WO2012056752A1

WO2012056752A1 - Bite block

Info

Publication number: WO2012056752A1
Application number: PCT/JP2011/059384
Authority: WO
Inventors: 啓介細谷; 崇至趙; 昭裕森本
Original assignee: Hosotani Keisuke; Cho Soongji; Morimoto Akihiro
Priority date: 2010-10-25
Filing date: 2011-04-15
Publication date: 2012-05-03

Abstract

A bite block for preventing the occlusion and deviation of the insertion position of an endotracheal tube at the lips is configured from a tubular main body extending in the axial direction, and a maxillary flange and a mandibular flange disposed on the outer surface of said tubular main body. The respective flanges are disposed at positions that are separated from each other in the axial direction of the tubular main body. With the bite block, alignment with and affixing of the endotracheal tube is easy and it is possible to reduce the risk of generating ulcers in the oral mucosa, etc.

Description

Byte block

The present invention relates to a bite block used for protecting an endotracheal intubation tube inserted from the mouth of a patient or the like toward the trachea.

During surgery under general anesthesia or when treating severely ill patients with difficult spontaneous breathing, insert a tube (intratracheal intubation tube) from the patient's mouth into the trachea and breathe using a ventilator. Assistance is done. At that time, in order to prevent obstruction of the tube caused by the patient or the like crushing the inserted endotracheal intubation tube or displacement of the tube, a medical instrument called “bite block” is used (Patent Document 1). , 2 etc.).

FIG. 3 is a diagram showing a configuration of a conventional general byte block.
The bite block 30 shown in this figure includes a substantially cylindrical main body 31 and a flange portion 32 disposed on the outer peripheral surface 31a of the main body 31, and uses an elastic material or hard material such as resin or rubber, It is formed so as to have a rigidity that does not cause biting.

The cylindrical main body 31 has a hollow cylindrical shape as a whole, and one end side in the longitudinal direction (axial direction) (the distal end side in use, the pharynx side) is easy to insert into the oral cavity. The outer diameter is formed in a tapered portion 31c that gradually becomes smaller (tapered) toward the end. In addition, the outer peripheral surface 31a is formed in a shape substantially in line with the shape when the mouth (lips) is opened, such as a circular shape, an elliptical shape, an oval shape, and the inner periphery (hollow portion 31b). A hole that can be used for treatment such as suction of saliva in the oral cavity is formed.

The flange portion 32 of the bite block 30 is integrated with the outer peripheral surface 31a of the main body at a position on the other end side (the rear end side in use, the lip side) of the outer peripheral surface 31a of the cylindrical main body 31. Or it is attached and arranged afterwards, and the shape is formed in a disc shape such as a collar protruding from the outer peripheral surface 31a, or a substantially circular or elliptical shape. As shown in FIG. 3, the flange portion 32 is provided with a notched (dented) tube housing portion 32a, and the endotracheal intubation tube previously inserted into the trachea is replaced with the tube housing portion 32a. The endotracheal intubation tube can be positioned by fitting into the concave shape.

When using the bite block 30, the endotracheal intubation tube is inserted into the trachea of a patient or the like prior to insertion of the bite block 30 into the oral cavity. Next, the distal end (taper 31c) side of the cylindrical main body 31 of the bite block is inserted into the oral cavity in such a way as to cause a patient or the like to feel it. As shown in FIG. 4, the upper and lower ends of the flange portion 32 of the bite block are placed between the upper lip of the patient and the upper jaw front teeth, and between the lower lip and lower jaw front teeth (both are “oral vestibule”). The tube accommodating portion 32a of the flange portion 32 is rotated and arranged on the appropriate side in the left-right direction of the oral cavity, and the endotracheal intubation tube 40 is fitted into the tube accommodating portion 32a. In this state, the bite block 30 and the endotracheal intubation tube 40 are fixed using a tape, a band, or the like, so that the tube 40 is protected (clogging prevention) and is prevented from being displaced. .

