SU1725875A1 - Endoprosthesis of the eye orbit inferior wall - Google Patents

Endoprosthesis of the eye orbit inferior wall Download PDF

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Publication number
SU1725875A1
SU1725875A1 SU894767662A SU4767662A SU1725875A1 SU 1725875 A1 SU1725875 A1 SU 1725875A1 SU 894767662 A SU894767662 A SU 894767662A SU 4767662 A SU4767662 A SU 4767662A SU 1725875 A1 SU1725875 A1 SU 1725875A1
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SU
USSR - Soviet Union
Prior art keywords
endoprosthesis
titanium nickelide
plates
orbit
curved plate
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SU894767662A
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Russian (ru)
Inventor
Юрий Алексеевич Медведев
Владимир Кузьмич Поленичкин
Флорид Тимофеевич Темерханов
Виктор Эдуардович Гюнтер
Воля Исаевич Итин
Леонид Абрамович Монасевич
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Новокузнецкий институт усовершенствования врачей
Сибирский физико-технический институт
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Priority to SU894767662A priority Critical patent/SU1725875A1/en
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Publication of SU1725875A1 publication Critical patent/SU1725875A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2875—Skull or cranium
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
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    • A—HUMAN NECESSITIES
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    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
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Abstract

Изобретение относитс  к медицине и может быть использовано в офтальмологии, пластической хирургии. Целью изобретени   вл етс  восстановление бинокул рного зрени , профилактика рубцов и энофталь- ма. Энопротез имеет сферически изогнутую пластину и дополнительно снабжен сферически изогнутой пластиной, ориентированной параллельно. Между ними установлена конусна  спиральна  пружина из сверх эластичного никелида титана. Пластины выполнены из пористого никелида титана. 4 ил.The invention relates to medicine and can be used in ophthalmology, plastic surgery. The aim of the invention is the recovery of binocular vision, scar prevention and enophthalmos. Enoprosthesis has a spherically curved plate and is additionally provided with a spherically curved plate, oriented parallel. Between them there is a conical spiral spring of super elastic titanium nickelide. The plates are made of porous titanium nickelide. 4 il.

Description

Изобретение относитс  к медицине, конкретно к челюстно-лицевой хирургии, и может быть использовано в офтальмологии, пластической хирургии.This invention relates to medicine, specifically to maxillofacial surgery, and can be used in ophthalmology, plastic surgery.

Цель изобретени  - восстановление бинокул рного зрени , профилактика рубцов и энофтальма.The purpose of the invention is the restoration of binocular vision, scar prevention and enophthalmos.

Поставленна  цель достигаетс  тем, что эндопротез нижней стенки глазницы, содержащий сферически изогнутую пластину, снабжен дополнительной сферически изогнутой пластиной, ориентированной параллельно и одинаково с основной, и конусной спиральной пружиной из сверхэластичного никелида титана, концы которой скреплены с пластинами в их средней части, при этом пластины выполнены из пористого никелида титана.The goal is achieved by the fact that the endoprosthesis of the lower wall of the orbit, containing a spherically curved plate, is provided with an additional spherically curved plate, oriented parallel to and the same with the main, and a conical helical spring of super-elastic titanium nickelide, the ends of which are attached to the plates in their middle part, The plates are made of porous titanium nickelide.

На фиг. 1 изображена основна  пластина с пружиной, вид сверху; на фиг, 2 - эндопротез , вид сбоку; на фиг. 3 - то же, перед введением в глазницу; на фиг. 4 - эндопротез в полости глазницы.FIG. 1 shows the main plate with a spring, top view; Fig, 2 - endoprosthesis, side view; in fig. 3 - the same, before the introduction into the orbit; in fig. 4 - endoprosthesis in the cavity of the orbit.

Эндопротез нижней стенки глазницы (фиг. 2 ) содержит основную 1 и дополнительную 2 сферически изогнутые пластины, ориентированные параллельно и одинаково . Со средними част ми пластин 1, 2 скреп- лена концами конусна  спиральна  пружина 3. Основна  1 и дополнительна  2 пластины выполнены из.пористого никелида титана. Пружина 3 выполнена из сверхэластичного никелида титана.The endoprosthesis of the lower wall of the orbit (Fig. 2) contains the main 1 and additional 2 spherically curved plates, oriented parallel and in the same way. With the middle parts of the plates 1, 2, the conical spiral spring 3 is fastened together. The main 1 and additional 2 plates are made of porous titanium nickelide. Spring 3 is made of super-elastic titanium nickelide.

Эндопротез примен ют следующим образом .The endoprosthesis is used as follows.

