JP5855776B1 - Throat larynx mirror - Google Patents

Abstract

Provided is a laryngoscope direct mirror that can accurately adjust the insertion position of a laryngoscope body, can be stably held, and can arbitrarily hold the size of an open mouth. A hanger is rotatably provided on a slide portion of an extension rod extending from a support leg, and is a pharyngeal direct mirror that is attached to the hanger, and is connected to an arm screwed to the hanger and a lower end of the arm The laryngoscope body that lifts the tongue, tongue base, and epiglottis, and the mouthpiece presser fitting that is pivotally attached to the arm with a pin, and the lower end of the mouthpiece presser fitting. An opening device, a pair of biting portions provided on the opening device to be engaged with the upper teeth of the patient, an operation shaft, a feed portion provided on the arm and screwed to the operation shaft, and an operation device provided on the opening device presser bracket. A receiving portion that rotatably holds the lower end of the shaft and an operation portion including a handle that rotates the operation shaft are provided. [Selection] Figure 3

Description

  The present invention relates to a pharyngeal direct mirror, and more specifically, can open a patient's mouth during surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and is further placed behind the tongue and throat. The present invention relates to a laryngeal direct mirror that can lift and hold a certain epiglottis stably.

  Patent Document 1 shows a laryngoscope that includes a tongue depressor with a lever and a palatal spatula that presses the jaw with a lever, and is inserted into the patient's oral cavity to expose the throat region. According to this, by operating the lever by hand, the tongue can be lifted and the palate can be expanded without damaging the teeth with little effort.

  However, the laryngoscope as described above is merely for expanding the palate, and it is impossible to adjust where the laryngoscope is positioned and to stably hold the adjusted laryngoscope. Further, the above laryngoscope cannot hold the size of the open mouth, that is, the length between the upper jaw and the lower jaw.

  As shown in FIG. 9, the patient is anesthetized during surgery and is in a suspended head position (face up, head down). In addition, as shown in FIG. 8, the pharynx (into) 26 extends from the back of the oral cavity 25 to the entrance of the esophagus 31 and is divided into an upper pharynx 26a, an oropharynx 26b, and a lower pharynx 26c. The part reaching 29 is called the larynx 23, and a vocal cord 32 exists behind the larynx 23. For example, when performing tumor resection on the hypopharyngeal pharynx 26c, the epiglottis 24 at the entrance of the trachea 29 obstructs the hypopharynx 26c. Therefore, it is necessary to lift the epiglottis 24, the tongue 22, and the tongue base 22a. In addition, it is necessary to hold the laryngoscope stably during the operation. Furthermore, it is necessary to hold the mouth in a greatly expanded state during the operation. The throat refers to the pharynx 26 and the larynx 23, and the laryngeal direct mirror is a device for operating this portion. The laryngoscope body is an auxiliary tool for lifting the epiglottis 24, tongue 22, and tongue base 22a.

Japanese National Patent Publication No. 8-510938

  An object of the present invention is to provide a pharyngeal direct-view mirror that can accurately adjust the insertion position of the laryngoscope body, can stably hold the laryngoscope body, and can arbitrarily hold the size of the open mouth. is there.

The laryngopharyngeal direct mirror according to the present invention is a laryngeal direct mirror that is attached to the hanger and is provided with a hanger rotatably attached to a slide portion of an extension rod extending from a support leg fixed to an operating table. A screw-fixed arm, a laryngoscope body that is connected to the lower end of the arm and has a convexly warped downward shape and lifts the tongue, tongue base, and epiglottis, and an opening that is pivotally attached to the arm with a pin A presser fitting, an opener connected to a lower end of the pusher clamp, a pair of biting portions provided on the opener and engaged with a patient's upper teeth, and an operation shaft provided with a male screw, A feed portion provided on the arm and provided with a female screw threadably engaged with the operation shaft; a receiving portion provided on the opener presser fitting for rotatably holding a lower end of the operation shaft; and rotating the operation shaft. handle When the handle is rotated in one direction with the biting portion engaged with the patient's upper teeth, the arm and the laryngoscope body are centered on the pin. Rotating to

  The opening device is provided with a frame having an adjustment lever with a hook on the upper portion, and the opening device holding metal fitting is provided with a plurality of locking plates for locking the hook in the vertical direction. To do.

