FR2632531A1 - Single-duct probe for lacrimal pathology - Google Patents

Abstract

According to the invention, the probe consists of a meatal plug 1 on which is fixed a flexible silicone tube 5, the tube 5 being terminated by a metal mandrel 6. Applications: treatment of conditions of the lacrimal ducts.

Description

MbNOCANALICULAR PROBE FOR LACRYMAL PATHOLOGY
The subject of the present invention is a probe, or intubation device, intended in particular, but not exclusively, to be used in lacrimal pathology,
We know that this pathology results, in particular, from stenoses blocking the flow channels (or canaliculi) of tears inside the nasal cavity.

It results from the blockage of one or both canaliculi the flow of tears on the cheeks, which very quickly becomes unbearable because the lacrimal secretion is continuous.

The current method to overcome this drawback is to intubate the canaliculi or lacrimal excretion pathways to treat traumatic or stenosante conditions. This intubation consists in introducing, using a catheter, a thread of biologically inert material such as a silicone inside the lower and upper tubes, then in carrying out a ligature of the two ends after passage through the channel. lacrymonasal.

The so-called bicanaliculo nasal intubation uses a silicone tube of approximately 20 cm long terminated by two metal mandrels with a foam tip.

In the majority of lacrimal pathologies, a mono-canalicular intubation would be sufficient, but if the need to obtain a suitable fixation of the catheter leads to a double introduction: in the lower canaliculus and in the superior canaliculus, at the risk of damaging the canaliculus healthy. There is therefore a loop of wire emerging in the palpebral slot, hence the risk of accidental externalization by traction. This exteriorization becomes unbearable for the patient and renders the therapy ineffective if the pathology concerns the vertical segment of the lacrimal passages.

In addition, a constriction force can be exerted on the ducts of the canaliculi, which can lead to stricturotomies.

The present invention aims to overcome the drawbacks resulting from the obligation to pass through the two canaliculi if only one is reached, the risks of stricturotomies, and the risks of accidental exteriorization.

According to the present invention, the intubation device for lacrimal pathology is characterized in that it comprises a meatic plug secured to a tube terminated by a metal mandrel. The tube and plug can be full or hollow over their entire length.

According to another characteristic of the present invention, the meatic plug comprises a collar, a neck with a diameter smaller than that of the collar and a bulb, the vertical section of the plug having the shape of an ace of spades.

Thus, the meatic plug ensures a freestanding fixation of the probe, which allows to work only on one canaliculus, leaving the other in normal operating state.

Other characteristics and advantages of the invention will appear during the following description of a particular embodiment, given solely by way of nonlimiting example, with reference to the drawings which represent Lafigure 1, a view in perspective of a device according to
the invention - Figure 2, a diagram explaining the use of the
Figure 3 probe, an example of a plug
meatic, and; C - Figure 4, a diagram showing the repair of a wound
in a canaliculus.

In FIG. 1, it can be seen that the intubation probe comprises a meatic plug generally designated by the reference 1, a tube or wire 5 of silicone or biologically inert flexible material, and a metal mandrel 6 intended to facilitate guiding the catheter.

In the upper part of FIG. 1, it can be seen that the plug 1 comprises a collar 2, a neck 3 and a bulb 4.

On the bulb 4 is fixed the tube 5, either on the tip, or according to a lateral fixing with a variable angle, for example between O and 1200 relative to the axis of the plug, which makes it possible to adapt it to all anatomical forms.

The shape of the plug 1 results from the observation of the structure of the meatus. The bulb 4 is housed in the vertical part of the canaliculus and its dilated shape prevents its expulsion towards the eyelids. The neck 3 connecting the bulb 4 to the collar is housed in the narrowed part of the vertical segment of the canaliculus.

The collar 2, wider than the meatus, prevents its burial and its migration into the canaliculus. It can be either circular, ~ or half-moon, or even truncated, to avoid friction against the conjunctiva, especially in children and patients whose free edge is narrow. The metal mandrel 6 is of course protected by a foam tip.

FIG. 2 represents the upper 7 and lower 8 tubes with a right eye, opening the upper 9 and lower 10 canaliculi which themselves open into the lacrimal sac 11. It is known that, under normal conditions, the lacrimal fluid flows, on average, at a rate of 20% in the upper canaliculus and 80% through the lower canaliculus.

Reference 15 indicates, in dotted lines, the path of a probe in the prior art, that is to say during a bicanaliculo-nasal intubation. As can be seen in the figure, the wire 15 is tied at 16, on the outside of the bag 11 and it crosses the palpebral slot 12, hence the risks of stricturotomies signaled above.

The probe according to the invention is referenced 14 in FIG. 2.

In this example, the implantation is monocanicular and the probe passing through the canaliculus 10 is maintained in the meatus 8 by the plug 1. As a result, no wire passes through the palpebral slot, and that stenoses such as that which is symbolized by the reference 13, are gradually absorbed, the lacrimal fluid passing in greater proportion in the canaliculus 9 remaining healthy or vice versa.

FIG. 3 represents a particular embodiment of the stopper 1 and the collar 2, the neck 3 and the bulb 4 are found in the drawing. In this embodiment, the collar comprises a window, the orifices 17 of which are aligned with hollow gutters 18 of the bulb to allow the flow of tears. Of course, the number of orifices can be arbitrary. The tube 5 is, moreover, glued to the plug (formed by injection) on a bent appendage 19 of the bulb, so that the tube 5 is bent, which avoids any traction on the plug and the inclination of the latter relative to the eyelids.

 The tube 5 has a length of about ten centimeters and the metal mandrel 6, of a length of five to six centimeters, for example, is crimped inside the tube.

FIG. 4 is a diagram representing the repair of a wound P of a canaliculus. In this case, the probe is cut 7 or 8 mm from plug 1, without intubation of the bag or the lacrmonasal canal. The repair is carried out on sight, after local anesthesia.

Of course, the operating time is reduced to the nasal recovery of a single mandrel, and in the pathologies of the sac or the lacrymonasal canal, the probe can be introduced by the upper canaliculus which, generally, is less functional.

It goes without saying that many variants can be introduced, in particular by substitution of technically equivalent means without departing from the scope of the invention.

Claims (5)

1. Monochannel probe for lacrimal pathology,  characterized in that it comprises a plug (1)  meatic, integral with a tube (5) made of biologically  inert, terminated by a metal mandrel (6). 2. Probe according to claim 1, characterized in that the  meatic plug (1) includes a flange (2) connected to  a neck (3) ending in a bulb (4). 3. Probe according to claim 2, characterized in that the  flange (2) is truncated. 4. Device according to claim 2, characterized in that  the collar (2) and the bulb (4) have  openings (17, 18) for the flow of tears. 5. Device according to one of claims 2 to 4,  characterized in that the bulb (4) is extended by a  bent appendage (19), on which the tube (5) is glued.