Производ т разрез кожи по ходу ресничного кра  нижнего века. Подлежащие ткани рассекают строго в подкожном слое, чтобы не травмировать сосуды и тарзальную пластинку. Скелетируют нижнеглазничный край. На всем прот жении раны тупо отодвигают тарзорбитальную фасцию и провод т ревизию нижней стенки глазницы. Удал ют мелкие костные фрагменты, сгустки крови, вправл ют пролабированные м гкие ткани, при наличии рубцов последниеMake a skin incision along the ciliary edge of the lower eyelid. Subject tissue is cut strictly in the subcutaneous layer, so as not to injure the vessels and tarsal plate. Skeletonizing lower ocular margin. Throughout the wound, the tarsorbital fascia is stupidly removed and the lower wall of the orbit is inspected. Small bone fragments, blood clots are removed, prolapsed soft tissues are set in, in the presence of scarring, the last

СWITH

4,four,

иссекают по периметру дефекта. В области нижнего кра  глазницы, латерально от хода подглазничного канала, проделывают два фрезерных отверсти  на рассто нии 5 мм друг от друга и глубиной 3-5 мм. Основную пластину 1 моделируют по форме дефекта, а конусную спиральную пружину 3 - по необходимой высоте подн ти  глазного  блока . Пластины эндопротеза 1, 2 сжимают специальным зажимом до рассто ни , равного сечению витка пружины. Конусность пружины 3 предотвращает перехлыст витков . В таком положении эндопротез ввод т в полость глазницы. Основную пластину 1 фиксируют к нижнеглазничному краю скобкой 4 из никелида титана с пам тью формы (фиг. 4), внедр   концы скобки в указанные отверсти , Рану промывают антисептиками , послойно ушивают и. дренируют. Первична  фиксаци  основной пластины обеспечиваетс  за счет компрессии скобки 4, при этом сила трени  на контакте кость - пористый никелид титана преп тствует миграции пластины. В дальнейшем надежна  фиксаци  основной пластины обеспечиваетс  в результате прорастани  ее костной тканью. Фиксаци  дополнительной пластины 2 к стенке глазного  блока первично обеспечиваетс  силой трени  в результате возвратного , действи  пружины 3. В дальнейшем пластина 3 прорастает соединительной тканью, интегриру сь в ткан х, окружающих глазное  блоко. Упругость и гибкость пружины 3 обеспечивает имитацию естественной упругости утраченных мышц и св зок . В ходе реабилитации у больного вырабатываетс  обеспечивающа  бинокул рное зрение подвижность глаза сохранившимис  мышцами и св зками.excised around the perimeter of the defect. In the region of the lower edge of the orbit, lateral to the course of the infraorbital canal, two milling holes are made at a distance of 5 mm from each other and a depth of 3-5 mm. The main plate 1 is modeled according to the shape of the defect, and the tapered helical spring 3, according to the required height of the eye block. The endoprosthesis plates 1, 2 are compressed with a special clamp to a distance equal to the cross section of the spring coil. The taper of the spring 3 prevents overlapping turns. In this position, the endoprosthesis is inserted into the cavity of the orbit. The main plate 1 is fixed to the lower orbital edge with a titanium nickelide bracket 4 with a shape memory (Fig. 4), inserting the ends of the bracket into the indicated holes. drained. The primary fixation of the main plate is ensured by compressing the bracket 4, and the frictional force on the bone – porous titanium nickelide friction prevents the plate from migrating. In the future, reliable fixation of the main plate is provided as a result of its growth by bone tissue. The fixing of the additional plate 2 to the wall of the eye block is primarily provided by friction force as a result of the return action of the spring 3. Subsequently, the plate 3 grows through connective tissue, integrating into the tissues surrounding the eye block. The elasticity and flexibility of the spring 3 provides an imitation of the natural elasticity of the lost muscles and ligaments. During rehabilitation, the patient develops binocular vision, eye mobility with preserved muscles and ligaments.

Пример (клинический). Больна  51 г поступила в клинику челюстно-лицевой хирургии 10.11.87с жалобами на эстетический дефект лица, двоение изображени , затруднение носового дыхани . В анамнезе т жела  черепно-лицева  травма 29.08.87.An example (clinical). Sick 51 g was admitted to the clinic of maxillofacial surgery 10.11.87 with complaints of aesthetic defect of the face, ghosting, difficulty of nasal breathing. History of cranio-facial injury 29.08.87.