  The biting portion is slidably fitted in a lower portion of the opening device and is pressed by a presser spring.

  According to the throat larynx direct mirror of the present invention, (a) the arm 1 and the laryngoscope body 2 can be rotated around the pin 9 by turning the handle 6 of the operation unit 21. (B) The rotation by the pin 9 has little friction, and the laryngoscope body 2 can be inserted smoothly and the depth can be adjusted. (C) The laryngoscope body 2 can be inserted to the vicinity of the vocal cords, and the larynx, tongue base and tongue can be lifted well. (D) The position of the laryngoscope main body 2 can be stably held by the operation shaft 6a of the handle 6, the feed portion 7 and the receiving portion 8 that are screwed together. (E) Since the laryngoscope can be lifted by the laryngoscope body 2, observation of the hypopharynx with a flexible endoscope and surgery with forceps are facilitated. (F) Since the opening device 4 is provided with the pair of biting portions 5, the opening device pressing member 3 and the opening device 4 can be stably held.

  A frame having an adjustment lever with a hook is provided on the upper part of the opening device, and on the other hand, a plurality of locking plates are provided in the vertical direction to lock the hook to the opening device presser fitting. By engaging with the plate, the opening device can be moved in the vertical direction with respect to the opening device retainer. Thereby, the patient's mouth can be opened and held in an arbitrary size.

  Since the biting portion can be slid to the lower part of the opening device and pressed by the presser spring, it can be prevented from easily moving from the position where the biting portion is slid.

It is a perspective view (front side) of the pharynx larynx direct mirror by this invention. It is a rear view of the laryngeal direct mirror according to the present invention. It is a perspective view (back side) of the pharynx larynx direct mirror by this invention. FIG. 4 is a detailed structural diagram of the adjustment lever of FIG. 3. It is a figure at the time of mounting | wearing with a pressing spring in the biting part of FIG. It is a perspective view which shows the other Example of a laryngoscope main body. It is operation | movement explanatory drawing of the pharynx larynx direct mirror by this invention. (A) shows a case where insertion of the laryngoscope body into the oral cavity is shallow. (B) shows the case where the laryngoscope body is inserted deeply into the vicinity of the epiglottis by turning the handle. It is a figure which shows the structure of an oral cavity and a pharynx. It is a figure which shows the operation state of a patient.

  Hereinafter, a laryngeal direct mirror according to the present invention will be described in detail with reference to the drawings.

  FIG. 1 is a perspective view (anterior side) of a laryngeal direct mirror 100 according to the present invention. The laryngoscope direct mirror 100 includes an arm 1 and a laryngoscope body 2 connected to the lower end of the arm 1. The laryngoscope body 2 is inserted into the oral cavity 25 of the patient and lifts the patient's tongue 22, tongue base 22a, and epiglottis 24. The laryngoscope main body 2 has a downwardly convex warped shape, a semicircular cross section, and a groove that guides forceps inside. Note that the warped shape may be an arc shape, for example. As shown in FIG. 1, an armor presser fitting 3 is attached to the arm 1 so as to be rotatable by a pin 9, and an aperturer 4 is connected to the lower end of the aperturer presser fitting 3. The pin 9 is on the arm 1 and is located near the center of the radius of curvature of the laryngoscope body 2 having a downwardly convex shape. A pair of biting portions 5 and 5 to be engaged with the patient's upper teeth 30 are provided below the opening device 4. The biting portions 5 and 5 are provided with three semicircular grooves and can be bitten in accordance with the position of the upper teeth 30 of the patient. The arm 1 is not limited to this shape, and may be L-shaped, saddle-shaped, semicircular, or arc-shaped.