The tube housing portion 32a may be formed as a hole that penetrates the flange portion 32. In addition, the tube housing portion 32a is provided on the outer peripheral surface 31a of the cylindrical main body 31 as a flat portion or a concave groove along the longitudinal direction, or the inner peripheral hollow portion 31b of the cylindrical main body. May also be used. When combined, the tracheal tube, the endotracheal intubation tube and the like are inserted through the hollow portion 31b.

JP-A-8-47535 JP 2001-190675 A

By the way, when the bite block is used, the endotracheal intubation tube does not follow the bite block and it may be difficult to fix the bite block. The reason is considered as follows. In other words, when inserting a bite block into the oral cavity, the mouth (lip) of the patient or the like is usually wide open so that the flange part of this bite block is inserted between the lips and the front teeth (oral vestibule). (The lower jaw is pulled out from the usual position). After that, in order to fix the bite block and the endotracheal intubation tube, the mouth of the patient or the like is closed until the upper and lower front teeth come into contact with the cylindrical body of the bite block. Due to the retreat, there is a shift in the engagement (biting) of the upper and lower jaw front teeth.

At this time, since the flange portion 32 of the conventional bite block 30 is formed in the same shape in the axial direction of the cylindrical main body in a bowl shape or a disk shape as described above, as shown in FIG. The flange portion 32 is tilted with the meshing deviation, and as a result, the entire bite block 30 including the cylindrical main body is tilted and is left in the oral cavity. Thus, when the bite block 30 is tilted and placed, the angle does not coincide with the endotracheal intubation tube 40 previously inserted into the oral cavity, and the endotracheal tube 32 of the flange portion 32 is inserted into the endotracheal tube. The intubation tube 40 is difficult to fit.

Further, as described above, the conventional bite block has a distal end portion (pharyngeal side detail 31c) of the cylindrical main body 31 that moves toward the upper jaw direction (or, rarely, the lower jaw direction). Since the tip part presses the part (X position in FIG. 4) which contacted in the oral cavity, there exists a possibility that an ulcer may generate | occur | produce in this part. Further, it has been reported that the flange portion 32 presses the upper lip (rarely the lower lip) due to this inclination, and an ulcer is also generated on the inner side of the lip (positions Y and Y ′ in FIG. 4). Is desired.

The present invention has been made in view of such circumstances, and it is easy to fix along an endotracheal intubation tube and can reduce the risk of ulcers occurring in the mucous membrane in the oral cavity. The purpose is to provide.

In order to achieve the above object, the present invention provides a bite block for preventing occlusion of an endotracheal intubation tube at the lip region and preventing displacement of the insertion position, a cylindrical main body extending in the axial direction, and the cylinder The upper jaw flange portion and the lower jaw flange portion disposed on the outer surface of the cylindrical body, and the upper jaw flange portion and the lower jaw flange portion, when viewed from the axial direction of the cylindrical body, The flange portions are provided at positions facing each other with the shaft interposed therebetween, and the flange portions are arranged at a distance from each other in the axial direction of the cylindrical main body according to a shift in meshing between the maxillary dentition and the mandibular dentition. It is characterized by that.

Further, the bite block of the present invention is provided with an insertion point whose outer diameter gradually decreases toward the end on one end side in the axial direction of the cylindrical main body, and the upper flange portion and the lower jaw flange. A configuration in which at least one of the portions is formed in a shape that inclines toward the tapered side from the root portion on the cylindrical main body side to the distal end portion on the outer diameter side is suitably employed.

Furthermore, the bite block of the present invention may be formed such that at least one of the upper jaw flange portion and the lower jaw flange portion is curved along the upper jaw front teeth row or the lower jaw front teeth row. .

On the other hand, in the bite block of the present invention, when the upper flange portion and the lower flange portion are viewed from the axial direction of the cylindrical body, the circumferential positions of the flange portions around the cylindrical body are: A tube housing portion that is formed so as not to overlap with each other, and a circumferential region sandwiched between the upper jaw flange portion and the lower jaw flange portion allows the endotracheal intubation tube to be inserted in the axial direction along the cylindrical main body. The structure formed in (4) can be suitably employed.

