WO1986006970A3 - Fermeture pour tracheotomie - Google Patents

Fermeture pour tracheotomie Download PDF

Info

Publication number
WO1986006970A3
WO1986006970A3 PCT/EP1986/000274 EP8600274W WO8606970A3 WO 1986006970 A3 WO1986006970 A3 WO 1986006970A3 EP 8600274 W EP8600274 W EP 8600274W WO 8606970 A3 WO8606970 A3 WO 8606970A3
Authority
WO
WIPO (PCT)
Prior art keywords
closure according
valve
valve housing
cannula stub
closure
Prior art date
Application number
PCT/EP1986/000274
Other languages
German (de)
English (en)
Other versions
WO1986006970A2 (fr
Inventor
Walter Koss
Ingo F. Herrmann
Original Assignee
Walter Koss
Herrmann Ingo F
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Walter Koss, Herrmann Ingo F filed Critical Walter Koss
Priority to JP61503296A priority Critical patent/JPH0798062B2/ja
Priority to DE8686903317T priority patent/DE3673328D1/de
Publication of WO1986006970A2 publication Critical patent/WO1986006970A2/fr
Publication of WO1986006970A3 publication Critical patent/WO1986006970A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • A61M16/0468—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters with valves at the proximal end limiting exhalation, e.g. during speaking or coughing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2209/00—Ancillary equipment
    • A61M2209/04—Tools for specific apparatus

