RU51872U1 - DEVICE FOR DRAINING AND AERATION OF THE MIDDLE EAR - Google Patents

Abstract

The utility model relates to medical equipment, and can be used in otorhinolaryngology, specifically for the treatment of otitis media in the presence of perforation of the tympanic membrane. A new technical result - increasing the effectiveness of treatment and reducing its time is achieved using the proposed device, which allows controlled drainage and visually controlled aeration of the middle ear cavities. The working part, in which the Siegel funnel 1 is hermetically connected to the optical nozzle 2, through the magnifying glass of which, during the procedure, the changes occurring in the ear canal and the tympanum are visible. On the side surface of the optical nozzle 2 there is an adapter channel 10 used to connect through a polyvinyl chloride tube 7 to a tee 9, to which a pressure gauge 5 and a rubber balloon 3 are connected through another 7.8 polyvinyl chloride tubes by means of which a controlled pressure is created in a sealed system. In this case, the inflammatory block of the anastomosis is eliminated or reduced, the pathological liquid contents are evacuated from the middle ear airways and replaced with atmospheric air.

Description

The utility model relates to medical equipment and can be used in otorhinolaryngology, specifically for the treatment of otitis media in the presence of perforation of the tympanic membrane.

A device for the treatment using vacuum of patients suffering from all types of hearing loss, except purulent otitis media [I]. The device consists of a rarefaction cylinder with a ball valve connected through a tee to a pressure gauge and two tubes ending in rubber olives. Olives are tightly inserted into the external auditory canals and are held there by the patient himself. During the procedure, due to compression of the balloon, a negative pressure is achieved in the auditory canals, which gradually aligns with atmospheric. In this case, the tension of the tympanic membranes decreases, the balance of the auditory ossicles and the sprain are caused.

The disadvantages of the known device are the need for fixation of olives in the external auditory canals by the patients themselves, which reduces the efficiency of use. The device also has a limited scope, due to the fact that the treatment of purulent otitis media and otitis media with perforations with its help is impossible.

Closest to the claimed utility model is a device that allows for metered vacuum therapy in patients with chronic catarrhal and exudative otitis media [2]. The device consists of a Jeanne syringe connected by a connector through a tee to a pressure gauge and individual earmolds located on the stethoscope springs. A Jeanne syringe creates a negative pressure in the external auditory canals, controlled by a manometer. The latter are obstructed by earmolds; system sealing is achieved by stethoscope springs.

The disadvantages of the known device is the lack of visual monitoring of the condition of the tympanic membrane and the mucous membrane of the middle ear, which reduces the effectiveness of the treatment. The disadvantages also include the scope of the device limited only by chronic catarrhal and exudative otitis media: acute and chronic purulent otitis media cannot be treated with it.

A new technical challenge is to increase the effectiveness of treatment by reducing

terms and expansion of scope.

The problem is solved by a new device for drainage and aeration of the middle ear consisting of a tee that connects pressure using a flexible tube, a pressure gauge for measuring it and the working part hermetically connected to the ear canal, and the pressure is created using a rubber balloon "and the working part is a funnel Siegel, equipped with an obturating cuff connected on one side with a syringe for pumping air through a non-return valve, and on the other with optical device.

The device (Fig. 1) consists of: a Siegel funnel (1) with an optical nozzle (2), a 32 ml rubber balloon (3), a mobile obturating cuff with a non-return valve (4), a pressure gauge (5), and a 2 ml syringe ( 6), two PVC pipes with a diameter of 7 mm and a length of 20 mm (7), one PVC pipe with a diameter of 7 mm and a length of 220 mm (8), a tee (9) for connecting the entire device into a single unit and an adapter channel located on the Siegel funnel (10) to connect the latter with a tee (9).