In the present invention, the flange part of the bite block arranged in the oral vestibule is divided into one for the upper jaw and one for the lower jaw from the single bowl type (disc type) in the conventional product at the time of use. It is intended to achieve the intended purpose by providing a front-rear difference corresponding to the "difference in meshing of the upper and lower jaw front teeth" that occurs when a person closes the mouth at the position where each flange portion is formed. .

That is, the bite block of the present invention is provided with two flange portions for the upper jaw and the lower jaw on the outer peripheral outer surface of the cylindrical main body, and these flange portions are used for meshing (biting) of the upper jaw front teeth and the lower jaw front teeth. According to the difference, the cylindrical main body is formed with a distance in the axial direction (shifted in the axial direction). Therefore, in this bite block, the upper jaw flange is inserted between the upper lip and the upper anterior teeth, the lower jaw flange is inserted between the lower lip and the lower anterior teeth, and the upper anterior teeth and the lower anterior teeth are cylindrical. Even when the mouth is closed until it hits the main body (when the cylindrical main body is left in the oral cavity), the distal end (back side) of the cylindrical main body is kept straightly inserted toward the pharynx side. Therefore, this bite block has the same insertion angle as the endotracheal intubation tube that has been previously inserted into the oral cavity, and the endotracheal intubation tube can be easily and easily disposed along the bite block. . Therefore, the bite block of the present invention can easily fix the endotracheal intubation tube at a predetermined position and can reliably prevent crushing by teeth or the like.

Furthermore, since the bite block maintains the state where the tip (back side) of the cylindrical body is inserted straight toward the pharynx side even when the mouth is closed as described above, It is suppressed that a part contacts or presses the mucous membrane etc. in the oral cavity. Thereby, the bite block of this invention can reduce the risk that an ulcer will generate | occur | produce in the mucous membrane etc. in an oral cavity.

Further, in the bite block of the present invention, an insertion detail with an outer diameter gradually decreasing toward the end is provided on one end side in the axial direction of the cylindrical main body, and the flange portion for the upper jaw and the lower jaw The bite block in which at least one of the flange portions for use is formed in a shape that inclines toward the tapered side from the root portion on the cylindrical main body side to the distal end portion on the outer diameter side, The portions become more consistent with the shape of the maxillary anterior teeth or the mandibular anterior teeth, and it becomes easier to fix the endotracheal intubation tube in place. In addition, the upper jaw flange portion or the lower jaw flange portion is alleviated from being pressed against the oral vestibule, the inside of the lip, and the like, and the occurrence of ulcers at this portion can be more reliably prevented.

Further, in the bite block of the present invention, at least one of the upper jaw flange portion and the lower jaw flange portion is curved along the maxillary anterior dentition or the anterior dentition of the lower jaw (that is, on the insertion detail side). The bite block that is inclined and has a shape that wraps around the mouth in the left-right direction along the shape of the oral vestibule) has an upper jaw flange portion and / or a lower jaw flange portion depending on the shape of the anterior teeth and the oral vestibule. Match exactly. Therefore, the bite block of the present invention makes it easier to fix the endotracheal intubation tube and can almost completely suppress the occurrence of ulcers in the oral mucosa.

In the bite block of the present invention, when the upper jaw flange and the lower jaw flange portion are viewed from the axial direction of the cylindrical body, the circumferential positions of the flange portions around the cylindrical body are mutually A circumferential region sandwiched between the upper jaw flange portion and the lower jaw flange portion is formed so as not to overlap with the tube storage portion for allowing the endotracheal intubation tube to be inserted in the axial direction along the cylindrical body. The formed bite block can be easily fixed along the bite block by inserting the endotracheal intubation tube to be protected by the bite block into either the left or right position of the bite block.

In consideration of the meshing direction of the maxillary anterior teeth and the mandibular anterior teeth and the accommodation position of the endotracheal intubation tube, the maxillary flange portion and the mandibular flange portion sandwich the central axis in the axial direction of the cylindrical body. It is the most rational arrangement in terms of configuration that the regions on the left and right sides of the cylindrical main body, which are arranged at opposing positions, are used as the tube housing portion.