Definitions

  • the invention relates to a tracheostoma closure according to the preamble of claim 1.
  • a closure is known from DE-GM 83 29 888 and the same DE-OS 34 36 777.
  • patients with a tracheostoma ie an artificial opening leading into the airway in the neck area, can speak in a known manner with the help of a speech or voice prosthesis, which is operative as a connection between the airway and the foodway is used.
  • the tracheostoma must then be closed to speak.
  • patients usually use a finger, which is placed on the opening and prevents the air from escaping at this point.
  • the above-mentioned from the documents known tracheostomy closure provides a proven solution for the 'explained issues. It enables a simple and secure attachment and easy handling by the patient ten.Es are but improvements desirable.
  • the invention is accordingly based on the object of further developing the known tracheostoma closure in such a way that a greater air throughput with a lower overall height and further improved attachment and handling is made possible.
  • the solution to the problem is specified in claim 1.
  • the valve flap enables a large passage cross-section with good and reproducible sensitivity.
  • valve flap and / or its seat made of resilient material, such that the flap after
  • Closing can pass through its seat if the specified dynamic pressure is exceeded. This special training ensures the necessary safety, because a sudden breath, for example when coughing, must always be possible.
  • the valve flap once it has passed through its seat, can be pushed back into its normal position by hand without removing the closure.
  • the security feature can also be implemented in a manner known per se in that the valve housing is plugged onto the cannula stub and can then be coughed up or removed if necessary.
  • the valve flap can be mounted in the lower region of the valve housing in the operating position and can be held in the open position by an additional weight.
  • the valve flap only fulfills its non-return function when a certain flow rate is exceeded during breathing, i.e. the patient wants to close the valve flap arbitrarily by a sudden breath in order to speak.
  • the valve flap can have a magnet which interacts with a further magnet on or in the wall of the valve housing and holds the valve flap in the open state. Magnet should be understood to mean that at least one component of the interacting pair is a permanent magnet.
  • the other component can consist of soft magnetic material, for example an iron plate.
  • a further possibility of keeping the valve flap in the open state up to a certain outflow speed is to urge the flap into the open position by spring force.
  • the spring force can be achieved by mounting the flap itself, for example in the form of a film hinge, or by a separate spring.
  • a development of the invention provides that the bearing point of the valve flap can be displaced in the circumferential direction of the cannula stub.
  • the effective gravity component can then be changed, and in the case of magnets, the displacement of the bearing position changes the magnetic force by changing the opposing effective surfaces of the magnets.
  • valve housing is plugged onto the cannula stub and can be rotated against it.
  • the cannula stub unites in the area of its contact surface with the valve housing has surrounding web. The inner edge of the valve housing then slides on the narrow web instead of on the entire contact surface.
  • a circumferential web can also be arranged in the area of its contact surface with the cannula stub, which snaps behind the web when the valve housing is pressed onto the cannula stub.
  • One of the circumferential webs can also have interruptions without impairing the tightness.
  • valve housing can also be in one piece part of the cannula stub.
  • valve flap is in the form of a thin disc which is connected via a film hinge to a radial extension which is sealingly inserted through a slot in the wall of the valve housing and preferably has a stop which defines and limits the insertion depth.
  • the slot in the circumferential direction of the valve housing can be so wide that the extension of the valve flap can be adjusted in its angular position.
  • the displaceable flange ring in this area has a recess on part of its circumference.
  • the flange ring can also be made of differently hard material in such a way that soft, well-fitting material is present in the region of the arch.
  • an individual shape adaptation of the flange ring to the anatomical conditions is possible.
  • the flange ring can be provided with a radially projecting tab with a bore, which enables the attachment of a band leading to the removable valve housing. The valve housing is then secured against loss. Instead, the valve housing can also be fastened to a radially projecting tab of the cannula stub with a band.
  • the flange rings can then be formed symmetrically so that they are easier to handle by the patient.
  • the closure member consists of a flange.
