrere hul i en løs elastisk plade, der ligeledes er beregnet til anbringelse af bånd eller lignende. Begge kanyler opfylder behovet for, at patienten kan udtage inderkanylen for 25 at rense denne for slim m.v., som samler sig i kanylen ved brug. Imidlertid udgøres yderkanylens krave af en plade, der på grund af kontakten med huden samler fugt og urenheder og derfor hygiejnisk er mindre egnet.In U.S. Patent No. 3,088,466, the outer cannula collar is provided with recesses for attaching ribbons or the like to hold the cannula to the neck. In US Patent No. 3,688,774, both the outer and inner cannula are inserted through a narrower hole in a loose elastic plate, which is also intended for application of tape or the like. Both needles meet the need for the patient to remove the inner cannula to clean it of mucus, etc., which accumulates in the cannula during use. However, the outer cannula collar is constituted by a plate which, due to the contact with the skin, accumulates moisture and impurities and is therefore hygienically less suitable.

30 Der kendes endvidere tracheal kanyler, der ligeledes omfatter en yderkanyle med en plade, hvortil bånd eller lignende kan fastgøres, og som tillige omfatter en inderkanyle, der kan skilles fra yderkanylen, hvor der på inderkanylen er fastgjort en taleventil bestående af et kort rør, hvori er anbragt en klap. Denne klap er hængslet i toppen af rø-35 ret og kan kun vippe indad mod luftrøret, hvorved ventilen fungerer som en en-vejs ventil. Indånding foregår således gennem trachealkany-len, medens udånding foregår gennem de normale luftveje, hvorved det bliver muligt for patienten at tale.Further, tracheal needles are known which also comprise an outer cannula having a plate to which tape or the like can be attached, and which also comprises an inner cannula which can be separated from the outer cannula, where a speech valve consisting of a short tube is attached to the inner cannula. in which is placed a flap. This flap is hinged at the top of the tube and can only tilt inward toward the trachea, whereby the valve acts as a one-way valve. Inhalation thus takes place through the tracheal cannula, while exhalation takes place through the normal airways, thereby enabling the patient to speak.

DK 170062 B1 2 I mange af de kendte tracheal kanyler er yderkanylen forsynet med små tunger, der går i indgreb med en bøjle på fastgørelsespladen på en sådan måde, at yderkanylen kan vrikke lidt i forhold til pladen. For enkelte af disse kanyler kan yderkanylen og fastgørelsespladen ikke 5 adskilles, hvorved rengøring af selve kanylen og omkring hullet i pladen vanskeliggøres og bliver ineffektiv. For andre af de kendte kanyler kan yderkanylen og fastgørelsespladen, omend med besvær, adskilles.In many of the known tracheal cannulas, the outer cannula is provided with small tongues which engage a bracket on the attachment plate in such a way that the outer cannula can pivot slightly with respect to the plate. For some of these needles, the outer cannula and attachment plate cannot be separated, thereby making cleaning of the cannula itself and around the hole in the plate difficult and ineffective. For other known needles, the outer cannula and attachment plate, albeit with difficulty, can be separated.

10 US patentskrift nr. 3.987.798 beskriver en tracheal kanyle, der fastholdes ved hjælp af en central del, der er forsynet med udefter vendende flige. Den centrale del fastholdes til halsen ved hjælp af fleksible bånd, og selve kanylen er forsynet med små arme, der er beregnet til at gå i indgreb med udsparinger, der er dannet i fligene.U.S. Patent No. 3,987,798 discloses a tracheal cannula which is retained by a central portion provided with outward facing tabs. The central part is held to the neck by flexible bands, and the cannula itself is provided with small arms designed to engage the recesses formed in the tabs.

15 Fligene er forsynet med flere udsparinger, således at man kan regulere kanylens afstand fra halsregionen. Kanylen besidder den ulempe, at den centrale del er fremstillet af et plademateriale, som vil ligge an mod halsregionen, hvorved der dannes et uhygiejnisk miljø mellem bagsiden og den centrale del af ydersiden af halsen.15 The tabs are provided with several recesses so that the distance of the cannula from the neck region can be adjusted. The cannula has the disadvantage that the central part is made of a sheet material which will abut against the neck region, thereby creating an unhygienic environment between the back and the central part of the outside of the neck.

20 US patentskrift nr. 2.039.142 beskriver en tracheal kanyle, hvor den del af kanylen, som sidder på den ydre halsregion, er udformet som et smykke. Yderkanylen er her udformet som en broche-lignende del bestående af en indkapsling med en dækplade, der er udformet som et kunst-25 færdigt perforeret låg. Ulempen ved denne udformning af kanylen er, at konstruktionen er stof og vil derfor kun virke naturlig, hvis den bæres af kvinder - de fleste mænd vil ikke synes om at have et så stort halssmykke på. Derudover medfører den broche-lignende indkapsling, at det areal, der er i kontakt med huden, bliver unødvendigt 30 stort og noget større end arealet af selve yderkanylens krave.U.S. Patent No. 2,039,142 discloses a tracheal cannula, wherein the portion of the cannula that sits on the outer neck region is designed as a piece of jewelry. The outer cannula is here designed as a brooch-like part consisting of an enclosure with a cover plate which is formed as an artificial perforated lid. The disadvantage of this design of the cannula is that the construction is fabric and will therefore only appear natural if worn by women - most men would not like to wear such a large necklace. In addition, the brooch-like enclosure causes the area in contact with the skin to become unnecessarily large and somewhat larger than the area of the outer cannula collar itself.

