RU16075U1 - CATHETRIC SUSPENSION OF THE SINGLE SINUS - Google Patents

Abstract

A maxillary sinus catheter obturator containing a rubber balloon and a plug, characterized in that the rubber balloon is made in the form of an inflatable cuff at the end of a double-lumen tube, and the plug is in the form of a valve mechanism, and interconnected through an air channel passing through the thickness of the tube.

Description

Catheter sinus obturator.

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MPKA6M 25/10

The utility model relates to medicine, namely to maxillofacial surgery. Known methods for treating fractures of the zygomatic bone with damage to the maxillary sinus using fixative splints, fixation with wire sutures, mini plates and metal structures with a shape memory effect does not always ensure that fragments are kept in the correct anatomical position. Tight tamponade of the maxillary sinus with gauze turunda does not allow to delay the treatment due to the frequent complications of an inflammatory nature.

Known pneumatic balloon for fixing fragments of the cheekbone complex (A.G. Kurashev, A.N. Isabaeva "Experience in fixing fractures of the zygomatic bone with a pneumatic balloon" // Dentistry 1985. N 5 p. 43-44) which consists of a rubber balloon connected with a thin an elastic tube with a cap.

To fix the cheekbone complex through the anastomosis of the lower nasal passage with the maxillary sinus, a rubber balloon is introduced with subsequent injection of air through the rubber tube, keeping the cheekbone complex in the correct anatomical position.

However, the proposed pneumatic cylinder has several disadvantages. It is known that the structure and dimensions of the maxillary sinus are variable and do not correspond to a spherical shape, and therefore, when obstructed by a pneumatic balloon, there remain areas where blood clots accumulate and the possibility of infection arises. With a long-term location of a pneumatic balloon (up to 15 days), there is a need for reorganization and deposition of drugs in the maxillary sinus.

The above disadvantages are eliminated by the proposed catheter obturator of the maxillary sinus with a device for monitoring air pressure in the cylinder.

The technical result of the utility model is the metered air supply to the cylinder by means of a valve mechanism and the ability to control air pressure. Figure 1 shows the proposed device; figure 2-device in operation; Fig. 3 is the same with pressure measurement.

The proposed catheter obturator is a dense rubber double-lumen tube (1) with a cross section of about 7 mm, which has a pneumatic inflatable cuff 7 at one end and a valve mechanism (3) with an inflatable cushion 4 at the other end. An inflatable pneumatic cuff is connected to the valve mechanism by means of an air channel (5) passing in the thickness of the wall of the rubber double-lumen tube.

The device is used as follows: after a radical sinusotomy on the maxillary sinus, removal of pathological tissues, evacuation of purulent exudate or reposition of fragments of the zygomatic complex, followed by antiseptic treatment, an obturator is placed in the sinus nojmcTb through the imposed anastomosis of the lower nasal passage. After that, the cannula of the pump with the piston allotted is connected to the obturator valve mechanism (3) and the cuff (2) is inflated by the pressure of the piston to complete the front wall fenestra in case of surgical intervention in the inflammatory process in the maxillary sinus or open reposition of the cheekbone fragments to restore the anatomical integrity of the fragments bones (figure 2). Then, a device for measuring air pressure is connected to the valve mechanism. On the manometer scale, readings of air pressure in the cylinder are taken and recorded in the journal or in the medical history.

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One of the cannulas is located on the side and connected to the pressure gauge, the other for pressure and pressure obturator (Fig.Z).

Example 1. Nikitin L.I. 38 years old, medical record No. 7856. He was hospitalized in the clinic of maxillofacial surgery with a diagnosis of "An old fracture of the zygomatic complex on the right with a shift. Complaints of the patient about the deformation of the zygomatic region on the right, numbness of the upper lip and teeth of the upper jaw on the right. On the roentgenogram of the paranasal sinuses, there is a violation of the integrity of the bone tissue of the zygomatic complex on the right with the displacement of fragments.

Under general anesthesia, an open reposition of the zygomatic complex on the right was performed using a pneumatic valve obturator. After radical maxillary sinusotomy on the right and application of the anastomosis with the lower nasal passage, treatment of the maxillary sinus with an antiseptic solution, a catheter valve obturator was inserted through the anastomosis. By means of an air pressure device, a pneumatic cuff is inflated, followed by reposition and fixation of fragments of the zygomatic bone. The surgical wound of the transitional fold of the upper jaw on the right is laden with kapron. Complex anti-inflammatory treatment was prescribed, including physiotherapy, vitamin therapy, washing of the maxillary sinus with antiseptic solutions through an obturator catheter.

The dynamics of the postoperative period without deterioration. Edema of the soft tissues of the infraorbital region on the right was stopped on the seventh day after surgery. There was a restoration of tooth sensitivity in the upper jaw and upper lip on the side of the lesion.

The pneumatic valve obturator was removed 10 days after surgery, as well as the surgical sutures of the transitional fold.

Towards the end of the patient’s treatment, restoration of the sensitivity of the teeth of the upper jaw and the elimination of deformation of the zygomatic region on the right were noted.

The patient was discharged on an outpatient basis to a dental surgeon at the place of residence in satisfactory condition for 15 days.

At the control examination, 3 months after discharge from the clinic, consolidation of the processes of the right zygomatic complex in the correct anatomical position is noted. Mouth openings in full. The face is symmetrical. On the roentgenogram of the paranasal sinuses of the maxillary sinus on the right is pneumatic, the processes of the zygomatic complex in the correct anatomical position.

Claims (1)

A maxillary sinus catheter obturator containing a rubber balloon and a plug, characterized in that the rubber balloon is made in the form of an inflatable cuff at the end of a double-lumen tube, and the plug is in the form of a valve mechanism, and interconnected through an air channel passing through the thickness of the tube.