  • the closing member is a piece of pipe attached to the inner end of the cannula stub and open towards the cannula stub. This presupposes that the trachea is not in the otherwise is usually guided under bending to the stoma, but that the trachea receives a cover after the larynx has been removed and the stoma is guided laterally into the trachea. This also enables a large-lumen stoma with a correspondingly large cross-section of the closure. '
  • the ends of the pipe section are expediently set off at an angle such that the pipe section is shorter on the side opposite the cannula stub.
  • the pipe section advantageously has an opening on the wall opposite the cannula stub.
  • the voice prosthesis can then pass through this opening and the wall of the trachea into the esophagus.
  • Another possibility is to open the tube piece completely on the side opposite the cannula stem, so that a channel-shaped structure is formed instead of the tube.
  • the tracheostoma closure according to the invention is advantageously made of an elastomeric plastic, preferably silicone rubber.
  • the piece of pipe is made of soft material.
  • the sealing washer with its radial extension and the film hinge can also be made from a resilient plastic, in particular a polyacetate resin (POM).
  • POM polyacetate resin
  • FIG. 1 shows schematically and in section the neck and head region of a patient with a tracheostoma, into which a valve closure according to an embodiment of the invention is inserted;
  • FIG. 2 is a front view of a composite
  • Closure according to the invention shows the partially sectioned side view of the closure according to FIG. 2; 4 shows a sectional side view of the closure according to FIGS. 2 and 3 with the flange ring and valve body removed; 5 shows a sectional side view of the valve body with the valve flap inserted for the valve body
  • FIG. 6 is an enlarged view of the valve flap for the closure according to FIGS. 2 to 5; 7 is a view of the flange ring for the closure according to FIGS. 2 to 5; .
  • FIGS. 8 to 5 shows a modified flange ring for the closure according to FIGS. 2 to 5; 9 shows the side view of a further exemplary embodiment of a closure according to the invention.
  • FIG. 10 shows an enlarged section of the closure according to FIG. 9 in the region of the valve body; 11 is an enlarged front view of the valve flap for the closure according to FIGS. 9 and 10; FIG. 12 shows an enlarged side view of the valve flap according to FIG. 11 in the angled state; 13 shows a perspective view of the closure according to FIGS. 9 and 10; 14 shows a perspective view of the closure according to FIGS. 2 to 5 with a modified end member. *
  • FIG. 1 shows schematically how a tracheostomy closure is arranged according to the invention.
  • the airway (trachea) 1 is connected to the outside air via a front opening cut using a template and a stoma 2.
  • a lid 3 made of muscle tissue closes the trachea at the opposite end.
  • a so-called speech or voice prosthesis 5 leads into the feedway, which enables speech even without a larynx.
  • Such prostheses are known. So that the patient can now speak over the speaking prosthesis 5 while breathing out air, the stoma 2 must be closed. This takes place either by placing a finger on it or by means of a valve connection 6.
  • valve closures 6 are described in more detail below.
  • a cannula stub 7 with a pushed-on flange ring 8 and a cup-shaped valve housing 9 is provided.
  • a pipe section 10 with inclined end faces 11 ' At the rear (proximal) end of the cannula stub 7 there is a pipe section 10 with inclined end faces 11 '.
  • the pipe section 10 later lies in the airway 1, and the cannula stub 7 leads through the stoma 2 to the outside.
  • the closure is made entirely of soft elastic material, for example silicone rubber, with a quality approved for medical purposes, the tube piece 10 can also be inserted subsequently into the airway 1 by the stoma 2. But there is also the possibility of the closure during the
  • Flange ring 8 is pressed tightly against the patient's skin.
  • a recess 12 (FIG. 8) can be provided in the lower region of the flange ring 8, which enables better adaptation to the anatomical conditions in the lower region of the stoma 2.
  • the rotatable valve housing 9, which is placed on the cannula stub 7, is connected to the flange ring 8 via a band 13, which leads to a bore 14 (FIGS. 7 and 8) in a radial tab 15, so that it also after the Ab ⁇ pulling from the cannula stub 7 cannot be lost.
  • the band 13 can also be connected to a radial extension 24 of the cannula stub 7 (not shown), so that the flange ring 8 remains free and can be replaced more easily. If the flange ring 8 is rounded symmetrically on both sides (cf. FIG. 9), then it can be placed on the cannula stub as desired in both directions. An easier turn of the
  • Valve housing 9 on the cannula stub 7 is reached by means of a circumferential web 31 in the front area of the cannula stub.
  • the valve housing 9 then slides in 1 essentially on this web 31.
  • a corresponding web 32 on the inside of the valve housing 9 snaps over the web 31 after being plugged in and prevents it from falling off unintentionally.
  • valve housing is located in the lower front area