Ulemperne ved de hidtidige tracheal kanyler er, at de er uhygiejniske i brug, idet yderkanylens krave, der er forholdsvis stor for at sikre, i at kanylen ikke ryger ned i halsen, udgør en kilde for slim, sved og 35 andre urenheder til at samle sig mellem kraven og halsen. Dette kan % danne basis for en infektion eller anden lidelse, såsom almindelig irritation af huden. For at indføre kanylen i halsen ind til luftrøret er der dannet et permanent hul i halsregionen. En infektion omkring dette hul kan risikere at brede sig til selve hullet, hvorfor det er 3 DK 170062 B1 meget vigtigt, at området omkring hullet holdes rent. Patienten kan ikke selv udtage yderkanylen, hvilket betyder, at det kun er muligt at rengøre effektivt bag kraven i forbindelse med lægekonsultation. Patienten kan dog benytte små forbindinger, der suger fugten, men de 5 understreger udseendet af et hjælpemiddel.The disadvantages of the previous tracheal cannulae are that they are unhygienic in use, with the outer cannula collar being relatively large to ensure that the cannula does not slide down the throat, a source of mucus, sweat and 35 other impurities to collect between the collar and neck. This may% be the basis of an infection or other disorder, such as general skin irritation. To insert the cannula into the throat into the trachea, a permanent hole is formed in the throat region. An infection around this hole can spread to the hole itself, which is why it is very important that the area around the hole is kept clean. The patient cannot remove the outer cannula himself, which means that it is only possible to clean effectively behind the collar during medical consultation. However, the patient can use small dressings that suck the moisture, but the 5 emphasize the appearance of an aid.

Derudover er den store krave uæstetisk på grund af et dominerende og teknisk udseende midt på halsen, og da kanylen bæres dagligt af pa tienten, er dette psykisk til stor gene for vedkommende. Patienten 10 anvender derfor ofte tynde halstørklæder for at skjule kanylen.In addition, the large collar is unaesthetic due to a dominant and technical mid-neck look, and since the cannula is worn daily by the patient, this is psychologically to great detriment to him. Therefore, patient 10 often uses thin scarves to conceal the cannula.

Formålet med den foreliggende opfindelse er at anvise en tracheal -kanyle, der gennem sin konstruktive udformning eliminerer eller i væsentlig grad mindsker ovennævnte ulemper for derved at øge både det 15 fysiske og psykiske velvære for patienten. Det fysiske velvære øges ved at nedsætte risikoen for, at urenheder samler sig omkring yderkanylen og dennes krave. Det psykiske velvære øges ved at gøre de dele af kanylen, som sidder på den ydre halsregion, så spinkle som mulige, således at det ikke i samme grad fremgår, at patienten lider af et 20 handicap. Yderkanylens krave skal dog være stor nok til at skjule selve hullet i halsen.The object of the present invention is to provide a tracheal cannula which, through its constructive design, eliminates or substantially reduces the above disadvantages, thereby increasing both the physical and mental well-being of the patient. Physical well-being is increased by reducing the risk of impurities accumulating around the outer cannula and its collar. The mental well-being is increased by making the parts of the cannula that sit on the outer neck region as flimsy as possible, so that it does not appear to the same extent that the patient suffers from a disability. However, the outer cannula collar should be large enough to hide the hole in the neck itself.

Dette formål opnås med den foreliggende opfindelse, der er særpræget ved, at hol del elementet er ringformet og plant eller plankrumt og er 25 forsynet med udsparinger, som ved indbyrdes drejning af holdeelementet og yderkanylens krave hovedsageligt i plan med kraven kan bringes i udløseligt indgreb med kantområder på kraven.This object is achieved by the present invention, which is characterized in that the hollow part element is annular and flat or planar and is provided with recesses which, by mutually rotating the holding element and the outer cannula collar, can be brought into engagement releasably with the collar. edge areas of the collar.

Den foreliggende opfindelse udmærker sig ved, at det areal, der ligger 30 an mod halsen, mindskes når der, som i den foreliggende opfindelse, benyttes et ringelement i stedet for en plade, og de hygiejniske forhold er dermed væsentligt bedre. Derudover er ringelementet spinkelt og dermed ikke så dominerende som en krave bestående af en plade med samme dimensioner.The present invention is characterized in that the area adjacent to the neck is reduced when, as in the present invention, a ring element is used instead of a plate, and the hygienic conditions are thus substantially better. In addition, the ring element is flimsy and thus not as dominant as a collar consisting of a plate of the same dimensions.

3535

Ovennævnte forhold gør tracheal kanylen ifølge den foreliggende opfindelse mere brugervenlig både fysisk og psykisk. Kanylen ifølge opfindelsen vil som nævnt være mere hygiejnisk, idet det kun er ringelementet, der ligger an mod halsen. Det areal af kanylen, der derved er 4 DK 170062 B1 i kontakt med halsen, er derfor væsentligt mindre end for de kendte kanyler. Kontaktarealet for kanylen ifølge opfindelsen vil tillige ligge længere væk fra hullet, som fører ind i luftrøret gennem halsen. Yderkanylens krave, der gennem et marginalt kantområde går i indgreb 5 med udsparingerne i ringen, vil ikke ligge i tæt kontakt med halsen, når udsparingerne er dannet som stort set radialt forløbende slidser, der strækker sig over en del af ringelementets omkreds. Således vil konstruktionen gøre det muligt at skabe lidt afstand mellem halsen og bagsiden af yderkanylens krave. Dette er medvirkende til at reducere 10 risikoen for, at der samles urenheder omkring kanylen. Dette vil fremgå af den efterfølgende beskrivelse af en udførelsesform ifølge opfindelsen.The above conditions make the tracheal cannula of the present invention more user-friendly both physically and mentally. As mentioned, the cannula according to the invention will be more hygienic, since only the ring element abuts the neck. Therefore, the area of the cannula thereby in contact with the neck is substantially smaller than that of the known cannula. The contact area of the cannula according to the invention will also lie further away from the hole leading into the trachea through the throat. The outer cannula collar, which engages through a marginal edge region 5 with the recesses in the ring, will not be in close contact with the neck when the recesses are formed as largely radially extending slits extending over a portion of the circumference of the annular element. Thus, the construction will allow some distance between the neck and the back of the outer cannula collar. This helps reduce the risk of impurities accumulating around the cannula. This will be apparent from the following description of an embodiment of the invention.

