RU59408U1 - DEVICE FOR RESEARCH AND TREATMENT OF MIDDLE EAR DISEASES - Google Patents

Abstract

The utility model relates to medical equipment and can be used in otorhinolaryngology for the diagnosis and treatment of otitis media in the presence of spontaneous or artificial perforation of the tympanic membrane. The proposed device consists of a tee connecting a rubber cylinder to create pressure, a device for measuring pressure and an optical nozzle worn on a Siegel funnel. The Siegel funnel is equipped with an obturating cuff for hermetic connection to the auditory meatus. The cuff is connected through a non-return valve to a syringe for pumping air. The device for measuring pressure is a tympanic manovacuum meter designed and having a scale for measuring: (1) positive pressure from 0 to 80 mm Hg, (2) negative pressure from 0 to (-80) mm Hg (hereinafter, negative pressure is denoted by a negative number in parentheses), (3) the drainage function of the auditory tube and (4) the ventilation function of the auditory tube. The advantages of the proposed device over the prototype due to the use of the tympanic manovacuum meter:

• increasing efficiency in the diagnosis and treatment. According to the indicators of the tympanic manovacuometer, it is possible to accurately dose the positive and negative air pressure in the cavities of the middle ear, to accurately establish the indicators and the degree of violation of the drainage and ventilation functions of the auditory tube. When using the device, the treatment time for the disease, the financial costs of the patient and the medical institution are reduced, complications from the middle and inner ear, intracranial complications are prevented;

• increased safety in the behavior of diagnosis and treatment;

• expansion of opportunities for use;

• increase of convenience in work for the ENT doctor.

Description

The utility model relates to medical equipment and can be used in otorhinolaryngology for the study, diagnosis and treatment of otitis media in the presence of spontaneous or artificial perforation of the eardrum.

Closest to the claimed utility model is a device for transmeatal drainage and aeration of the middle ear with purulent otitis media (Ageenko I.V. et al. Device for drainage and aeration of the middle ear: RF patent for utility model No. 51872; prototype). The prototype device is intended for the treatment of purulent forms of inflammation of the middle ear and allows, in the presence of perforation in the tympanic membrane, to diagnose the state of cavities and channels of the middle ear, to carry out their drainage and aeration.

The prototype device consists of a tee connecting a rubber cylinder creating pressure, a pressure gauge for measuring pressure and an optical nozzle worn on a Siegel funnel. The Siegel funnel is equipped with an obturating cuff connected through a non-return valve with a syringe for pumping air.

A disadvantage of the known device is the use in its composition of a manometer, usually used to measure blood pressure. This pressure gauge is designed to measure only positive values of air pressure from 0 to 300 mm Hg. and has a pitch of 2 mm Hg. There is no scale for measuring negative pressure. In connection with this circumstance, the use of a manometer when creating negative pressure has a number of disadvantages. In addition, there are no scales on the manometer to determine the amount of drainage and ventilation function of the auditory tube. The prototype device is not

was intended for the introduction of medicinal solutions into the cavities and channels of the middle ear.

Utility Model Disclosure

The proposed device for the study and treatment of middle ear diseases consists of a tee connecting a rubber balloon to create pressure, a device for measuring pressure and an optical nozzle worn on a Siegel funnel. The Siegel funnel is equipped with an obturating cuff for tight connection to the ear canal, which is connected through a non-return valve to a syringe for pumping air. A device for measuring pressure is a tympanic manovacuum meter designed and having a scale for measuring: (1) positive pressure from 0 to 80 mm Hg, (2) negative pressure from 0 to (- 80) mm Hg. (hereinafter, negative pressure is denoted by a negative number in parentheses), (3) the drainage function of the auditory tube and (4) the ventilation function of the auditory tube.

The proposed device is presented in figure 1, 2.

The list of figures illustrative material:

Figure 1. The device for the study and treatment of diseases of the middle ear (device for transmeatal research, drainage, aeration and injection of solutions into the middle ear) disassembled.

Figure 2. A device for research and treatment of diseases of the middle ear (a device for transmeatal research, drainage, aeration and injection of solutions into the middle ear) in assembled form.