  • Valve housing 9 is present.
  • the valve flap 18 then has the correct position in the valve housing 9.
  • the "hinge” of the valve flap 18 is a so-called film hinge in
  • the valve flap 18 carries a small and flat magnet 21 in the upper region, which lies for example in a thin-skinned pocket (not shown) and with _ «
  • FIG. 4 Another magner 22 (FIG. 4) is embedded in the inner wall of the cannula 20. If the valve housing 9 is in the fully extended angular position in FIG. 2 and the valve flap is pushed downwards when inhaled, there is a magnetic adhesive effect between the two magnets 21 and 22.
  • the two magnets need to be a permanent magnet.
  • the other can consist of a simple piece of iron with appropriate corrosion protection.
  • the magnetic adhesive force between the magnets 21 and 22 is dimensioned such that only at a ratio
  • valve housing 9 can be rotated to both sides, expediently by gripping a handle 24, in an angular range indicated in FIG. 2 of 50 ", for example.
  • valve flap 18 is made of a flexible material and is dimensioned such that, when a certain dynamic pressure occurs, it overcomes its seat 23 and emerges from the valve housing 9. Instead, the valve housing 9 can be designed so that it automatically presses off when coughing becomes.
  • the valve flap 18 may be also 'provided with * an additional weight, which has, for example, similar in shape to the magnetic 21st
  • the weight and the hinge formation must then be such that the flap 18 rests on the bottom of the cannula stub in the idle state, ie without air flowing through it, and only closes at higher exhalation speeds.
  • a rotation of the valve housing 9 leads to a setting for the air speed at which the closing takes place.
  • the tube piece 10 has an opening 25 in its wall opposite the cannula stub 7, through which the voice prosthesis 5 (see FIG. 1) leads into the closure 6. Instead of the opening 25, the pipe section 10 can also be completely opened, as the perspective view in FIG. 14 shows.
  • the embodiment of FIG. 9 differs from the embodiment described above in that the valve housing 29 is now integrally formed on the cannula stub 7. Otherwise corresponds the valve with its flap 18 and the magnets 21, 22 of the embodiment according to FIGS. 2 to 5. The same applies to the flange ring 8 and the pipe section 10.
  • the valve flap 18 is fastened with its radial extension 17 in the valve housing 29 in that the extension 17 is inserted through a slot 30.
  • the radial extension has two webs 19 as stops, one of which lies outside of the valve housing 29 after the plugging in, and the other lies inside the valve housing 29.
  • the slot 30 is widened in the circumferential direction so that the radial extension 17 in the slot 30 can be displaced in the circumferential direction. This allows the same adjustment as when turning the valve housing 9 in the embodiment according to FIGS. 2 to 5 to achieve.
  • the slot 30 is different .gestaltet from the illustration in Fig. 10 so that "its edges Where the Fortsa tz-19 is not sealingly other place anein-.
  • FIG. 12 shows the valve flap 18 according to FIG. 1 in a side view. 12 shows the rest position, ie the position in which the flap 18 with its extension 17 has been manufactured. As a result, a spring force can additionally be generated via the hinge 20, which urges the valve disk 18 into the rest position according to FIG. 12.
  • FIG. 13 shows the exemplary embodiment according to FIG. 9 again in perspective.
  • the pipe section 10 instead of the pipe section 10 with an opening 25, the pipe section 10 cut open in a channel-shaped manner according to FIG. 14 can also be used here.
  • the tube piece 10 is advantageously made of a soft material so that irritation or even injury to the patient is avoided.
  • FIG. 9 enables a further improvement in this direction by the integrated valve housing 29.
  • Such a reduction in overall height is particularly important for the patient for aesthetic reasons.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Une fermeture pour trachéotomie comprend une soupape (18, 23) volontairement actionnable lors de l'expiration, ce qui permet à la personne de parler. Une section de canule (10) ouverte et introduisible dans l'ouverture de la trachée comprend un bout de canule (7) qui traverse l'ouverture et s'ouvre à l'extérieur, portant sur son côté antérieur un boîtier (9) pour la soupape. Un anneau de bride (8) ajustable entoure le bout de canule (7) et rend étanche l'ouverture de la trachée. La soupape est formée d'un clapet de non-retour (18) agencé de façon pivotable dans le corps (9) de la soupape qui s'ouvre pendant l'inspiration et se ferme pendant l'expiration lorsqu'une vitesse prédéterminée d'écoulement est dépassée.
PCT/EP1986/000274 1985-05-21 1986-05-10 Fermeture pour tracheotomie WO1986006970A2 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP61503296A JPH0798062B2 (ja) 1985-05-21 1986-05-10 気管気孔閉止装置
DE8686903317T DE3673328D1 (de) 1985-05-21 1986-05-10 Tracheostoma-verschluss.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE8514859U DE8514859U1 (de) 1985-05-21 1985-05-21 Tracheostoma-Verschluß
DEG8514859.8U 1985-05-21