Further, at least one of the upper jaw flange portion and the lower jaw flange portion may be formed to be movable in the axial direction of the cylindrical main body. By sliding the flange portion in the axial direction in this way, it is possible to deal more closely with the “individual difference” of the engagement of the upper and lower jaw front teeth, that is, individual differences in the lip shape and intraoral shape. Thus, the risk of developing ulcers in the oral cavity can be further reduced.

Further, a mark for identifying the upper jaw flange portion and the lower jaw flange portion may be formed on the bite block. This mark prevents a wrong direction (vertical direction) when inserting the byte block. Therefore, anyone can place this byte block in an appropriate position, and medical errors can be prevented.

They are the top view (a), side view (b), and axial end view (c) seen from the insertion direction of the bite block in the first embodiment of the present invention. It is the top view (a) and side view (b) of the bite block in 2nd Embodiment of this invention. It is a perspective view which shows the structure of the conventional bite block. It is a figure explaining the use condition of the conventional byte block.

Next, embodiments of the present invention will be described in detail with reference to the drawings. However, the present invention is not limited to this embodiment.

1A and 1B are diagrams showing a configuration of a bite block 1 according to a first embodiment of the present invention, where FIG. 1A is a top view, FIG. 1B is a side view, and FIG. FIG. The z direction in the figure represents the vertical direction when the byte block 1 is used. The axial direction (dashed line) of the cylindrical main body 11 coincides with the longitudinal direction (x direction) of the bite block 1 and indicates the direction of insertion into the lips.

The basic structure of the bite block 1 in the first embodiment is the same as that of the conventional bite block (30), and a substantially cylindrical main body 11 and a flange (12a) disposed on the outer surface 11a of the main body 11 are used. 12b). As shown in FIG. 1 (c), the bite block 1 is characterized in that the flange is divided into two upper and lower flange portions (upper jaw flange portion 12a and lower jaw flange portion 12b). As shown in FIG. 1B, the lower jaw flange portion 12b is disposed with a distance L (5 mm in this example) in the axial direction (x direction in the drawing) of the cylindrical main body 11 and shifted in position. It is a point.

Another feature of the bite block 1 according to the first embodiment is that the outer diameter of the bite block 1 is gradually reduced toward one end side (x side in the drawing) of the cylindrical body 11 toward the end portion. A tip detail 11c is provided, and the upper flange portion 12a on the upper side of the figure extends from the root portion (12a ₁ ) on the cylindrical main body 11 side to the distal end portion (12a ₂ ) on the outer diameter side along the inclination of the maxillary anterior dentition. and _(in this example 10 degrees) predetermined angle theta ₁ is formed so as to be inclined, the flange portion 12b for the lower jaw shown lower side, the outer diameter side from the root portion of the cylindrical main body 11 side (12b ₁₎ It is a point formed so as to incline at a predetermined angle θ ₂ (5 degrees in this example) along the inclination of the lower jaw front tooth row over the distal end portion (12b ₂ ).

The preferred range of the axial distance L between the upper jaw flange portion 12a and the lower jaw flange portion 12b varies depending on adults, children, etc., but is generally 1 to 20 mm, preferably 2 to 10 mm. More preferably, it is about 3 to 6 mm.

Further, the angle θ _{1 at which the} upper flange portion 12a is inclined toward the tapered portion 11c side of the cylindrical main body 11 from the base portion (12a ₁ ) on the cylindrical main body 11 side to the distal end portion (12a ₂ ) on the outer diameter side. Is preferably 1 to 30 degrees, more preferably 5 to 15 degrees, and ideally around 10 degrees. Similarly, the angle θ at which the lower jaw flange portion 12b is inclined toward the tapered portion 11c side of the cylindrical body 11 from the base portion (12b ₁ ) on the cylindrical body 11 side to the distal end portion (12b ₂ ) on the outer diameter side. ₂ is preferably from 1 to 30 degrees, more preferably from 1 to 10 degrees, and ideally around 5 degrees.