  The operation unit 21 includes an operation shaft 6a having a male screw, a feed unit 7 having a female screw provided on the arm 1 and screwed to the operation shaft 6a, and a lower end of the operation shaft 6a attached to the opening device presser bracket 3 so that the lower end thereof can be rotated. And a handle 6 that is provided at the upper end of the operation shaft 6a and rotates the operation shaft 6a. By rotating the handle 6, the interval between the feeding portion 7 and the receiving portion 8 can be increased or decreased. Since the lower end of the opening device holder 3 and the opening device 2 are fixed to the upper teeth 30 by the biting portion 5 and the upper end rotates around the pin 9, it is impossible to move in the front-rear direction. When the handle 6 is rotated, the arm 1 and the laryngoscope body 2 connected thereto move back and forth.

  FIG. 2 is a rear view of the laryngeal direct mirror 100 according to the present invention. A pair of biting portions 5 and 5 are fitted in the lower portion of the opening device 4 and can be slid in the left-right direction. The adjustment lever 19 can slide the opening device 4 in the vertical direction by operating the adjustment lever 19. The vertical position of the opening device 4 can be adjusted by the adjustment lever 19 so that the biting portion 5 can be adjusted to the position of the patient's upper teeth. By fixing the biting portions 5 and 5 at the position of the upper teeth of the patient and adjusting the position of the opening device 4 with the adjustment lever 19, the patient's mouth can be held open to an arbitrary size. it can.

  FIG. 3 is a perspective view (rear side) of the laryngeal direct mirror 100 according to the present invention. The feed portion 7 is a female screw tap that is screwed into the male screw of the operation shaft 6 a and is attached to the side surface of the arm 1. However, the feed portion 7 may be formed in the arm 1 by drilling a female screw. The receiving portion 8 is formed with a hole in the tap, and is held so as to be rotatable so that the lower end of the operation shaft 6a does not come off.

  FIG. 4 is a detailed structural view of the adjusting lever 19 of FIG. The opening device 4 is provided with a frame 16 that can slide up and down. The frame body 16 is provided with an adjustment lever 19, and a hook 18 is provided at the tip thereof. On the other hand, a plurality of locking plates 17 on which the hooks 18 are locked are provided in the opening device pressing member 3 in the vertical direction. As indicated by reference numeral A, when the adjustment lever 19 is pressed against the spring 20, the hook 18 is removed from the hole of the frame body 16 as indicated by reference numeral B. In this state, the adjustment lever 19 and the frame body 16 are slid as indicated by reference numeral C, and the opening device 4 is slid up and down.

  FIG. 5 is a view when the presser spring 10 is attached to the biting portions 5 and 5 of FIG. 3. The pair of biting portions 5 and 5 are slidably fitted into the frame of the opening device 4, and one side of the biting portions 5 and 5 is pressed by the presser spring 10. Accordingly, the biting portions 5 and 5 can be held so as not to slide easily.

  FIG. 6 is a perspective view showing another embodiment of the laryngoscope main body 2. In FIG. 1, the laryngoscope main body 2 has a semicircular cross section, but here, it has a plate shape with a wide cross section and a flat top surface. Both ends are bent slightly downward. According to this, since there is no height, a wide space in the front side region of the opening device 4 can be secured, and forceps, fibers, and the like can be easily inserted into the opening device 4. Moreover, since the cross section is wide and the upper surface is flat, the contact area with the tongue 22 increases, and this can be lifted stably.

  FIG. 7 is an explanatory diagram of the operation of the pharyngeal direct mirror 100 according to the present invention. (A) shows the case where the insertion of the laryngoscope body 2 into the oral cavity is shallow. (B) shows the case where the laryngoscope body is inserted deeply into the vicinity of the epiglottis 24 by turning the handle. When the handle 6 is turned to one side in the state of (A), the distance between the feeding part 7 and the receiving part 8 is narrowed, and the laryngoscope body 2 can be inserted deeply into the vicinity of the epiglottis 24 as shown in (B). Although not shown in the drawing, the laryngoscope body 2 can be inserted up to the vicinity of the vocal cord 32. Conversely, when the handle 6 is turned to the other side in the state of (B), the distance between the feeding part 7 and the receiving part 8 is widened, and the laryngoscope body 2 is separated from the epiglottis 24 or the vocal cord 32 as shown in (A). be able to. Here, it is assumed that the arm 1 is fixed to the hanger 11 with a screw. Moreover, the hanger 11 shall be attached so that rotation with the axis | shaft 40 of a worm gear is possible. The shaft 40 of the worm gear rotates when the knob 41 (see FIG. 9) is rotated, and is used when the whole including the hanger 11 is rotated. Here, the overhang bar 13 is illustrated as not being fixed to the support leg 14. According to this, since the opening device 4 is being fixed to the patient's upper tooth 30, it can be made into the state shown to FIG. 7 (A) and (B) by turning the handle | steering-wheel 6. FIG.