The proposed device for the study and treatment of diseases of the middle ear consists of: Siegel funnel (1) with an optical nozzle (2); rubber bottle (3) with a volume of 32 ml; an obturating cuff (4) with a non-return valve; tympanic manovacuometer (5) with scales for measuring: positive pressure from 0 to 80 mm Hg, negative pressure from 0 to (-80) mm Hg, drainage and ventilation functions of the auditory tube; two short PVC tubes (6) with outer

diameter 7 mm, inner diameter 4 mm, length 20 mm; one long polyvinyl chloride tube (7) of the same diameter 220 mm long; plastic tee (8) - a plastic tube (9) with an outer diameter of 5 mm, an inner 3 mm, a length of 27 mm for a tight and stable connection of a short PVC pipe with a rubber balloon; syringe (10) with a volume of 2 ml (figures 1, 2).

As already mentioned above, the pressure gauge in the prototype is equipped with a scale for measuring only positive pressure from 0 to 300 mm RT.article. with a pitch of 2 mmHg

Using the tympanic manovacuometer, developed jointly with the Tomsk plant "Manotom", it is possible to measure positive and negative air pressure, determine the state of the air and ventilation function of the auditory tube. The tympanic manovacuometer of the proposed device contains four of the following scales:

1. on the left (when the observer is facing the dial) half of the dial clockwise is a scale for measuring positive pressure from 0 to 80 mm Hg. with a pitch of 1 mm Hg;

2. on the right half of the dial counterclockwise marked scale for measuring negative pressure from 0 to (-80) mm Hg with a pitch of 1 mm Hg;

Scales are designed for maximum pressure values of ± 80 mm Hg. for the reason that positive and negative air pressure in excess of ± 80 mm Hg can lead to destructive disorders in the mucous membrane of the middle ear. In the pressure gauge according to the prototype, there are 160 divisions per half circle of the dial, and 80 divisions in the tympanic manovacuometer. Due to the elongation of the scale and a more fractional step of division, the accuracy of pressure measurement and the convenience for the doctor when using the device increase;

3. on the left half of the dial clockwise in numbers and in color is a scale for measuring the drainage function of the auditory tube. The colors indicate the degrees of her condition:

- 1st degree (excellent condition of the drainage function) corresponds to a range of values from 0 to 15 mm Hg. (not including 15 mmHg). The numerical value corresponds to the magnitude of the generated pressure at which the auditory tube opens (Lebedev Yu.A., Shakhov V.Yu. Criteria for the quantitative assessment of tubular function in patients with secretory otitis media. // Bulletin of otorhinolaryngology. - 1997. - No. 3. - C .30-34). This range is indicated in green;

- 2nd degree (good condition of the drainage function) corresponds to a range of values from 15 to 22 mm Hg. (not including 22 mmHg), this range is indicated in blue;

- 3rd degree (moderate violations of the drainage function) corresponds to a range of values from 22 to 29 mm Hg. (not including 29 mmHg), this range is indicated in yellow;

- 4th degree (severe violations of the drainage function) corresponds to a range of values from 29 to 37 (including 37 mmHg), the range is indicated in red;

- 5th degree (no drainage function) corresponds to a range of values above 37 mmHg to 80 mmHg, this range is indicated in pink;

4. on the right half of the dial counter-clockwise is plotted in numbers and in color for measuring the ventilation function of the auditory tube. The color indicates the degree of her condition. The degree is determined as follows. Create a negative pressure equal to (-22) mm Hg, the patient performs sequentially with an interval of 30 seconds. 5 empty sips and, if occurs:

- equalization of air pressure in the tympanic cavity to 0, which means the ventilation function is in excellent condition (this is the first degree, it is not shown in color);

- equalization of air pressure in the tympanic cavity to any value in the range (-7) -0 mm Hg (excluding 0), then the ventilation function is in good condition (2nd degree, this range is marked in blue);

- equalization of air pressure in the tympanic cavity to any value in the range of (-15) - (- 7) mm Hg, excluding (-7) mm Hg, which means there are moderate violations of the ventilation function (3rd degree, this range is marked in yellow);

- equalization of air pressure in the tympanic cavity to any value in the range (-22) - (- 15) mm Hg (excluding (-22) mm Hg), then there are pronounced violations of the ventilation function (4th degree, the range is marked in red);

- there is no alignment - it means there is no ventilation function (5th degree).

When studying the ventilation function, the initial negative pressure is created equal to (-22) mm Hg. The creation of a higher negative pressure leads to increased closure of the walls of the auditory tube in the membranous-cartilaginous region, and therefore the indications of the ventilation function will be unreliable. To indicate this, the range of scale values is from (-22) to (-80) mmHg. marked in pink.

Due to the presence of a tympanic manovacuometer, the device can be used not only for drainage and ventilation, but also to conduct a qualitative study of the ventilation and drainage functions of the auditory tube, to track the dynamics of their changes during treatment.