Anvendelsen af ringelementet for kanylens fastholdelse til halsregio-15 nen danner en spinklere konstruktion og deraf følgende mindre dominans på halsen. Dette bevirker, at bæreren ikke føler så stort psykisk u-behag ved at anvende kanylen. Ringelementet og selve kanylen vil med fordel kunne fremstilles således, at kanylen fremstår som et smykke. Kanylen er derfor fortrinsvis fremstillet i sølv, forgyldt sølv, 20 rustfrit stål eller i et materiale, der kan eloxeres i ønskede farver, for eksempel titanium. Ved brug af rustfrit stål og specielt titanium kan vægten af kanylen reduceres, idet materiale-dimensionerne for ringelementet samt for yder- og inderkanylens kraver og rørdele kan mindskes. Andre materialer end de metalliske vil også kunne benyttes 25 ved fremstillingen af kanylen, for eksempel plast. Ved materialevalget er der også taget hensyn til, at materialet ikke må kunne fremkalde all ergi-reaktioner hos bæreren.The use of the ring element for the cannula retention to the neck region forms a flatter construction and consequent less dominance on the neck. This causes the wearer to not feel as much mental discomfort by using the cannula. The ring element and the cannula itself can advantageously be manufactured so that the cannula appears as a piece of jewelry. The cannula is therefore preferably made of silver, gilded silver, stainless steel or in a material that can be anodized in desired colors, for example titanium. By using stainless steel and especially titanium, the weight of the cannula can be reduced, as the material dimensions of the ring element as well as the outer and inner cannula collars and pipe parts can be reduced. Materials other than the metallic may also be used in the manufacture of the cannula, for example plastic. The choice of material also takes into account that the material must not be able to induce all the ergic reactions of the wearer.

De udsparinger, der er dannet i ringelementet, er over i det mindste 30 en del af disses udstrækning udformet med en lidt større bredde end tykkelsen af yderkanylens krave. Når yderkanylens krave er i indgreb med udsparingen, tilvejebringes der således mulighed for, at yderkanylen kan foretage små sideværts vippe- eller rokkebevægelser. Dette øger komforten ved at bære tracheal kanylen ifølge opfindelsen, idet 35 vippebevægelsen gør det muligt for eksempel at foretage en let drejning af hovedet, uden at der opstår spændinger omkring kanylen og halsen som følge af en for stram fastholdelse af kanylen.The recesses formed in the annular member are formed over at least a portion of their extent with a slightly greater width than the thickness of the outer cannula collar. Thus, when the outer cannula collar is in engagement with the recess, the outer cannula is able to make small lateral tilting or rocking movements. This enhances the comfort of carrying the tracheal cannula of the invention, the tilting movement allowing, for example, a slight turn of the head, without creating tension around the cannula and neck as a result of too tight retention of the cannula.

Det "løse" indgreb mellem udsparingerne i ringelementet og yderkany- 5 DK 170062 B1 lens krave medfører ligeledes, at det bliver lettere at adskille de to dele, hvilket er nødvendigt ved rensning omkring hullet, som kanylen er ført igennem, samt når de enkelte dele skal rengøres og pudses.The "loose" engagement between the recesses in the ring element and the outer cannula collar also makes it easier to separate the two parts, which is necessary by cleaning around the hole through which the cannula is passed, as well as when the individual parts must be cleaned and polished.

5 For yderligere at øge komforten ved at bære tracheal kanylen ifølge opfindelsen er ringelementet forsynet med en større eller mindre krumning omkring en lodret akse, således at ringelementet ligger korrekt an langs den del af halsens omkreds, som ringelementet strækker sig over. Såfremt tracheal kanylen ifølge opfindelsen benyttes på en person 10 med en kraftig hals, er det stort set ikke nødvendigt at forsyne ringelementet med nogen krumning, idet krumningen af halsen på den pågældende person vil være lig eller næsten lig nul over den del af halsens omkreds, som ringelementet strækker sig over. Benyttes tracheal kanylen derimod på en person med en spinkel hals, vil krumningen af halsen 15 over den pågældende strækning, som ringelementet dækker, være af en vis størrelse, hvorfor ringelementet skal bibringes en tilsvarende krumning, således at ringelementet ligger an med hele sit mulige anlægsareal. De ovennævnte kendetegn for tracheal kanylen ifølge opfindelsen sikrer, at der tilvejebringes en kanyle, der besidder en højere 20 grad af brugervenlighed end de tidligere kendte kanyler. Kanylen i-følge opfindelsen er som nævnt både mere hygiejnisk og mere æstetisk, og derfor også mere velegnet som dagligt redskab til at leve med et handicap.To further enhance the comfort of carrying the tracheal cannula of the invention, the ring member is provided with a greater or lesser curvature about a vertical axis so that the ring member is properly aligned along the portion of the neck circumference over which the ring member extends. If the tracheal cannula of the invention is used on a person 10 with a strong neck, it is virtually unnecessary to provide the ring member with any curvature, since the curvature of the neck of that person will be equal to or nearly equal to that portion of the circumference of the neck. which the ring element extends over. If, on the other hand, the tracheal cannula is used on a person with a slender neck, the curvature of the neck 15 over the relevant stretch which the ring element covers will be of a certain size, so that the ring element must be given a corresponding curvature so that the ring element abuts with all its possible abutment area. . The aforementioned characteristics of the tracheal cannula of the invention ensure that a cannula is provided which possesses a higher degree of ease of use than the prior art cannulas. As mentioned, the cannula according to the invention is both more hygienic and more aesthetic, and therefore also more suitable as a daily tool for living with a disability.

25 Opfindelsen vil herefter blive beskrevet nærmere under henvisning til den medfølgende tegning, hvor fig. 1 er et perspektivisk billede af en yderkanyle til brug i forbindelse med tracheal kanylen ifølge opfindelsen, 30 fig. 2 er et perspektivisk billede af en inderkanyle til brug i forbindelse med tracheal kanylen ifølge opfindelsen, fig. 3 er et perspektivisk billede af en første udførelsesform for et ringelement til brug i forbindelse med tracheal kanylen ifølge opfindelsen, 35 fig. 4 er et perspektivisk billede af en alternativ udførelsesform for et ringelement, fig. 5 er et perspektivisk billede af en tredje udførelsesform for et ringelement, fig. 6A, 6B, 6C og 6D er skematiske planbilleder af ringelementer 6 DK 170062 B1 ifølge opfindelsen anbragt på bærerens hals, fig. 7A og 7B er planbilleder af en taleventil beregnet til montering på inderkanylen, og fig. 8 er et perspektivisk billede, der viser, hvorledes et ring-5 element og en yderkanyle ifølge opfindelsen samvirker. *The invention will now be described in more detail with reference to the accompanying drawing, in which fig. 1 is a perspective view of an outer cannula for use with the tracheal cannula of the invention; FIG. 2 is a perspective view of an inner cannula for use with the tracheal cannula of the invention; FIG. 3 is a perspective view of a first embodiment of a ring member for use with the tracheal cannula of the invention; FIG. Figure 4 is a perspective view of an alternative embodiment of a ring element; 5 is a perspective view of a third embodiment of a ring element; FIG. 6A, 6B, 6C and 6D are schematic plan views of ring elements 6 DK 170062 B1 according to the invention arranged on the wearer's neck. 7A and 7B are plan views of a voice valve intended for mounting on the inner cannula; and FIGS. 8 is a perspective view showing how an annular element and an outer cannula of the invention interact. *