  FIG. 8 is a diagram showing the structure of the oral cavity 25, the pharynx 26, and the vocal cords 32. Air entering from the nose 27 passes through the nasal cavity 28, passes through the pharynx 26 and vocal cords 32, and enters the trachea 29. The food that has entered the mouth enters the esophagus 31 from the oral cavity 25 through the pharynx 26. Here, the epiglottis 24 prevents food from entering the trachea 29 when the food is swallowed. The pharynx 26 is divided into an upper pharynx 26a, an oropharynx 26b, and a hypopharynx 26c. In the operation or the like of the hypopharynx 26c, it is necessary to lift the epiglottis 24, the tongue base 22a, and the tongue 22.

  FIG. 9 is a diagram showing a surgical condition of a patient. The patient is in a suspended position with the head hanging. The support leg 14 is fixed to the operating table, and the overhang bar 13 extends obliquely upward from the support leg 14. A slide portion 12 is provided at the tip of the overhang bar 13. The hanger 11 is attached to a shaft 40 of a worm gear provided at the lower part of the slide portion 12. When the knob 41 is rotated, the shaft 40 of the worm gear can be rotated, and the whole including the hanger 11 is rotated to fix the overhanging bar 13 to the support leg 14. The arm 1 is connected by fixing to the legs of the hanger 11 (two in front and rear, and two in left and right in total) with screws.

  The laryngopharyngeal direct mirror of the present invention is a device that opens the patient's mouth at the time of surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and can stably hold the patient's larynx in a lifted state. Is preferred.

DESCRIPTION OF SYMBOLS 1 Arm 2 Laryngoscope body 3 Opening device presser fitting 4 Opening device 5 Biting part 6 Handle 6a Operation shaft 7 Feeding part 8 Receiving part 9 Pin 10 Pressing spring 11 Hanger 12 Slide part 13 Overhang bar 14 Support leg 15 Forceps 16 Frame 17 Locking plate 18 Hook 19 Adjusting lever 20 Bounce spring 21 Operation part 22 Tongue 22a Tongue root 23 Larynx 24 Larynx 25 Oral 26 Pharynx 26a Nasopharynx 26b Oropharynx 26c Hyopharynx 27 Nasal 28 Nasal cavity 29 Trachea 30 Patient upper teeth 31 Esophagus 32 vocal cords 40 worm gear shaft 41 knob 100 throat larynx direct mirror

Claims (3)

A hangar is provided on the slide part of the overhanging rod extending from the support leg fixed to the operating table so that the hanger can be rotated,
An arm screwed to the hanger;
A laryngoscope body that is connected to the lower end of the arm and has a downwardly convex warped shape, lifting the tongue, tongue base, and epiglottis;
An opening retainer fitting that is pivotally attached to the arm with a pin;
An opener connected to the lower end of the opener retainer;
A pair of biting portions provided in the opening device and engaged with the upper teeth of the patient;
An operation shaft provided with a male screw, a feed portion provided with a female screw that is provided on the arm and screwed with the operation shaft, and a receiving portion that is provided on the opening device pressing member and rotatably holds the lower end of the operation shaft. And an operation unit comprising a handle for rotating the operation shaft,
When the handle is rotated in one direction with the biting portion engaged with the patient's upper teeth, the arm and the laryngoscope body rotate about the pin. Direct mirror.
The opening device is provided with a frame having an adjustment lever with a hook on the upper portion, and the opening device holding metal fitting is provided with a plurality of locking plates for locking the hook in the vertical direction. The throat larynx direct mirror according to claim 1.
The throat larynx direct delivery mirror according to claim 1, wherein the biting portion is slidably fitted into a lower portion of the opening device and pressed by a presser spring.

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