In addition, the device can be used to introduce medicinal solutions into the cavities and channels of the middle ear. Earlier for

the introduction of drug solutions used a device for the treatment of diseases of the middle ear (utility model RU 46429 authors Ageenko I.V and others). The disadvantage of this device is that when a medicinal solution is injected into the cavities and channels of the middle ear using a syringe, the doctor judges by the syringe the negative and positive pressure in the cavities and channels of the middle ear. One division of the scale on the syringe (0.1 ml) corresponds to 15-30 mm Hg. Calculations were preliminarily carried out and a correspondence table was created between the displacement of the syringe piston and the pressure created by it. However, firstly, the correspondence was approximate (since it is impossible to accurately determine the volume of the ear canal and air cavities of the middle ear), and secondly, the indirect determination of pressure using tables is inconvenient. Thus, when using RU 46429, it is not possible to precisely control the pressure created.

The proposed device due to the above-described tympanic manovacuum meter solves this problem.

In addition, when using the device according to RU 46429 there is no visual control over the movement of the drug solution in the ear canal and tympanic cavity. In case of pressure overdose, mucosal damage is indicated by the appearance of blood in the syringe.

In the proposed device, you can visually control the nature of the movement of the injected drug solution, its color and transparency when creating variable pressure, which is important for monitoring the safety and effectiveness of the treatment procedure.

The advantages of the proposed device over the prototype due to the use of the tympanic manovacuum meter:

• increasing efficiency in the diagnosis and treatment. According to the indicators of the tympanic manovacuometer, it is possible to accurately dose the positive and negative air pressure in the cavities of the middle ear, to accurately establish the indicators and the degree of violation of the drainage and

ventilation functions of the auditory tube. When using the device, the treatment time for the disease is reduced, complications from the middle and inner ear, intracranial complications are prevented; the financial costs of the patient and the hospital are reduced;

• improving safety during diagnostics and treatment;

• expansion of opportunities for use;

• increase of convenience in work for the ENT doctor.

The device operates as follows.

The first option to use the proposed device

This option is used to drain the cavities and canals of the middle ear; studies of the drainage and ventilation function of the auditory tube; studies of the state of the internal structures of the tympanic cavity, mobility of the tympanic diaphragm, patency of the entrance to the cave of the mastoid process; performing baromassage of the mucous membrane of the middle ear, pneumobuying; revealing granulations hidden in the epitympanum, polyps, cholesteatom, signs of a hidden labyrinth fistula.

In the position of the patient sitting in the membranous-cartilaginous part of the ear canal, a Siegel funnel (1) with a pre-worn obturating cuff (4) is inserted, a syringe (10) with pre-drawn air is connected to the non-return valve. The cuff air balloon is inflated to create a stable tightness between the cuff and the auditory meatus, the cuff and the Siegel funnel. The required volume of air introduced into the air balloon of the cuff obstruction with a syringe depends on the diameter of the ear canal, the size of the ear funnel and is 0.2-0.4 ml in children and 0.4-1.0 ml in adults. Having a swinging effect on the outer part of the funnel, check the stability of its position. Next, an optical nozzle is hermetically connected to the funnel with the rest of the device, which is assembled as follows. On the side surface of the optical nozzle there is an adapter channel to which

a plastic tee (8) is connected through a short PVC pipe (6). A rubber balloon (3) is attached to the tee through the second channel and the second short polyvinyl chloride tube (6), to which the plastic tube (9) is connected in advance. To the third channel of the tee through a long polyvinyl chloride tube (7) is attached a tympanic manovacuometer (5). Squeezing the rubber balloon gradually with the thumb of the right hand, a positive air pressure of up to 75 mmHg is created in the ear canal and tympanic cavity, thereby checking the tightness between the ear canal and the Siegel funnel. The device is ready for use.

The procedure for removing pathological contents from the cavities and channels of the middle ear begins with the fact that the optical nozzle is disconnected from the Siegel funnel, the rubber balloon is compressed to ½ of its volume. Holding the created volume of the balloon with your thumb, the nozzle is again hermetically connected to the funnel. By restraining the elastic return of the wall of the rubber container to the initial volume, negative air pressure is created up to (-75) mm Hg. Performing additional pressure on the cylinder, create a positive air pressure of up to 75 mm Hg. The air pressure created during the procedure is controlled by the parameters of the tympanic manovacuometer and the otoscopic picture in the ear canal and tympanic cavity observed through the optical nozzle of the Siegel funnel.