Fig. 1 illustrerer en yderkanyle 1, som udgør en del af tracheal kanylen ifølge opfindelsen. Yderkanylen omfatter en rørdel 2 samt en krave 3. Derudover er der på yderkanylen l's krave 3 monteret en slå 4, der 10 svinger omkring en akse 5, og som er beregnet til at fastholde kraven på en inderkanyle (se fig. 2). Endvidere er der på yderkanylens krave 3 monteret en stopstift 6, hvis funktion vil blive forklaret senere. Yderkanylens krave er stort set ellipseformet med en lilleakse a^ og en storakse bj. Ellipseformen udgør den foretrukne form, men andre 15 former vil ligeledes kunne anvendes. Formen på yderkanylens krave 3 afhænger primært af formen på et ringelement (se fig. 3A og 3B), som kraven går i indgreb med.FIG. 1 illustrates an outer cannula 1 which forms part of the tracheal cannula of the invention. The outer cannula comprises a pipe portion 2 as well as a collar 3. In addition, on the collar 3 of the outer cannula 1 is a bore 4 which swivels about an axis 5 and is intended to hold the collar on an inner cannula (see Fig. 2). Furthermore, a stop pin 6 is mounted on the outer cannula 3, the function of which will be explained later. The outer cannula collar is largely elliptical with a small axis a ^ and a large axis bj. The ellipse shape is the preferred shape, but other shapes can also be used. The shape of the outer cannula collar 3 primarily depends on the shape of a ring element (see Figures 3A and 3B) with which the collar engages.

Yderkanylens rørdel 2 er krum for let at kunne indføres gennem et hul i halsregionen på den patient, der skal bære tracheal kanylen. Tvær-20 snittet af røret 2 omkring en ydre åbning 7 er stort set vinkelret på tværsnittet af røret 2 ved en indre åbning 8, som sidder inde i luftrøret. Rørdelen 2's længde lj og diameter dj varierer afhængig af den person, der skal bære tracheal kanylen - det vil sige primært, om det er et barn eller en voksen person.The outer cannula tube portion 2 is curved to be readily inserted through a hole in the neck region of the patient to carry the tracheal cannula. The cross-section of the tube 2 around an outer aperture 7 is substantially perpendicular to the cross-section of the tube 2 at an inner aperture 8 located inside the trachea. The length lj and diameter dj of the tube part 2 varies depending on the person who is to carry the tracheal cannula - that is, primarily whether it is a child or an adult.

2525

Vinkelret på rørdelen 2's ydre åbning 7 er kraven 3 fastgjort. Slåen 4, som er fastgjort til kraven 3, er i sin ydre ende forsynet med en smykkesten 9, hvorved denne del af tracheal kanylen får et æstetisk udseende. Alternativt kunne slåen 4 være forsynet med en sølvknop el- 30 ler lignende, der kan opfylde samme formål som smykkestenen. Langs en del af slåen 4's udstrækning er denne formet som en bue 10 således, at når slåen skydes ind over en inderkanyles krave, vil denne bue 10 ligge langs en anden rørdel på inderkanylen (se fig. 2). Stopstiften 6 udgøres af en tap eller stift, der er fremspringende fra yderkanylens 35 krave 3.Perpendicular to the outer opening 7 of the pipe part 2, the collar 3 is fixed. The bead 4, which is attached to the collar 3, is provided at its outer end with a gemstone 9, giving this part of the tracheal cannula an aesthetic appearance. Alternatively, the turn 4 could be provided with a silver knob or the like, which can fulfill the same purpose as the gemstone. Along a portion of the extension of the muzzle 4, it is shaped like an arc 10 such that when the muzzle is pushed over the collar of an inner cannula, this arc 10 will lie along another pipe portion of the inner cannula (see Figure 2). The stop pin 6 consists of a pin or pin projecting from the outer cannula 35 collar 3.

Yderkanylen 1 vil fortrinsvis være fremstillet af eller belagt med et materiale, der ikke fremkalder allergi reaktioner hos bæreren. Dette vil således primært være sølv eller guld eller andre metaller, såsom DK 170062 Bl 7 titanium, der samtidig giver kanylen et smykkepræg. Benyttes titanium vil det være muligt at reducere kanylens godstykkelser og dermed vægten.The outer cannula 1 will preferably be made of or coated with a material that does not cause allergic reactions in the carrier. Thus, this will primarily be silver or gold or other metals, such as DK 170062 B1 titanium, which at the same time gives the cannula a jewelery mark. If titanium is used it will be possible to reduce the thickness of the cannula and thus the weight.

