RU218030U1 - Lunev's cannula for probing and washing the frontal sinus - Google Patents

Abstract

The utility model relates to devices used in otorhinolaryngology and is intended for probing and flushing the frontal sinus through the natural fistula during the treatment of inflammatory diseases. The device is a cannula made of rigid material. The cannula contains a crescent-shaped tube, the bend of which is adapted for insertion into the sinus, with a sealed and oval working end. The end has through slot-like holes located at different heights and in perpendicular planes. A screw thread is made on the inner surface of the working end of the tube. At the opposite end of the tube there is a flattened pavilion for attaching the syringe, which has two wide parallel faces, the pavilion plane is perpendicular to the direction of the bending plane of the working end of the tube. One of the faces of the pavilion has a mark indicating the direction of the working end of the tube.

Description

The utility model relates to the field of medicine, namely to devices used in otorhinolaryngology for the treatment of inflammatory diseases of the frontal sinus (frontal sinus).

From patent RU 2252040, a device (cannula) for washing the maxillary sinus through a natural fistula is known, made in the form of a special S-shaped curved tube with a sealed end and side holes, having a pavilion for attaching a syringe with liquid and a pelota with a label to facilitate the positioning of the cannula.

From patent RU 2318540, a device (cannula) is also known, used in otorhinolaryngology for washing the paranasal sinuses in cases where, when the cannula is inserted into the sinus, there is no outlet for the reverse flow of fluid. The device has a feed tube with a bend and a hole at the working end, is equipped with a pavilion and a pilot. The bend of the cannula is adapted to insert the working end of the delivery tube into the frontal sinus. To the working end of the supply tube with an offset relative to the latter, congruently and close to it, a return tube with a sealed working end having a side hole and an open peripheral end is attached. When washing the sinus, which is in a state of obstruction, the drug solution is supplied with a syringe through the supply tube and exits the sinus through the return tube into the nasal cavity, and from there out.

This device is taken as a prototype.

The disadvantage of this device is the impossibility of full washing of the sinus, since the holes indicated in the invention at the working end of the cannula allow spraying the solution supplied through the cannula only in a limited direction. In addition, the allocation of a pavilion for attaching a syringe and a pilot, which allows you to determine and set the direction of the cannula, in the form of separate structural elements is inconvenient when performing manipulations without additional tools (tweezers), which, given the "tactility" of the method, may adversely affect the accuracy and efficiency of the procedure. operations.

The proposed device allows to overcome the shortcomings of the prototype.

In FIG. 1 shows in two projections a schematic design of the proposed device. In FIG. 2 shows an enlargement of fragment A. FIG. 3 shows fragment A in section. In FIG. 4 shows the appearance of the implemented device.

The device is made of a rigid material that is biologically and chemically inert; has a crescent-shaped tube 1, the bend of which is adapted for insertion into the frontal sinus, with a sealed and ovalized working end 2, having through slot-like side holes 3 located at different heights and in perpendicular planes. A screw thread 4 is applied to the inner surface of the tube 1 in the region of the working end 2. On the opposite peripheral end of the tube 1 there is a pavilion 5 for attaching a syringe, which has a flattened shape with two wide parallel edges, while the plane of the pavilion 5 is perpendicular to the plane of the bend of the working end 2 of the tube 1. On one of the faces of the pavilion 5 there is a mark 6 in the form of a risk, indicating the direction of the working end 2 of the tube 1.

Through holes at the working end of the cannula, located at different levels and perpendicular to each other, allow for circular spraying of the liquid, which, in turn, allows for more efficient irrigation of the sinus mucosa. The screw thread on the inner surface of the working end of the tube is designed to impart rotation to the liquid passing through the cannula, which forms a wider and more intense jet of liquid at the exit. The slit-like shape of the holes, firstly, allows you to maintain the mechanical strength of the end of the tube, and secondly, it creates additional pressure for the outgoing fluid, which also favorably affects the efficiency of irrigation and washing of the entire surface of the sinus mucosa.

The combination of the pilot and pavilion for attaching the syringe and giving it a flattened shape with wide edges allows manipulation directly by hand, without the use of additional tools such as tweezers, which increases accuracy and efficiency.

The cannula is used as follows: after local anesthesia is performed, the end of the cannula is inserted into the middle nasal passage, brought to the mouth of the frontonasal canal behind the uncinate process, and the cannula is directed upward, laterally and somewhat anteriorly; the control of the manipulations is carried out tactilely, the entrance of the cannula into the anastomosis is accompanied by a feeling of "falling through". After penetration of the working end of the cannula into the sinus, a syringe with a medicinal solution is attached to the pavilion and the sinus is washed.

An example of the implementation of the utility model is shown in Fig. 4 device. The cannula is made of stainless surgical steel. The total length of the cannula is 130 mm. The part containing the crescent-shaped tube with a diameter of 1.6 mm has a length of 115 mm. The pavilion for attaching the syringe has two parallel wide edges with a notch on one of them and two lateral rounded edges, the dimensions of the pavilion are 15 mm × 8 mm × 6 mm (length × width × height). In the tube at the working end of the cannula at a distance of 2 mm and 4 mm from the sealed oval end, through slot-like holes 1.5 mm × 0.5 mm in size are made, located in mutually perpendicular planes. On the inner surface of the working end of the tube, a screw thread is made for 20 mm.

The use of the described cannula is demonstrated by the following clinical example.

Patient A., 37 years old. Was admitted to the otorhinolaryngological department with a diagnosis of left-sided acute purulent frontal sinusitis. The first complaints of a headache in the forehead on the left, difficulty in nasal breathing, discharge from the nose and an increase in body temperature up to 38°C in the patient occurred 8 days ago, after suffering an acute respiratory viral infection. According to the results of computed tomography, a darkening of the left frontal sinus was revealed, with the presence of a liquid component.

While in the department of otorhinolaryngology, the patient was repeatedly probing and washing the left frontal sinus through the natural fistula using the cannula described in Fig. 4. During washing, the separation of purulent contents from the sinus was observed. The patient noticed an improvement in her condition and the disappearance of unpleasant sensations immediately after the first manipulation. After 7 days, at the time of discharge, there are no complaints. On the control computed tomography of the paranasal sinuses, performed after 14 days, there are no data for sinusitis (frontal sinusitis). All sinuses are pneumatized, which is the norm.

Claims (1)

Cannula for probing and washing the frontal sinus, made of rigid material in the form of a crescent-shaped tube, the bend of which is adapted for insertion into the frontal sinus, with a sealed and ovalized working end having side holes, with a pavilion for attaching a syringe to the opposite peripheral end of the tube, which differs due to the fact that the inner surface of the working end of the tube has a screw thread, the side holes at the working end of the tube have a slit-like shape and are through through the opposite walls of the tube, located at different heights and in perpendicular planes, the pavilion located at the peripheral end of the tube has a flattened shape with two parallel faces, while the plane of the pavilion is perpendicular to the plane of the bend of the working end of the tube, and one of the faces of the pavilion has a mark indicating the direction of the working end of the tube.

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