RU2562515C1 - Intubation kit for bicanalicular drainage of lachrymal passages - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: intubation kit for bicanalicular drainage of lachrymal passages consists of a drain tube configured as a flexible cylindrical tube 200 mm long, 1 mm in an outer diameter and a guide line 400 mm long; the tube and guide line are unconnected. In its central portion, the drain tube has an oval opening 20×0.5 mm in size, a greater axis of which extends along a tube axis.

EFFECT: reducing postoperative complications in intubation of both a natural, and newly formed lachrymal passage.

1 dwg, 2 ex

Description

The invention relates to medicine, and more particularly to ophthalmology.

Known intubation kit manufactured by FCI (France) (Davydov D.V. et al. Method for bicanalicular intubation of elastic stents with endoscopic dacryocystorhinostomy // Refractive surgery and ophthalmology. - 2005, volume 5. - No. 1. - P. 56-60) .

However, this device has several disadvantages: the presence of postoperative complications in the form of granulation, a toxic-allergic reaction to the material (silicone) from which the drainage is made, leading to relapse of the disease, the complexity and high cost of manufacture and use - polypropylene guides are soldered into a silicone tube, which, with a slight effort applied during intubation, can prematurely separate from the drainage and its further use is impossible.

There is also an intubation kit for bicanalicular drainage of the tear ducts, consisting of a polyurethane cylindrical tube and a fishing line, not connected to each other (Shkolnik S.F. Method of bicanalicular drainage of the tear ducts // RU 2387421, IPC ⁷ A61F 9/007).

Both of these devices have a common drawback: the lack of passage of tear fluid, because the stent blocks the lacrimal opening.

The technical problems solved by the invention are the reduction of postoperative complications both during intubation of the natural and newly created lacrimal drainage paths, simplification of the drainage procedure, the possibility of x-ray control of the drainage position, retention of the lacrimation at the time of stent drainage in the lacrimal ducts, which ultimately ensures normal functioning lacrimal system.

These technical problems are solved by the fact that the intubation set consists of two parts: a flexible cylindrical tube narrowed at the ends, 200 mm long and 1 mm outer diameter, and a fishing line (PL) 400 mm long, not interconnected. In the central part of the drainage tube there is an oval-shaped opening, the large axis of which is located along the axis of the tube, 20 × 0.5 mm in size. The material of the tube serving as drainage is X-ray contrast polyurethane, used in the production of subclavian and jugular vein catheters.

Drainage for bicanalicular drainage of the tear ducts is illustrated in FIG. 1, which shows a general view of the intubation kit, where 1 is a drainage tube (DT), 2 is a fishing line, 3 is an opening for the removal of tears from the conjunctival sac.

Work with an endotracheal kit for bicanalicular drainage of the tear ducts is performed as follows:

Transcanalicularly through the lower lacrimal opening dilated by conic probes, the Ritleng probe equipped with an internal canal is inserted into the lacrimal-nasal canal or dacryocystorhinostoma. Through the probe, a colored LP is carried out, the end of which, under the control of the rhinoscope, is removed from the nasal cavity using a Ritleng hook. The Ritleng probe is removed. From the vestibule of the nose, it is worn before the end of the fishing line from the lower end of the DT. Holding the drainage tube on the LP, pull the opposite end of the LP until the upper end of the drainage tube is removed from the lower lacrimal opening. Through the upper lacrimal opening dilated with conical probes, a Ritleng probe is inserted into the lacrimal-nasal canal or dacryocystorhinostoma. Through the probe, a colored LP is carried out, the end of which, under the control of the rhinoscope, is removed from the nasal cavity using a Ritleng hook. The Ritleng probe is removed. The upper end of the drug is introduced into the DT until it is removed from the lower end of the tube. While holding the tube on the fishing line, they pull it on the opposite end of the fishing line, while the upper end of the pipe along with the fishing line is introduced through the upper lacrimal opening into the lacrimal duct, and then into the lacrimal-nasal canal or dacryocystorhinostoma, the nasal cavity is brought out through the vestibule of the nose. Fishing line is removed from the cavity of the DT. The drainage tube is installed so that the oval hole is in the medial corner of the eye and is facing laterally. The ends of DT are trimmed at the level of the vestibule of the nose.

Example 1. Patient V., 72 years old, diagnosis: chronic suppurative dacryocystitis, phlegmon of the lacrimal sac (SM). Complaints of lacrimation, purulent discharge from both eyes for about 1 year, swelling at the inner corner of the eye on the left. A history of phlegmon of the lacrimal sac on the left. Probing of the lacrimal passages was conducted at the place of residence. Reflux test is negative. OS - tubules are impassable closer to the mouth. Concomitant diagnosis: chronic bilateral maxillary sinusitis, curvature of the nasal septum, turbinate hypertrophy. Access to the area of the lacrimal sac is not limited (front position SM). A classical endonasal dacryocystorhinostomy (EDDR) with large rhinostomy was performed. The contents of the bag are mucopurulent in nature. Flushing with slight regurgitation. Bicanalicular drainage was performed for 3 weeks. During follow-up examinations - after 1, 6, 12 months, the patient had no complaints. Tear flow is free.

Example 2. Patient N., 52 years old, diagnosis: chronic suppurative dacryocystitis, obstruction of the nasolacrimal duct. Complaints of constant lacrimation and purulent discharge from the right eye. The diagnosis of dacryocystitis is confirmed by computed tomography, which revealed an increase in the size of the lacrimal sac on the right. An EDDR operation was completed, which ended with bicanalicular drainage of the tear ducts according to the above method, in which the ends of the DT are removed from the nasal cavity through the lacrimal-nasal anastomosis formed during the DCR. The operation and the postoperative period proceeded without complications. The drainage tube was removed 2 weeks after surgery. During follow-up examinations - after 1, 6, 12 months the patient did not complain. Dacryocystorhinostoma is wealthy. Tear ducts are freely passable.

Using the proposed intubation kit allows, without resorting to complex manufacturing technology, to achieve a positive solution to the technical problems specified in the description.

Claims (1)

An endotracheal kit for bicanalicular drainage of the tear ducts, consisting of a drainage tube made in the form of a flexible cylindrical tube 200 mm long, 1 mm outer diameter and 400 mm long fishing line, not interconnected, characterized in that the drainage tube in the central part has an oval-shaped hole, the major axis of which is located along the axis of the tube, with dimensions of 20 × 0.5 mm.