5 Fig. 2 illustrerer en inderkanyle 11 ligeledes bestående af en rørdel 12 og en krave 13. Rørdelen 12 består af én rørdel 14, der har samme krumning som yderkanylen l's rørdel 2, og som er beregnet til at indføres i yderkanylen, samt en anden rørdel 15, der strækker sig på den anden side af kraven 13. Ved indføring føres den ende 16 af inder-10 kanylens krumme rørdel 14, der er fjernt fra inderkanylens krave 13, ind i den ende 7 af yderkanylen 17s rørdel 2, hvortil yderkanylens krave 3 er monteret. Inderkanylen 11 føres helt ind, indtil bagsiden af inderkanylens krave 13 går i anlæg mod forsiden af yderkanylens krave 3. Derpå skydes slåen 4, der er monteret på yderkanylen l's 15 krave 3, ind over inderkanylens krave 13 for at fastholde inderkanylen 11 til yderkanylen 1. Længden 12 af inderkanylens rørdel 14, regnet fra kraven 13 og ned langs den krumme del, er kortere end længden lj af yderkanylen l's rørdel 2. Dermed strækker inderkanylen 11 sig ikke ud over yderkanylen l's yderste ende 8, fjernt fra dens krave 3. Dia-20 meteren d2 af inderkanylens rørdel 14 er lidt mindre end diameteren dj af yderkanylen l's rørdel 2, således at inderkanylen 11 kan føres ind i yderkanylen 1.FIG. 2 illustrates an inner cannula 11 also consisting of a pipe part 12 and a collar 13. The pipe part 12 consists of one pipe part 14 having the same curvature as the outer cannula 1's pipe part 2, which is intended to be inserted into the outer cannula, and another pipe part 15, extending on the other side of the collar 13. Upon insertion, the end 16 of the curved tube portion 14 of the inner cannula removed from the inner cannula collar 13 is inserted into the end 7 of the outer cannula 17's tube portion 2, to which the outer cannula 3 is mounted. The inner cannula 11 is inserted all the way until the back of the inner cannula 13 collides with the front of the outer cannula collar 3. Then, the mower 4 mounted on the outer cannula 1 collar 3 is pushed over the inner cannula collar 13 to secure the inner cannula 11 to the outer cannula 1. The length 12 of the inner cannula 14, counted from the collar 13 and down the curved portion, is shorter than the length Ij of the outer cannula 1's pipe portion 2. Thus, the inner cannula 11 does not extend beyond the outer end 8 of the cannula 1, distant from its collar 3. The diameter d2 of the inner cannula tube portion 14 is slightly smaller than the diameter dj of the outer cannula 1's tube portion 2, so that the inner cannula 11 can be inserted into the outer cannula 1.

Inderkanylens krave 13 er ligesom yderkanylens stort set ellipsefor-25 met, men også denne krave kan have andre former. Kraven 13 er forsynet med indsnit 17 for at gøre plads til stopstiften 6 og slåen 4's akse 5, som begge er monteret på yderkanylen l's krave 3, når inderkanylen føres ind i yderkanylen. Inderkanylens krave 13 skal primært sikre, at inderkanylen ikke glider helt ned i yderkanylen l's rørdel 2. Derud-30 over skal inderkanylens krave 13 tjene til fastholdelse af inderkanylen til yderkanylen, idet kraven danner anlæg for slåen 4. Det er da ikke muligt for inderkanylen at forskydes ud af yderkanylen, når slåen 4 er skudt ind foran inderkanylens krave 13.Like the outer cannula, the inner cannula 13 is largely the ellipse shape, but this collar may also have other shapes. The collar 13 is provided with notches 17 to make room for the stop pin 6 and the axis 5 of the strut 4, both of which are mounted on the collar 3 of the outer cannula 1 as the inner cannula is inserted into the outer cannula. The inner cannula collar 13 must primarily ensure that the inner cannula does not slide fully into the tube part 2 of the outer cannula 1. In addition, the inner cannula collar 13 must serve to hold the inner cannula to the outer cannula, as the collar forms the bore for the bore 4. being displaced out of the outer cannula when the slit 4 is inserted in front of the inner cannula 13.

35 Inderkanylens anden rørdel 15, som strækker sig på den anden side af kraven 13, er kortere end den krumme rørdel 14. Denne anden rørdel 15 er beregnet til at fastholde en eventuel taleventil ved hjælp af dertil egnede fastholdelsesmidler, som for eksempel et gevind, en bajonetfatning eller blot ved en prespasning mellem denne anden rørdel 15 8 DK 170062 B1 og en tilsvarende rørformet del en af tal eventil. Der er på den viste udførelsesform illustreret han-delen af en bajonetfatning bestående af to diametralt modsatstående stifter 18 (kun én vist), der er beregnet til at gå i indgreb med spor i en rørformet del af en tal eventil (se 5 fig. 4). *The second tube portion 15 of the inner cannula, which extends on the other side of the collar 13, is shorter than the curved tube portion 14. This second tube portion 15 is intended to retain any speech valve by means of suitable restraining means, such as a thread, a bayonet socket or simply by a press fit between this second pipe member 15 and a corresponding tubular member one of a number of cases. In the illustrated embodiment, the male portion of a bayonet fitting consisting of two diametrically opposed pins 18 (only one shown) is illustrated, which is intended to engage grooves in a tubular portion of a number of eventualities (see 5 Fig. 4 ). *

Fig. 3 illustrerer et ringelement 20 til brug i forbindelse med yder-og inderkanylen, 1 og 11, som er beskrevet ovenfor. Ringelementet 20 udgøres af to dele 21,22 af hver sin ring, der er sammenføjet ved 10 svejsning, lodning, limning eller på anden måde, og ringelementet 20 er i den viste udførelsesform ellipseformet. Ringelementet er i den viste udførelsesform plant, men kan som nævnt være krummet omkring lilleaksen for at tilpasse sig krumningen på halsens forside. De to ringdele 21,22 strækker sig begge langs over halvdelen af ringelemen-15 tet 20's periferi, hvorved de langs en del af ringelementets periferi overlejrer hinanden. Langs den del af ringelementet 20's periferi, hvor de to separate ringdele 21,22 overlejrer hinanden, dannes et mellemrum mellem disse dele, som udgør udsparinger 23, hvori yderkanylen l's krave 3 (se fig. 1) går i indgreb. For at yderkanylen 1 20 kan foretage sideværts rokkebevægelser, når dens krave 3 er i indgreb med udsparingerne 23, er de to separate, sammenføjede ringelementer 21,22 bukket langs en del af den udstrækning, hvor de overlejrer hinanden. Bukningen er foretaget således, at der dannes en permanent udsparing, som har en bredde, der er lidt større end tykkelsen af yder-25 kanylen l's krave 3 og således, at der ved udsparingernes åbning dannes et stop ved, at det yderste 24,25 af den separate ringdel 21,22 ligger an mod den anden separate ringdel 22,21, som den overlejrer.FIG. 3 illustrates a ring element 20 for use in connection with the outer and inner cannula, 1 and 11, described above. The ring element 20 is made up of two parts 21, 22 of each ring, joined together by welding, soldering, gluing or otherwise, and the ring element 20 is elliptical in the illustrated embodiment. The ring element is flat in the illustrated embodiment, but as mentioned, may be curved around the small axis to adapt to the curvature of the front of the neck. The two ring portions 21, 22 both extend over half of the periphery of the ring member 20, whereby they overlap one another along the periphery of the ring member. Along the portion of the periphery of the ring element 20, where the two separate ring portions 21, 22 overlap, a gap is formed between these portions which form recesses 23 in which the outer cannula 1's collar 3 (see Fig. 1) engages. In order for the outer cannula 1 20 to make lateral rock movements when its collar 3 engages the recesses 23, the two separate joined ring members 21, 22 are bent along a portion of the extent where they overlap. The bend is made so as to form a permanent recess having a width slightly greater than the thickness of the outer cannula 1 collar 3 and such that at the opening of the recesses a stop is formed by the outer 24.25 of the separate ring portion 21.22 abuts the second separate ring portion 22.21 which it overlays.