Publications (2)

Publication Number Publication Date
WO1986006970A2 WO1986006970A2 (fr) 1986-12-04
WO1986006970A3 true WO1986006970A3 (fr) 1987-04-23

Family

ID=6781302

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1986/000274 WO1986006970A2 (fr) 1985-05-21 1986-05-10 Fermeture pour tracheotomie

Country Status (4)

Country Link
EP (1) EP0221973B1 (fr)
JP (1) JPH0798062B2 (fr)
DE (2) DE8514859U1 (fr)
WO (1) WO1986006970A2 (fr)

Families Citing this family (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL9102095A (nl) * 1991-12-16 1993-07-16 Gijsbertus Jacob Verkerke Tracheostoma-ventiel alsmede weefselconnector en behuizing voor toepassing als onderdeel daarvan.
DE9313765U1 (de) * 1993-09-11 1993-11-25 Eska Medical GmbH & Co, 23556 Lübeck Tracheostoma-Verschluß
DE19636050C2 (de) * 1996-09-06 2001-04-19 Primed Medizintechnik Gmbh Tracheostomaplatzhalter
DE19900712C1 (de) 1998-09-23 2000-08-03 Adeva Medical Ges Fuer Entwick Tracheostoma-Ventil
DE19843527C1 (de) * 1998-09-23 2000-03-02 Adeva Medical Ges Fuer Entwick Tracheostoma-Ventil
US6189534B1 (en) * 1998-10-13 2001-02-20 Mallinckrodt Inc. Bi-functional in-line phonation valve
ES2201578T3 (es) 1999-02-01 2004-03-16 Adeva Medical Gesellschaft Fur Entwicklung Und Vertrieb Von Medizinischen Implantat-Artikeln Mbh Valvula para un traquostoma.
DE10326829B4 (de) * 2003-06-12 2005-09-29 ADEVA - medical Gesellschaft für Entwicklung und Vertrieb von medizinischen Implantat-Artikeln mbH Tracheostomaventil
DE102005020725B3 (de) * 2005-05-02 2006-05-11 Iskia Gmbh & Co.Kg Tracheostomaplatzhalter
JP2007325714A (ja) * 2006-06-07 2007-12-20 Koken Co Ltd 気管切開チューブ
DE202008013257U1 (de) 2008-10-04 2008-12-18 Neubauer, Norbert Tracheostomaplatzhalter
DE202009007342U1 (de) 2009-05-22 2009-08-06 Neubauer, Norbert Tracheostomaplatzhalter
DE202017000842U1 (de) 2017-02-15 2017-03-30 Norbert Neubauer Tracheostomaplatzhalter

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH408292A (fr) * 1964-02-06 1966-02-28 Neuenschwander Rene Obturateur pour canule fenêtrée de trachéotomie
US3721233A (en) * 1970-10-30 1973-03-20 W Montgomery T-shaped tracheal stent
US3952335A (en) * 1974-09-25 1976-04-27 The Aro Corporation Laryngeal prosthesis
US4040428A (en) * 1976-08-30 1977-08-09 The Aro Corporation Control valves for tracheotomy patient or laryngeal prosthesis
EP0078685A1 (fr) * 1981-10-29 1983-05-11 Hansa Medical Products Inc. Appareil destiné à être utilisé dans un tracheotomy stoma
EP0132957A1 (fr) * 1983-06-30 1985-02-13 Bivona, Inc. Dispositif de prothèse vocale

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT1157494B (it) * 1982-12-22 1987-02-11 Marco Rangoni Cannula per intubazione dell'aria a valvola esterna

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH408292A (fr) * 1964-02-06 1966-02-28 Neuenschwander Rene Obturateur pour canule fenêtrée de trachéotomie
US3721233A (en) * 1970-10-30 1973-03-20 W Montgomery T-shaped tracheal stent
US3952335A (en) * 1974-09-25 1976-04-27 The Aro Corporation Laryngeal prosthesis
US4040428A (en) * 1976-08-30 1977-08-09 The Aro Corporation Control valves for tracheotomy patient or laryngeal prosthesis
EP0078685A1 (fr) * 1981-10-29 1983-05-11 Hansa Medical Products Inc. Appareil destiné à être utilisé dans un tracheotomy stoma
EP0132957A1 (fr) * 1983-06-30 1985-02-13 Bivona, Inc. Dispositif de prothèse vocale

Also Published As

Publication number Publication date
DE8514859U1 (de) 1985-07-18
JPH0798062B2 (ja) 1995-10-25
EP0221973B1 (fr) 1990-08-08
WO1986006970A2 (fr) 1986-12-04
DE3673328D1 (de) 1990-09-13
JPS62502875A (ja) 1987-11-19
EP0221973A1 (fr) 1987-05-20

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