Alternating exposure to air pressure from (-30) - (- 75) mmHg up to 0 mmHg drives the liquid and gaseous contents in the cavities and canals of the middle ear in the direction of the rubber balloon and vice versa. The liquid contents under the influence of the created negative pressure are evacuated from the cavities and channels of the middle ear into the ear canal, draining under the influence of gravity on its lower wall. To exclude the reverse suction of liquid pathological contents into cavities and channels during equalization of air pressure to

atmospheric (up to 0 mm Hg), their mouths must be passable for air and be located above the evacuated liquid.

Giving the patient's head a position in which the main mouths of the tympanic cavity of the studied ear occupy a more elevated position than the bottom of the ear canal is one of the main conditions for the correctness of the procedure. Pathological fluid that enters 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 cavities and canals of the middle ear as much as possible.

The second option to use the proposed device

This option is used for treatment with medicinal solutions, the introduction of radiopaque substances for subsequent x-ray studies.

In the patient’s position on the side, and the plane of the patient’s ear is parallel to the floor plane, a Siegel funnel (1) with a pre-worn cuff (4) is inserted into the membranous-cartilaginous part of the ear canal. By connecting a syringe (10) with pre-drawn air to the non-return valve of the cuff, inflate its air balloon to create tightness and stable immobility between the cuff and funnel, cuff and auditory meatus. Check the stability of the funnel in a given position. Next, an optical nozzle (2) is tightly connected to the funnel with the rest of the device assembled. Exerting pressure with a thumb on a rubber balloon, gradually create positive air pressure in the ear canal and tympanic cavity up to 75 mm Hg, thereby checking the stability of the position of the device in the ear canal and the tightness of the connection between the cuff and the ear canal. The device is ready for use.

The procedure begins with disconnecting the optical nozzle from the Siegel funnel. A preliminary funnel is inserted into the ear canal through the funnel

heated to 37 ° C drug solution in an amount of from 4-10 drops to 0.5-1 ml. The optical nozzle is again put on the funnel with the rest of the device assembled, having previously reduced the volume of the rubber balloon to ½. Creating alternating pressure in the auditory meatus from (-30) - (- 75) mm Hg up to 0 mm Hg, air is evacuated from the middle ear cavities. Due to the negative pressure arising in the cavities of the middle ear, the drug solution is sucked into them. After filling the cavities of the middle ear with a medicinal solution, alternating negative and positive pressures from (-75) mm Hg are created. up to 75 mm Hg, which is achieved by the additional introduction of a medicinal solution in the middle ear cavity, hydromassage and washing of the mucous membrane and internal structures of the tympanic cavity from pathological contents are performed. In cases where there is patency of the auditory tube, creating in the auditory meatus alternating from (35-75) mmHg up to 0 mmHg air pressure carry out hydro- and then hydropneumobusic treatment of the auditory tube.

The negative air pressure created by a 32 ml rubber cylinder is three times less than the average pressure, which violates the integrity of the membrane of the round window of the cochlea, which is an additional condition for the safety of drainage, aeration, and injection procedures (Lebedev Yu.A., Shakhov V.Yu. ., Polukhina TA Transmeatal hyperbaric aerosol therapy in the treatment of some forms of chronic purulent otitis media. // Bulletin of otorhinolaryngology. - 1999. - No. 4. - P.4-7).

The device and the above methods for its use have been tested in the treatment of 75 patients with various types of otitis media: 35 patients with acute purulent otitis media, stage of perforation (or after paracentesis); 28 patients with chronic purulent otitis media, stage of exacerbation; 12 patients with exudative otitis media after paracentesis. The use of the proposed device in the treatment

the aforementioned patients allowed to achieve the cessation of otorrhea in 2-5 procedures both for catarrhal acute, accompanied by exudation, and for acute and chronic purulent otitis media. The duration of treatment was reduced by an average of 5-8 days. There were no complications when using this device. In all cases, the use of the device improved the diagnosis of the disease, the dynamics of its course during treatment and observation. In all cases, without the use of surgical treatment, it was possible to achieve remission or improvement during a chronic disease, or recovery in an acute process. The following clinical examples demonstrate the effectiveness of the device.

Example 1. Patient P., 40 years old, complained of purulent discharge from the left ear canal, hearing loss and noise in the left ear, throbbing non-intense pain in the back of the ear at night. Discharge from the ear canal occurs mainly at night in the supine position on the side of the affected ear.