Ringelementet 20 er fremstillet af et fjedrende materiale, idet hver 30 af de separate ringdele 21,22, som er bukket, og hvis yderste ende 24,25 ligger an mod den anden separate ringdel, skal kunne åbnes for indføring af yderkanylen l's krave 3 i udsparingerne 23 for derpå at lukkes igen for at tilbageholde yderkanylens krave i udsparingerne. Derudover skal materialet opfylde visse sekundære krav, blandt andet 35 må materialet ikke fremkalde all ergi-reaktioner ved kontakt med bære- * rens hud.The ring member 20 is made of a resilient material, each 30 of the separate ring portions 21, 22, which are bent and whose outer end 24,25 abuts the other separate ring member, must be open for insertion of the outer cannula 1's collar 3 into the the recesses 23 to then be closed again to retain the outer cannula collar in the recesses. In addition, the material must meet certain secondary requirements, among other things, the material must not induce all ergic reactions upon contact with the wearer's skin.

Fig. 4 illustrerer en alternativ udførelsesform for et ringelement. Ringelementet 30, der ligeledes er ellipseformet og plant, udgøres af 9 DK 170062 B1 en lukket ring 31, der er forsynet med fjedrende bøjler 32. Bøjlerne er fastgjort på samme aks i al e side, men på modsatstående perifære sider af ringelementet. Bøjlerne 32 er bukket således, at de opfylder samme formål som bukningen af de separate ringdele 21,22 i udføre!-5 sesformen i fig. 3. Der er dannet udsparinger 33 til optagelse af yderkanylen l's krave 3 (se fig. 1) samt stop 34, der sikrer, at kraven ikke utilsigtet går ud af sit indgreb med ringelementet 30. Sammenføjningen af ringelementet 30 og de fjedrende bøjler 32 foretages langs bøjlernes flige 35 ved svejsning, lodning, limning eller på an-10 den måde.FIG. 4 illustrates an alternative embodiment of a ring element. The ring member 30, which is also elliptical and flat, is formed by a closed ring 31, which is provided with resilient shackles 32. The shackles are fixed on the same axis on all sides, but on opposite peripheral sides of the ring element. The shackles 32 are bent so that they fulfill the same purpose as the bending of the separate ring portions 21, 22 in the embodiment of FIG. 3. Recesses 33 are formed for receiving the outer cannula 1 collar 3 (see Fig. 1) as well as stop 34 ensuring that the collar does not inadvertently exit from its engagement with the ring element 30. The joining of the ring element 30 and the resilient braces 32 is made. along the tabs 35 of the shackles by welding, brazing, gluing or otherwise.

Fig. 5 illustrerer en tredje og foretrukken udførelsesform for et ringelement. Ringelementet 40 udgøres i denne udførelsesform af en lukket ring 41, i hvilken udsparingerne 42 udgøres af udfræsninger på 15 langs af ringelementets plan. Ringelementet 40 er også i denne udførelsesform ellipseformet og plant, men også andre former vil kunne benyttes. Udsparingerne 42 er dannet på langs af ellipseformens storakse og på hver sin side af lilleaksen, hvorved ringelementet er symmetrisk om både stor- og lilleaksen. Det vil imidlertid være muligt at 20 anbringe udsparingerne 42 andre steder langs ringelementets periferi. Udsparingerne 42 er bredere end tykkelsen af yderkanylen l's krave 3 for dermed at tillade yderkanylen at foretage rokkebevægelser.FIG. 5 illustrates a third and preferred embodiment of a ring element. The ring element 40 in this embodiment is constituted by a closed ring 41, in which the recesses 42 are formed by cuts of 15 along the plane of the ring element. In this embodiment, the ring element 40 is also elliptical and flat, but other forms can also be used. The recesses 42 are formed longitudinally of the major axis of the ellipse shape and on each side of the small axis, whereby the annular element is symmetrical about both the large and small axis. However, it will be possible to place the recesses 42 elsewhere along the periphery of the ring element. The recesses 42 are wider than the thickness of the outer cannula 1 collar 3, thereby allowing the outer cannula to make rocking movements.

Ringelementet 40, der er illustreret i denne figur, er ligesom ring-25 elementerne 20,30 i de foregående figurer fremstillet af et materiale, der ikke fremkalder allergi-reaktioner hos bæreren. Derudover er der ikke yderligere krav til materialet eller dimensionerne, når blot faktorer som styrke, slidbestandighed og andre fysiske egenskaber i-agttages. Under hensyn til at det ønskes, at ringelementet er så 30 spinkelt som muligt, vil elementet fortrinsvis være fremstillet af et materiale med høj styrke, såsom rustfrit stål eller titanium, for at gøre det muligt, at gøre dimensionerne så små som mulige.The ring element 40 illustrated in this figure, like the ring elements 20, 30 in the preceding figures, is made of a material that does not elicit allergic reactions in the carrier. In addition, there are no additional requirements for the material or dimensions when only factors such as strength, durability and other physical properties are taken into account. Given that it is desired that the annular member be as flimsy as possible, the member will preferably be made of a high strength material such as stainless steel or titanium to allow the dimensions to be as small as possible.

