RU224370U1 - Lunev needle-cannula for probing and washing the maxillary sinus - Google Patents

Abstract

The utility model relates to the field of medicine, namely to devices used in otorhinolaryngology for the treatment of inflammatory diseases of the maxillary (maxillary) sinus (sinus), for washing the maxillary sinus by inserting the tip of the cannula into the sinus through the natural anastomosis or fontanella with piercing the uncinate process in those cases when the anatomical features of the structure of the patient’s ostiomeatal complex do not allow displacement and circumvention of the uncinate process. The device is made of a rigid material, biologically and chemically inert, and has an S-shaped bent tube, the bend of which is adapted for insertion into the maxillary sinus. The working end of the tube is blind and has the shape of a needle point. In the area of the working end there are through slot-like side holes located at different heights in mutually perpendicular planes. A screw thread is applied to the inner surface of the tube in the area of the working end. At the opposite end of the tube there is a pavilion for attaching a syringe, which has a flattened shape with two wide parallel edges. A mark in the form of a mark is applied to one of the faces of the pavilion, indicating the direction of the working end of the tube. 2 ill., 1 pr.

Description

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

From patent RU 218 032 U1 a device for washing the maxillary sinus through the anastomosis (fontanella) is known. The device is a cannula made of rigid material. The cannula contains a curved 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. There is a screw thread on the inner surface of the working end of the tube. At the opposite end of the tube there is a flattened pavilion for connecting a syringe, which has two wide parallel edges; the plane of the pavilion is perpendicular to the direction of the bending plane of the working end of the tube. A mark indicating the direction of the working end of the tube is applied to one of the faces of the pavilion.

We adopted this device as a prototype.

This device is used for washing the maxillary sinus in a “gentle” way, without the need for puncture. The method is carried out by inserting the tip of the cannula into the sinus through the natural anastomosis or fontanella, while the cannula along the way should go around the uncinate process, behind which there is an anastomosis (fontanella). However, in some cases, the anatomical features of the structure of the patient’s ostiomeatal complex do not allow moving and going around the uncinate process and directing the tip of the cannula into the sinus anastomosis. In such cases, the method of probing and washing the maxillary sinus can be carried out by piercing the uncinate process, which will still be a less painful procedure compared to the “classical” sinus puncture. However, the device described in RU 218 032 U1 does not allow piercing the uncinate process, since it has a rounded working end. The device we propose allows us to overcome this shortcoming of the prototype.

The technical result of the proposed utility model is to expand the arsenal of devices used for probing and washing the maxillary sinus.

In fig. 1 shows the schematic design of the proposed device in two projections. In fig. Figure 2 shows an enlarged cross-section of fragment A.

The proposed device is made of rigid material, biologically and chemically inert; has an S-shaped bent tube 1, the bend of which is adapted for insertion into the maxillary sinus. The working end 2 of the tube 1 is blind and has the shape of a needle point. In the area of the working end there are through slot-like side holes 3 located at different heights in mutually perpendicular planes. A screw thread 4 is applied to the inner surface of the tube 1 in the area of the working end 2. At the opposite end of the tube 1 there is a pavilion 5 for connecting a syringe, which has a flattened shape with two wide parallel edges, while the plane of the pavilion is perpendicular to the direction of the bending plane of the working end 2 of the tube 1 On one of the faces of pavilion 5 there is a mark 6 in the form of a mark, indicating the direction of the working end 2 of tube 1.

The presence of a pointed end allows you to pierce the uncinate process when inserting the cannula, ensuring easy and painless penetration through the tissue. Plugging the sharp end makes it possible to prevent the tube from being “clogged” with tissue fragments when pierced, and also provides additional mechanical strength to the working end and “redirects” the liquid flow to the slot-like side holes, creating additional liquid pressure at the outlet and increasing irrigation efficiency.

The slit-like shape of the holes at the working end of the cannula, firstly, allows you to maintain the mechanical strength of the end of the tube, and secondly, creates additional pressure for the exiting liquid, which has a beneficial effect on the efficiency of irrigation and washing the surface of the sinus mucosa.

A screw thread inside the working end of the tube imparts rotation to the liquid at the exit from the cannula, which increases the speed of movement and pressure of the liquid and intensifies the process of irrigation of the sinus cavity.

Combining the pilot and pavilion for attaching the syringe and giving it a flat shape with wide edges allows you to comfortably carry out manipulations directly with your hands, without the use of additional tools such as tweezers, which ensures increased accuracy and efficiency.

The cannula is used as follows: after local anesthesia has been performed, under visual control (for example, using an endoscope), the working end of the cannula is inserted into the middle nasal meatus, with which the uncinate process is pierced. After this, the end of the cannula is advanced further to the anastomosis (fontanella) and inserted into it. After inserting 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 a utility model is a cannula made of stainless surgical steel. The total length of the cannula is 95 mm. The part containing the S-shaped bent tube with a diameter of 1.6 mm has a length of 80 mm. The pavilion for connecting the syringe has two parallel wide edges with a mark on one of them and two side rounded edges, the dimensions of the pavilion are 15 × 8 × 6 mm (length x width x height). In the tube at the working end of the cannula, at a distance of 5 mm and 7 mm from the working end, there are through slot-like holes measuring 1.5 × 0.5 mm, located in mutually perpendicular planes. On the inner surface of the working end of the tube, a screw thread is made over a length of 20 mm.

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

Patient K., 18 years old. He was admitted to the otorhinolaryngology department with a diagnosis of acute left-sided purulent sinusitis. The patient's first complaints of headache, difficulty breathing, nasal discharge and an increase in body temperature to 39° arose 5 days ago, after suffering an acute respiratory viral infection. The results of computed tomography revealed darkening of the left maxillary sinus, with the presence of a fluid component.

While in the otolaryngology department, the patient repeatedly underwent probing and lavage of the left maxillary sinus through the natural anastomosis using the described cannula. When inserting the cannula into the nasal passage and piercing the uncinate process, the patient did not report any pain or discomfort. During washing, separation of purulent contents from the sinus was observed. The patient noted an improvement in his 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 a control computed tomography scan of the paranasal sinuses, performed after 14 days, there was no evidence of sinusitis (sinusitis). All sinuses are pneumatized, which is the norm.

Claims (1)

A needle-cannula for probing and washing the maxillary sinus, made of rigid material in the form of an S-shaped bent tube, the bend of which is adapted for insertion into the maxillary sinus, with a working end having through slit-like holes and a screw thread on its inner surface, with a pavilion for connecting a syringe to the opposite peripheral end of the tube, characterized in that the working end of the tube is blind and has the shape of a needle point.