The device works as follows: the position of the patient sitting on a chair. A Siegel funnel (1) is introduced into the membranous-cartilaginous part of the auditory meatus (1) with a pre-worn obturating cuff (4), which is inflated with a syringe (6) until the Siegel funnel is sealed and held in position. An optical nozzle (2) is put on the funnel. On the side surface of the optical nozzle, there is a nick-transition channel (10), used to connect through a PVC pipe (7) with a tee, to which a manometer (5) and a rubber balloon (3) are connected through PVC pipes (7 and 8). Making pressure on a rubber cylinder under the control of gauge indicators up to + 75 mm. Hg. Art., check the tightness of the system. Next, the optical nozzle is disconnected from the Siegel funnel, the rubber balloon is squeezed onto volume, the nozzle is again hermetically attached to the funnel. Under the control of vision through the optical nozzle, changes occurring in the ear canal and tympanum are monitored. Holding back the elastic return to the initial volume of the cylinder wall, create an adjustable negative pressure of up to - 30-75 mm. Hg. Art. Performing additional pressure on the cylinder, create a positive pressure of up to + 30-75 mm. Hg. Art. The alternating atmospheric pressure, controlled by magnitude and time, in the cavities of the middle ear sets in motion liquid and gaseous contents in the direction of the rubber balloon and vice versa. Negative Pressure Content

evacuated from the cavities of the middle ear into the ear canal, flowing down to its lower wall. Further, when equalized to atmospheric pressure, air is drawn from the ear canal into the free cavities of the middle ear. The exudate entering the external auditory meatus from the cavities of the middle ear is removed through the Siegel funnel with an ear pad. Then the optical nozzle is reattached, the procedure is repeated until the pathological contents are removed from the middle ear cavities as much as possible.

The pressure created by a 32 ml rubber cylinder (3) due to the elasticity of its walls is three times less than the average pressure, causing a violation of the integrity of the round window membrane [3], which is a safety condition for the drainage procedure. A pressure gauge (5) is necessary to control the magnitude of the created positive and negative pressure in the cavities of the middle ear. A cuff with a non-return valve (4) is necessary to create a tightness between the ear canal and the Siegel funnel, it also protects the skin of the ear canal from contact and damage by the funnel during the treatment procedure. The required volume of air introduced into the balloon of the mobile cuff (4) with a syringe (6) depends on the diameter of the ear canal and is 0.2-0.4 ml in children and 0.4-1.0 ml in adults.

The device was tested in the office of the ENT specialist of the clinic and the ENT department of the Tomsk City Hospital No. 3 MKLPMU in the treatment of 80 patients with various types of perforated otitis media: 22 patients with chronic purulent otitis media, 20 patients with exudative otitis media, 38 patients with acute purulent otitis media. The use of the proposed device allowed to achieve the cessation of otorrhea in 3-5 procedures both with purulent and catarrhal acute and chronic otitis media. The duration of treatment was reduced by an average of 5-7 days. There were no complications when using this device. In all cases, without the use of surgical treatment, it was possible to achieve an improvement in the course of a chronic disease, or recovery in an acute process. The following clinical examples demonstrate the effectiveness of the device.

Example 1. Patient R., 18 years old, was admitted to the ENT department - a department with complaints of purulent discharge from the right ear, hearing loss and noise in the right ear, headache, fever up to 38 ° C.

From the anamnesis: 3 weeks sick. After hypothermia noted pain in the ear. which decreased slightly the next day. At the same time, purulent discharge from the right external auditory canal appeared. She was treated independently: she instilled dioxin in her ear, and used antipyretic and analgesic drugs in

for 3 weeks, however, there was no effect from treatment. I turned to the ENT specialist - a doctor at the clinic.

When otoscopy in the right external auditory canal is observed viscous purulent discharge coming through linear perforation of the tympanic membrane. The latter is hyperemic, edematous. With acumetry and audimetry, conductive hearing loss was detected on the right. Appointed traditional therapy of acute perforated purulent otitis media. For drainage of the middle ear, the above device was used.

In the first procedure, up to 2 ml of purulent discharge was obtained from the cavities of the middle ear, after which the patient noted a significant improvement in well-being: the feeling of heaviness in the ear disappeared, headaches significantly decreased, and hearing improved.