Fig. 6A-6D illustrerer skematisk, hvorledes ringelementet 20,30,40 35 ifølge opfindelsen kan være krummet omkring en akse A parallel med længdeaksen L for halsen H på den person, der bærer tracheal kanylen. Såfremt ringelementet er ellipseformet, som vist på figurene, er ringelementet krummet omkring lilleaksen.FIG. 6A-6D illustrate schematically how the annular element 20, 30, 40 of the invention may be curved about an axis A parallel to the longitudinal axis L of the neck H of the person carrying the tracheal cannula. If the ring element is elliptical, as shown in the figures, the ring element is curved around the small axis.

10 DK 170062 B110 DK 170062 B1

Fig. 7A og 7B illustrerer en taleventil 50 til brug i forbindelse med inderkanylen 11 og dermed udgør en del af tracheal kanylen ifølge opfindelsen. Taleventilen 50 består af en rørformet del 51 med en ind-erdiameter d^, der er omtrent lige så stor som yderdiameteren på in-5 derkanylen ll's anden rørdel 15. I taleventilen 50's rørformede del 51 t er dannet spor 52, som udgør hun-delen af en bajonetfatning, og som er beregnet til at gå i indgreb med stifterne 18 på inderkanylen 11's anden rørdel 15, som udgør bajonetfatningens han-del. Ved den ene ende af taleventilen 50's rørformede del 51 er anbragt en dækplade 53 med 10 et ovalt hul 54. På indersiden af denne dækplade 53 er der monteret en oval klap 55, der er hængslet i den øvre del af dækpladen og med en omdrejningsakse 55 for hængsl ingen, der er parallel med den største afstand c mellem to modsatliggende punkter på den ovale klap 55's periferi. Klappen 55 er oval i horisontal retning, hvilket vil sige, at 15 den største afstand c ligger i horisontal retning. Den ovale klap 55 overlapper langs hele sin udstrækning det ovale hul 54's periferi.FIG. 7A and 7B illustrate a voice valve 50 for use with the inner cannula 11 and thus form part of the tracheal cannula of the invention. Speech valve 50 consists of a tubular portion 51 having an inner diameter d 1 which is approximately equal to the outer diameter of the second tube portion 15 of the inner cannula 11. In the tubular portion 51 t of the tubular valve 50, grooves 52 are formed. the portion of a bayonet socket and which is intended to engage the pins 18 on the second tube portion 15 of the inner cannula 11, which constitutes the male portion of the bayonet socket. At one end of the tubular portion 51 of the voice valve 50 is provided a cover plate 53 with an oval hole 54. On the inside of this cover plate 53 is mounted an oval flap 55 hinged in the upper portion of the cover plate and with a rotary axis 55 for hinges none parallel to the greatest distance c between two opposite points on the periphery of the oval flap 55. The flap 55 is oval in the horizontal direction, that is, the largest distance c lies in the horizontal direction. The oval flap 55 overlaps throughout its circumference with the periphery of the oval hole 54.

Herved kan klappen 55 kun svinge én vej, nemlig indad væk fra taleventilen 50's dækplade 53.Hereby, the flap 55 can only swing one way, namely inwardly away from the cover plate 53 of the voice valve 50.

Fordelen ved den illustrerede taleventil 50 er, at denne vil yde min-20 dre modstand end en ventil med cirkulær klap og med samme tværsnitsareal som den ovale klap 55, idet i nertimomentet for den ovale klap er mindre end for en cirkulær klap.The advantage of the illustrated voice valve 50 is that it will provide less resistance than a circular flap valve with the same cross-sectional area as the oval flap 55, being less than a circular flap at the downward moment of the oval flap.

I det følgende vil det primært blive beskrevet, hvorledes ringelemen-25 tet samvirker med yderkanylen for tilvejebringelse af tracheal kanylen ifølge opfindelsen, idét der henvises til fi g. 8.In the following, it will be described primarily how the annular element interacts with the outer cannula for providing the tracheal cannula of the invention, with reference to Fig. 8.

Et ringelement 40, som det, der er beskrevet under fig. 5, består af en lukket, elliptisk ring med udsparinger 42 langs modsatstående dele 30 af periferien på hver side af lilleaksen b^. Dette ringelement har en åbning med et ellipseformet tværsnit med et givet tværsnitsareal. Y-derkanylen l's krave 3 har et tværsnit, som er mindre end den ellipseformede åbnings tværsnit, og som i mindst én stilling gør det muligt at føre kraven 3 gennem ringelementet 40's åbning, samtidig med at 35 kravens plan er parallelt med ringelementets plan. For de viste udfø- f relsesformer for yderkanylen 1 og ringelementet 40 vil det være i det tilfælde, hvor ringelementets storakse er sammenfaldende med storaksen aj for yderkanylens krave 3.A ring element 40, such as that described in FIG. 5, consists of a closed elliptical ring with recesses 42 along opposite portions 30 of the periphery on each side of the small axis b ^. This ring member has an aperture having an elliptical cross-section with a given cross-sectional area. The collar 3 of the outer cannula 1 has a cross section which is smaller than the cross-section of the ellipse opening and which, in at least one position, allows the collar 3 to pass through the opening of the ring element 40, at the same time as the plane of the collar is parallel to the plane of the ring element. For the embodiments shown for the outer cannula 1 and the ring element 40, it will be in the case where the large axis of the ring element coincides with the large axis aj of the outer cannula 3.

