RU200432U1 - Ear canal protector for forming the anterior angle between the ear canal and the tympanic membrane - Google Patents

Abstract

The utility model relates to the field of medicine, namely otorhinolaryngology and 3D modeling. The protector of the external auditory canal for the formation of the anterior angle between the external auditory canal and the tympanic membrane has the form of a hollow tube with a blind cut at an angle of 30 ° at the end, 25 mm long and within 9 ÷ 12 mm, which is chosen depending on the individual dimensions of the patient's external auditory canal. The protector is made of medical grade silicone. For its manufacture, a matrix and a punch are used, which are created using 3D modeling and 3D printing. The technical result of using the protector is painless removal of tampons from the external auditory canal, improving the healing process of the meato-tympanic flap (especially in the anterior angle), simplifying the detonation process and reducing the time of outpatient admission of patients operated on for ear pathology.

Description

The utility model relates to the field of medicine, namely to otorhinolaryngology and 3D modeling.

The final stage of almost any surgical intervention on the ear is the tamponade of the ear canal. Tamponade is performed with various materials: gauze turunda, ear tampons. The length of the external auditory canal in an adult is on average 2.5 cm, and the diameter is about 9 mm [5]. Due to the narrowness of the external auditory canal, suturing at the edges of the incision is not possible. The surgeon straightens the meatal flap according to the edge-to-edge principle, and then tampons the external auditory canal. The external auditory canal is plugged for 2-14 days, depending on the volume of surgical treatment. In addition to hemostasis, the purpose of tamponade of the ear canal is to create a framework along which the meatal flap heals (meatotympanic, non-tympanic membrane, as well as mastoidoplasty). Also, tamponade is a prolonged source of local antiseptic and antibacterial agents on the surgical site in the postoperative period [2, 3, 7]. To prevent trauma and improve the healing process of the meatotympanic flap (especially in the anterior angle), as well as to ensure accurate removal of tampons without trauma to the flap or ingrowth of tampons under the flap in the postoperative period, “protectors” (silicone or latex of a sterile surgical glove) are used before installing the tamponade , which cover the edges of the incision of a meatotympanic flap or a created nontympanic membrane, or mastoidoplasty. Typically, the “protectors” are cut intraoperatively from a sterile surgical glove. The size and number of “protectors” is determined by the surgeon. In this regard, the following problems arise: the first is the risk of leaving the protector due to reparative processes and the same color gamut of the epidermis and the color of the “protector” material or tampon, the second is the process of removing tampons in the postoperative period, in some cases it can take a long time, which will take time to see an outpatient doctor and a patient [1, 6].

The closest technical solution to the utility model developed by us is the method developed by A.L. Kolochikhin, A.L. Chistyakov, A.V. Krendikova, V.V. Gorokhov, R.A. Akhverdiev. [4]. The essence of a similar model is that at the final stage of surgical treatment, to prevent atresia of the ear canal, a through silicone tube is inserted into the external ear canal and fixed with suture material to the tragus.

However, the disadvantage of the above model is the absence in the design of the anterior angle, which is located between the external auditory canal and the tympanic membrane. Therefore, our task was to create a useful model that differs in its functionality - the formation of the anterior angle, which would make it possible to repeat the anatomical structure of the external auditory canal and promote better healing of the meatotympanic flap.

In accordance with the task, a protector of the external auditory canal was developed. The technical result of its use is the accurate and most painless removal of tampons from the external auditory canal, improvement of the healing process of the meatotympanic flap (especially in the anterior angle), simplification of the detonation process and reduction of the time for outpatient admission of patients operated on with ear pathology.

Description of drawings.

Figure 1. Reusable plastic punch, where:

1 - the angle of the working part of the punch 30 °, 2 - the length of the working part of the punch 21 mm, 3 - the diameter of the working part of the punch 8 ÷ 10 mm

Figure 2. Reusable plastic matrix, where:

4 - the angle of the working part of the matrix 30 °, 5 - the length of the counterpart of the matrix 25 mm, 6 - the diameter of the working part of the matrix 10 ÷ 12 mm

Figure 3. Finished silicone protector for forming the front corner, where:

7 - tread angle 30 °, 8 - tread inner diameter, 9 - tread length, 10 - tread outer diameter.

To implement this model of the product, a combination of 3D printing technology and the use of medical silicone material was used. The shape of the protector matrix of the external auditory canal is based on an oval (beveled) surgical ear funnel (a different size ruler is possible depending on the diameter of the external auditory canal of a particular patient), then the punch is designed. The choice of the beveled ear funnel is explained by the fact that it has an acute angle of 30 °, and the protector created on its basis allows the formation of the anterior angle between the external auditory canal and the tympanic membrane at the final stage of tympanoplasty. Then, using 3D modeling and 3D printing, a punch (Fig. 1) and a matrix (Fig. 2) were created, according to GOST 16675-80. Liquid medical silicone was poured into the resulting form. After curing, the silicone protector was removed. The finished silicone protector has the shape of a hollow tube with a blind cut at an angle of 30 ° at the end, the protector length is 25 mm, and the outer diameter - within 9 ÷ 12 mm - is selected before the operation depending on the individual dimensions of the patient's external auditory canal (Fig. 3). After sterilization, the protector is ready for use.

The die and punch can be reused.

At the end of the surgical treatment, the silicone protector of the external auditory canal is installed in the external auditory canal, with an acute angle anteriorly, to the eardrum, after which tamponade is performed. Due to the swelling of the tampons, the protector adheres to the wall of the external auditory canal and creates a frame. To remove the tampons from the external ear canal, simply pull on the protector.

The use of the developed protector of the external auditory canal is aimed at minimizing the risks of recurrent perforations in the anterior sections of the tympanic membrane in the postoperative period, increasing the effectiveness of postoperative treatment and patient management, and reducing the time for outpatient admission to patients operated on with ear pathology.

The proposed useful model is used in the State Budgetary Institution of Healthcare "Scientific Research Clinical Institute of Otorhinolaryngology named after LI Sverzhevsky" of the Moscow City Health Department.

The ear canal protector can be used in medical institutions in Moscow, as well as throughout the Russian Federation.

Literature

1. Vlasov A.F., Plechev V.V., Gataullin N.G. Postoperative iatrogenic foreign bodies (Corpus olineum). - Ufa, 2000.

2. Garov E.V., Sidorina N.G., Zelenkova V.N., Lavrova A.S., Akmuldieva N.R. Analysis of the effectiveness of tympanoplasty in patients with chronic perforated otitis media. Bulletin of otorhinolaryngology. - 2014 - No. 6 - P.8-11.

3. Eremeeva K.V. Dissertation work Surgical rehabilitation of patients who underwent general cavitary ear surgery.

4. Patent RU No. 2419404 publ. 05/27/2011 Kolochikhin A.L., Chistyakov A.L. and other Method of plastics of the external auditory canal.

5. Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. Textbook 3rd edition, revised and enlarged. - 2014. - pp. 330–337.

6. Pristanskov V. D. Features of the investigation of iatrogenic crimes committed in the provision of medical care. - 2007 - P.38.

7. Yashkin A.A. Dissertation work Optimization of postoperative management of patients with mesotympanito after tympanoplasty.

Claims (1)

The protector of the external auditory canal for the formation of the anterior angle between the external auditory canal and the tympanic membrane, which has the shape of a hollow tube with a blind cut at an angle of 30 ° at the end, 25 mm long and an outer diameter in the range of 9 ÷ 12 mm, which is chosen depending on the individual the size of the patient's external auditory canal, made of medical silicone, made using a matrix and a punch created using 3D modeling and 3D printing.

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