From the patient’s history: about a month ago, she went to the ENT doctor in the clinic at the place of residence about the stuffiness of the ear after water got into it when bathing in the pool. On examination, an ENT doctor discovered a sulfur plug. A nurse performed an auditory canal flushing. During the washing, the patient became ill, dizzy, pain in the ear appeared. Dizziness bothered about an hour, the pain subsided, but resumed in the evening. At night, yellow discharge from the ear appeared, the temperature increased to 37.8 ° C. She didn’t turn to the ENT doctor for help again, she was treated on her own: she instilled a 3% solution of hydrogen peroxide and Tsipromed into her ear. Against the background of treatment, a slight improvement was noted. From the anamnesis during a focused survey it turned out that a few years ago her husband hit her left ear with her palm. After the strike were

short pains, noise and hearing loss. A week later, the noise disappeared, and hearing was restored. I did not contact the ENT doctor for help.

With otoscopy, purulent viscous overlays were found in the left external auditory canal, the tympanic membrane was hyperemic, swollen, and perforation was immense. After taking a smear on the microflora and determining its sensitivity to antibiotics, the ear canal toilet is made. With acumetry and audiometry, conductive hearing loss was detected on the left. On radiographs of the temporal bones according to Schuller and Mayer, the veil of the mastoid cells on the left is visible.

Assigned therapy of acute perforated purulent otitis media: 0.1% naphthyzine solution 3-4 drops in the nose, diazolin 0.1 1 tablet 2 times a day, ascorutin 1 tablet 3 times a day.

Locally, for the diagnosis, drainage, aeration, and subsequent administration of a drug solution into the middle ear cavity, the proposed device was used.

On the first day, when performing the procedure according to the first variant of using the device, perforation of the tympanic membrane was found in the anteroposterior quadrant up to 0.3 cm in diameter, and a serous-purulent discharge of up to 0.5 ml was obtained. Patency of the auditory tube was absent.

When performing the procedure according to the second variant of using the device, the tympanic cavity is filled with a solution consisting of 1% dioxidine and dexamethasone phosphate. Patency of the auditory tube is absent.

On the second day, the patient noted that the discharge at night was small, slept well, without waking up. Hearing improved, ear noise decreased. When otoscopy in the ear canal, a small amount of serous-mucous overlays of a grayish-yellow color was found. When performing the procedure according to the first use case, the devices were obtained through perforation of a serous discharge of up to 0.2

ml The drainage patency of the auditory tube corresponds to the IV degree (manovacuometer reading is 30 mmHg), there is no air permeability. Performed a hydroboughening of the auditory tube with a medicinal solution (2nd use of the device). The passage of the drug into the nasopharynx was determined according to the characteristic sensations of the patient in the throat. Symptoms of "failure" of the drug in the nasopharynx were not observed.

On the third day, the patient noted that she slept calmly at night, there was no pain in her ear. On cotton turunda inserted at night, a meager amount of dry, yellowish discharge. The hearing has improved, the noise in the ear is intermittent and not intense. When otoscopy in the ear canal no overlap was found, the eardrum is gray. When performing the procedure according to the first use of the device, a discharge was not received, the drainage and air permeability of the auditory tube are grade III (the reading of the vacuum gauge for the drainage function is 24 mmHg, for the ventilation (-14) mmHg). When performing the procedure according to the second variant of using the device, the doctor quickly noted that the result of buzzing of the auditory tube became positive and more successful when the doctor quickly reduced the volume of medicine and the noise of the passage of air with liquid through the auditory tube

On the fourth day, the patient noted that there was no discharge from the ear during the day, the hearing was restored, the noise disappeared. When otoscopy in the ear canal no overlap was found, the eardrum is gray, perforation is up to 0.3 cm in diameter. When performing the procedure for the first use of the device, no detachable device from the ear was obtained, the drainage and air permeability of the auditory tube are II degree (the reading of the pressure gauge when determining the drainage function is 17 mmHg, when determining the ventilation function (-6) mmHg .). The treatment according to the second embodiment of the use of the device.

On the fifth day, the patient did not complain. When performing the procedure according to the first use of the device, no discharge from the ear was obtained, the drainage and air permeability of the auditory tube are grade I (the pressure gauge for determining the drainage function is 10 mm Hg, and for determining the ventilation function it is 0 mm Hg) Completed treatment (second use of the device). Auditory tube prowling occurred when positive air pressure was created up to 10 mm Hg.

On the sixth day, the patient had no complaints. With otoscopy, the ear canal is pink, no overlap. The eardrum is gray, the perforation is up to 0.3 cm in diameter.