Первична  реконструкци  не проводилась. На основании клинико-рентгенологическо- го и офтальмологического исследований ус- тановлен диагноз: деформаци Primary reconstruction was not carried out. Based on clinical, radiological and ophthalmologic studies, diagnosis was made: deformity

носо-орбито-скулового комплекса справа, травматический эно- и гипофтальм, ограничение открывани  рта. Под эндотрахеаль- ным наркозом 18.11.87 проведена операци : рефрактура и остеосинтез скулового комплекса справа, устранение дефектаnasal-orbit-zygomatic complex on the right, traumatic eno- and hypophthalmos, restriction of mouth opening. Under endotracheal anesthesia, on 18.11.87, an operation was performed: refracture and osteosynthesis of the zygomatic complex on the right, elimination of the defect

0 нижней стенки глазницы и репозици  глазного  блока с помощью эндопротеза из пористогоникелидатитана . Послеоперационное течение гладкое, заживление ран первичным нат жением. В ре5 зультате проведенной операции устранена деформаци  глазницы и восстановлено бинокул рное зрение. Контрольные осмотры через 6, 12, 18 мес показали эффективность проведенного хирургического лечени .0 the lower wall of the orbit and reposition of the eye block with the help of an endoprosthesis made from poristogonickelidatitan. The postoperative course is smooth, wound healing by primary tension. As a result of the operation, the deformity of the orbit was eliminated and binocular vision was restored. Control examinations after 6, 12, 18 months showed the effectiveness of surgical treatment.

Claims (1)

0 Эффективность использовани  предлагаемого эндопротеза состоит в снижении травматичности за счет малой толщины устройства в момент установки; в создании благопри тных условий дл  течени  репара- тивных процессов в окружающих эндопро5 тез ткан х за счет отсутстви  антигенной активности и сходства механических характеристик никелида титана и биологических тканей; снижени  в св зи с этим веро тности послеоперационных осложнений. Формула изобретени 0 The effectiveness of the proposed endoprosthesis is to reduce the morbidity due to the small thickness of the device at the time of installation; in creating favorable conditions for the reparative processes in the surrounding endoprotic tissues due to the absence of antigenic activity and the similarity of the mechanical characteristics of titanium nickelide and biological tissues; reducing the likelihood of postoperative complications. Invention Formula 0 Эндопротез нижней стенки глазницы, содержащий сферически изогнутую пластину , отличающийс  тем, что. с целью восстановлени  бинокул рного зрени  путем профилактики рубцов и энофтальма, он0 The endoprosthesis of the lower wall of the orbit, containing a spherically curved plate, characterized in that. in order to restore binocular vision by preventing scarring and enophthalmos, he 5 снабжен дополнительной сферически изогнутой пластиной, ориентированной параллельно и одинаково изогнутой с основной, и конусной пружиной из сверхзластичного никелида титана, концы которой скреплены с пластинами в их средних част х, при этом5 is provided with an additional spherically curved plate, oriented parallel to and equally curved with the main one, and with a conical spring of super-elastic titanium nickelide, the ends of which are fastened to the plates in their middle parts, 0 пластины выполнены из пористого никелида титана.0 plates are made of porous titanium nickelide. Фиг iFig i Фиг. 2FIG. 2 Фцг. ЗFzg H ЩрЗЙ%/ SHRZY% / . .. . Фиг, 4FIG 4
SU894767662A 1989-12-11 1989-12-11 Endoprosthesis of the eye orbit inferior wall SU1725875A1 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5522889A (en) * 1995-01-13 1996-06-04 University Of Kentucky Research Foundation Apparatus and method for restoring eyelid function
EP0781531A1 (en) * 1995-12-28 1997-07-02 Raymond-René Derycke Process and apparatus for facilitating bone growth, in particular for dental and maxillo-facial surgery and apparatus for carrying out the process
US6511508B1 (en) * 2000-08-04 2003-01-28 Environmental Robots, Inc. Surgical correction of human eye refractive errors by active composite artificial muscle implants

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
Александров Н.Т. Травма челюстно-лицевой области. М., 1986, с. 267. *

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5522889A (en) * 1995-01-13 1996-06-04 University Of Kentucky Research Foundation Apparatus and method for restoring eyelid function
EP0781531A1 (en) * 1995-12-28 1997-07-02 Raymond-René Derycke Process and apparatus for facilitating bone growth, in particular for dental and maxillo-facial surgery and apparatus for carrying out the process
FR2742982A1 (en) * 1995-12-28 1997-07-04 Derycke Raymond Rene METHOD AND DEVICE FOR FACILITATING BONE GROWTH, IN PARTICULAR DENTAL SURGERY AND MAXILLO-FACIAL SURGERY AND DEVICE FOR CARRYING OUT SAID METHOD
US6511508B1 (en) * 2000-08-04 2003-01-28 Environmental Robots, Inc. Surgical correction of human eye refractive errors by active composite artificial muscle implants
US7090696B2 (en) 2000-08-04 2006-08-15 Environmental Robots, Inc. Surgical correction of human eye refractive errors by active composite artificial muscle implants

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