DK 170062 B1 11 Når yderkanylens krave 3 er ført præcis så langt gennem ringelementet 40's åbning, at ringelementets plan i alt væsentligt falder sammen med kravens plan, roteres yderkanylen 90° omkring en akse, der er vinkelret på kraven. Derved bringes kraven 3's storakse a-^ til at være sam-5 menfaldende med ringelementet 40's lilleakse b^. Kraven 3's storakse er længere end lilleaksen b^ for ringelementet 40's åbning, og kraven vil da ved ovennævnte rotation gå i indgreb med udsparingerne 42, der er dannet i ringelementets periferi, hvorved yderkanylen 1 fastholdes til ringelementet 40.When the outer cannula collar 3 is passed exactly so far through the opening of the ring element 40 that the plane of the ring element substantially coincides with the plane of the collar, the outer cannula is rotated 90 ° about an axis perpendicular to the collar. Thereby, the large axis α- of the collar 3 is caused to coincide with the small axis b ^ of the ring element 40. The major axis of the collar 3 is longer than the small axis b ^ of the opening of the ring element 40, and the collar will then engage the recesses 42 formed in the periphery of the ring element by the above rotation, thereby holding the outer cannula 1 to the ring element 40.

1010

Aksen 5, hvorom den slå 4 (ikke vist), der er monteret på yderkanylen 1's krave 3, svinges, samt stopstiften 6 sikrer, at yderkanylen ikke kan forskydes frem eller tilbage langs ringelementets lilleakse b^ roed risiko for, at kraven går ud af sit indgreb med ringelementets udspa-15 ringer 40.The axis 5, about which the strike 4 (not shown) mounted on the outer cannula 1 collar 3, is pivoted, and the stop pin 6 ensures that the outer cannula cannot be moved forward or backward along the small axis of the annular element, causing the collar to exit its engagement with the ring element recesses 40.

Efterfølgende kan inderkanylen 11 (ikke vist) anbringes i yderkanylen 1, og slåen 4 på yderkanylens krave 3 skydes for inderkanylens krave 13 for at fastholde inderkanylen til yderkanylen. Derpå kan taleven-20 tilen 50 (ikke vist) eventuelt monteres på inderkanylens anden rørdel 15.Subsequently, the inner cannula 11 (not shown) can be placed in the outer cannula 1, and the slit 4 on the outer cannula 3 is slid to the inner cannula collar 13 to hold the inner cannula to the outer cannula. Then, the voice valve 50 (not shown) can optionally be mounted on the second pipe portion 15 of the inner cannula.

Som det fremgår af ovenstående beskrivelse af, hvorledes de enkelte dele af tracheal kanylen samvirker, er det nødvendigt, at yderkanylens 25 krave kan føres ind gennem ringelementets åbning, og efterfølgende roteres og bringes i indgreb med ringelementets udsparinger. Dette vil kunne realiseres med andre geometriske former end den elliptiske for henholdsvis ringelementet og yderkanylens krave. For eksempel vil ovennævnte montage også kunne foretages med rektangulære ringelementer 30 og kraver. Det skal derfor ikke ses som en afgrænsning af opfindelsen, at de viste udførelsesformer for disse to dele er illustreret som værende elliptiske.As can be seen from the above description of how the individual parts of the tracheal cannula interact, it is necessary that the collar of the outer cannula 25 be inserted through the aperture of the annular member and subsequently rotated and engaged with the recesses of the annular member. This can be realized with geometric shapes other than the elliptical for the ring element and the outer cannula, respectively. For example, the above assembly may also be made with rectangular ring members 30 and collars. Therefore, it is not to be construed as a limitation of the invention that the embodiments shown for these two parts are illustrated as being elliptical.

3535

Claims

12 DK 170062 B1 PATENT REQUIREMENT.

A tracheal cannula comprising a retaining member (20, 30, 40) as well as an outer and an inner cannula (1,11), both provided with a collar 5 (3.13), and the retaining member (20, 30, 40). ) is held to the neck by means of ribbons or the like and is provided with a central opening around an insertion opening located in a free area intended for insertion of the outer cannula (1) held to the neck region by means of the retaining member, and wherein the outer cannula (1) is further provided with locking means for retaining the inner cannula and wherein the inner cannula is optionally provided with parts for retaining a speech valve (50), characterized in that the retaining member (20, 30, 40) is annular and flat or planar and is provided with recesses (23, 33, 42) which, by mutually rotating the retaining element 15 and the outer cannula collar (3), can be brought into engagement releasably with edge regions on the collar.

Tracheal cannula according to claim 1, characterized in that the ring element (40) is formed by a closed ring (41) and that the recesses 20 (42) in the ring are formed by slitting part of the periphery of the ring in a plane parallel to the ring. ring plan.

Tracheal cannula according to claim 1, characterized in that the ring element (20) is made up of joined parts (21, 22) which over a portion 25 of their extent overlap and that the recesses (23) are formed in the space between the superposed parts.

Tracheal cannula according to claim 1, characterized in that the ring element (30) is constituted by a closed ring (31), on which one axial 30 side is secured with resilient braces (32) and the recesses (33) are formed in the space. between the resilient braces (32) and the side of the closed ring to which the braces are attached.

The tracheal cannula according to any one of the preceding claims, 35, characterized in that the collar (3) of the outer cannula (1) has an outer cross-sectional area smaller than the inner cross-sectional area of the annular element (20,30,40). the outer periphery of the outer cannula collar may be caused to cut the inner periphery of the annulus at two substantially opposite regions. DK 170062 B1 13

Tracheal cannula according to any one of the preceding claims, characterized in that the recesses (23,33,42) of the annular element (20,30,40) in which the collar (3) of the outer cannula (1) is engaged part of their extent, has a width greater than the thickness of the outer cannula collar.

Tracheal cannula according to any one of the preceding claims, characterized in that the collar (3) of the outer cannula (1) is provided with stop means (6) for the inner cannula, which stop devices form projecting parts on the collar and which are located at a distance from the circumferential circumference of the collar greater than the smallest distance existing between two points on the inner periphery of the ring member.

Tracheal cannula according to any one of the preceding claims, characterized in that the annular element (20, 30.40) and the collar (3) of the outer cannula (1) are both elliptical.

Tracheal cannula according to any one of the preceding claims, 20, comprising a number of valves (50) provided with a flap (55) hinged horizontally in the upper part of the speech valve, characterized in that the distance from the center of mass of the flap to its outer periphery is less in the vertical direction than in the horizontal direction.

Tracheal cannula according to any one of the preceding claims, characterized in that the inner cannula (11) is held to the outer cannula (1) by means of a punch (4) mounted on the outer cannula (3) and which is displaced over the inner cannula collar (13). 30 35