The sick leave is closed on the 7th day. Hearing has recovered, with otoscopy, the perforation is preserved, the diameter is about 0.3 cm, the edges are calloused. Recommended after 6 months in a planned manner myringoplasty of the tympanic membrane.

Example 2. Patient K., 60 years old, turned for help to an ENT doctor regarding discharge from the right ear during the last 2 months, hearing loss and noise in the ear. Sick about 35 years. For help, the ENT doctor at the place of residence did not apply regularly; he was treated mainly on his own. In the last month, two or three times a day, the patient independently cleared the right auditory canal from the liquid contents. The latter exacerbation is associated with hypothermia.

With otoscopy: the ear canal is wide, pink in color; in the lower part of it, in the bone section, purulent deposits of yellow color; hyperemia of the skin. Perforation of the tympanic membrane of the total type with calloused edges. In the tympanic cavity, the mucous membrane is hyperemic, edematous with uneven hypertrophy in the hypo- and mesotympanum. The impurities are purulent, without a fetid odor. Patency of the auditory tube during the test A. Valsalva is absent. Diagnosis: exacerbation of left-sided chronic purulent otitis media, mesotympanitis.

Therapy was prescribed: lomilan 10 mg, 1 tablet 1 time per day, ascorutin 1 tablet 3 times a day after meals. For the diagnosis and treatment of otitis media, the device described above was used. When performing the procedure according to the first variant of using the device, serous-purulent discharge from the epitympanum was obtained in a volume of up to 0.7 ml. Confirmed the lack of patency of the auditory tube. When performing the procedure according to the second variant of using the device, a solution of sodium hypochlorite at a concentration of 700-750 mg / l was introduced in the middle ear cavity, and no signs of drug passage into the nasopharynx were obtained. According to the results of the procedure, the diagnosis of the disease was clarified: exacerbation of left-sided chronic purulent otitis media, epimesotympanitis.

After the third session of the procedures for the first and second use cases, the devices for separation from the auditory meatus stopped. When otoscopy in the tympanic cavity there was only a serous color overlay in a small amount, the drainage patency of the auditory tube is IV degree, there is no ventilation patency.

After completing the 4th and 5th sessions using the overlay device in the tympanic cavity, the mucous membrane was pink. Drainage and ventilation patency of the auditory tube are III degree.

When viewed on the 7th day from the start of treatment, the mucous membrane of the tympanic cavity is pink, there are no overlays. Noise in the right ear decreased, hearing improved. The procedure for the first use of the device is not performed, the discharge is not received, ventilation and drainage patency of the auditory tube are of the III degree.

On the 8th day the patient was discharged from the hospital with an improvement under the supervision of an ENT doctor at the place of residence. According to extracts from case histories, outpatient records, average hospital stay and outpatient

the patient’s treatment for this disease was previously 18 days. The last course of therapy using the proposed device made it possible to achieve a remission of the disease, while halving the time of treatment and the consumption of expensive drugs.

Thus, the proposed device allows for controlled deep drainage and aeration of the middle ear cavities under the control of the tympanic manovacuometer, followed by the deep injection of the drug solution into them. In this case, the inflammatory block of anastomoses is reduced or eliminated, and the liquid pathological contents are evacuated from the middle ear airways with replacement by atmospheric air. The device allows to detect pathological changes hidden in a routine examination and formation in the tympanic cavity, for example, cholesteatoma, polyps in the epitympanum, the place of growth of polyps in the meso- and hypothympanum; to carry out the collection of pathological contents from the deep sections of the middle ear for the study of microflora; to determine the degree of violation of the drainage and ventilation function of the auditory tube, to trace the dynamics of its changes during treatment; perform baromassage of the mucous membrane of the middle ear, pneumo-and hydropneumobuzhdeniya of the auditory tube, hydromassage with washing the mucosa and internal structures of the tympanic cavity from pathological contents; detect manifestations of the hidden fistula of the labyrinth.

The use of the device can be recommended in outpatient practice and inpatient settings.

Claims (1)

A device for research and treatment of diseases of the middle ear, containing a tee connecting a rubber balloon to create pressure, a device for measuring pressure and an optical nozzle mounted on a Siegel funnel equipped with an obturating cuff connected through a non-return valve with a syringe for pumping air, characterized in that The device for measuring pressure is a tympanic manovacuometer designed and having scales for measuring positive pressure from 0 to 80 mmHg, negative pressure from 0 to (-80) mmHg drainage and ventilation function of the auditory tube.