The procedure for evacuating the middle ear cavities when creating negative and positive pressure was carried out daily. On the third day of treatment, otoscopy of the free discharge in the external auditory canal was not observed. During visual inspection through the Siegel funnel and optical nozzle during use, the device cannot be detached from the deep sections of the middle ear.

The sick-list is closed on the 7th day from the time of the initial visit to the ENT doctor: the hearing has recovered, with otoscopy, the perforation is closed with a tender scar.

Example 2. Patient V., 49 years old, on admission to the ENT department - the department complained of pain and scanty mucopurulent discharge from the left ear, hearing loss, headaches, meager runny nose and nasal congestion. Sick for over 20 years. He was periodically treated both on an outpatient basis and in an ENT hospital. The exacerbation of the disease is associated with the ingress of water into the ear when swimming, as well as with hypothermia.

The last deterioration in health was noted a week ago. Objectively - there is a perforation of the central type in the left tympanic membrane with calloused edges. There is no free discharge in the ear canal. When conducting a Valsalva test, the auditory tube is not passable. Diagnosis: Exacerbation of left-side chronic mesothympanitis.

A standard course of therapy for this disease (antibiotics, antihistamines, etc.) has been prescribed. For drainage of the middle ear, in addition to the vasoconstrictor drops in the nose, the device described above was used. In the first drainage-aeration procedure of the middle ear, up to 3 ml of mucopurulent discharge was obtained. In the next 4 days, a device was used daily, allowing

At the end of the procedure, get the mucous membrane from the deep airway cells of the middle ear. On the 5th day, during the Valsalva test, the patency of the auditory tube was restored. Headaches stopped, hearing improved.

On the 8th day, the patient was discharged from the hospital with improvement. According to extracts from case histories, the average term of hospitalization and outpatient treatment of a patient for this disease was previously 14 days. The last course of therapy using the proposed device has almost halved the time of treatment and achieve stable remission.

Thus, the proposed device allows for controlled drainage and visually controlled aeration of the cavities of the middle ear. In this case, the inflammatory block of the anastomosis is eliminated or reduced, the pathological liquid contents are evacuated from the middle ear airways and replaced with atmospheric air. Controlled atmospheric pressure has a charitable effect on the mucous membrane, improving blood and lymph circulation in it, both by increasing the flow rate and by opening reserve capillaries.

The advantages of the claimed device are as follows: the device is easy to use, safe, has high efficiency in the treatment of various types of acute and chronic otitis media. During the procedure, it is possible to control the treatment process and monitor the condition of the eardrum and the mucous membrane of the tympanic cavity. When using the device, the treatment time for the disease is reduced. The use of the device can be recommended both in outpatient practice and in stationary conditions.

Sources of information used in the preparation of the description:

1. Ioffe N.S. The therapeutic and diagnostic value of the vacuum in the external auditory canals // Journal of ear, nose and throat diseases.-1968.-No. 1.-P.81-84.

2. Karpov V.P. Yenin I.P. Lopotko A.I. The method of dosed vacuum therapy in patients with chronic catarrhal and exudative otitis media and a device for its implementation // No. 2221527, B. I. 01/20/2004.

3. Lebedev Yu.A., Shakhov V.Yu., Polukhina T.A. Transmeatal hyperbaric aerosol therapy in the treatment of certain forms of chronic purulent otitis media // Bulletin of Otorhinolaryngology.-1999.-No. 4.-P.4-7.

4. Tarasov D.I., Fedorova O.K., Bykova V.P. Middle ear disease. - M.: Medicine, 1988.-288s.

Claims (1)

A device for drainage and aeration of the middle ear, consisting of a tee connecting the device that creates pressure, a manometer for measuring it and the working part, hermetically connected to the ear canal, characterized in that the device that creates pressure is made in the form of a rubber balloon, and the working part It is a Siegel funnel equipped with an obturating cuff connected on one side through a non-return valve with a syringe for pumping air, and on the other, with an optical device located on it m