The configuration of the bite block 1 will be described in more detail. The cylindrical main body 11 has a hollow cylindrical shape as a whole, and is one end side in the longitudinal direction (axial direction) (the distal end side in use and the pharynx side: The right side in the figure is a small diameter tapered tip 11c so that insertion into the oral cavity is easy. Further, the outer shape of the outer surface 11a (axial cross section) is a substantially square shape, and the corners thereof are rounded. In addition,

concave portions

11d and 11d for fixing the endotracheal intubation tube along the side surfaces of the cylindrical main body 11 are formed, and saliva in the oral cavity is formed on the inner periphery (hollow portion 11b). A hole that can be used for treatment such as suction is formed. A tube can be inserted into the hollow portion 11b.

Further, the upper jaw flange portion 12a and the lower jaw flange portion 12b are arranged around the cylindrical main body 11 when viewed from the axial direction (x direction) of the cylindrical main body 11 as shown in FIG. The cylinders are formed so that the directional positions do not overlap each other (in this example, at positions facing each other across the central axis), and are sandwiched between the upper jaw flange portion 12a and the lower jaw flange portion 12b. A circumferential region (space S, S ′) around the cylindrical main body 11 is integrated with the

recesses

11 d, 11 d, and an endotracheal intubation tube can be inserted along the cylindrical main body 11 in the axial direction. It is a “tube housing part”.

When the bite block 1 is viewed from the axial direction (x direction) of the cylindrical body 11, the bite block is formed on the outer (outer lip) end surface of the cylindrical main body 11 as shown in FIG. The mark M which shows the upper and lower sides (top and bottom) of the usage direction is provided.

Even when the bite block 1 having the above-described configuration is used, the endotracheal intubation tube is inserted into the trachea of a patient or the like prior to insertion of the bite block 1 into the oral cavity. Next, the distal end side (the tapered detail 11c on the right side of the figure) of the cylindrical body 11 of the bite block is inserted into the oral cavity so as to be lifted by a patient or the like. Then, the upper flange portion 12a of the bite block 1 is sandwiched between the upper lip of the patient or the like and the upper jaw front teeth, and the lower jaw flange portion 12b is sandwiched between the lower lip and the lower jaw front teeth (see FIG. 4). In this state, it arrange | positions so that the endotracheal intubation tube may be inserted in either of the recessed

parts

11d and 11d of the said cylindrical main body 11 side surface.

Here, when the bite block 1 is inserted into the oral cavity, as described above, the bite block 1 is placed on the end surface outside the lip of the cylindrical main body 11 (that is, the position not hidden by the lip of the patient or the like). Since the mark M indicating the upper and lower sides (top and bottom) of the use direction is provided, medical personnel or the like who insert the bite block 1 do not make the insertion direction wrong and put the bite block 1 in an appropriate direction. Can be inserted.

Further, the flange of the bite block 1 is divided into a flange portion 12a dedicated to the upper jaw and a flange portion 12b dedicated to the lower jaw, and a “difference in meshing between the upper and lower jaw front teeth, which occurs when a person closes his / her mouth between them. The bite block 1 is placed in the oral cavity as described above even when the patient's mouth is closed as described above. The state where the tip (back side) of the main body 11 is inserted straight toward the pharynx side is maintained. Therefore, in this bite block 1, the endotracheal intubation tube can easily be along the recess 11d on the side surface of the cylindrical main body 11 and the tube housing portion, and the endotracheal intubation tube can be easily fixed.

Further, in the bite block 1 of the present embodiment, the upper jaw flange portion 12a and the lower jaw flange portion 12b are arranged along the inclination of the oral vestibule caused by “the difference in meshing between the upper jaw anterior teeth and the lower jaw anterior teeth”. Therefore, no pressure is applied to the upper lip and the lower lip, and the inside of these lip portions, and it can be maintained without difficulty. As a result, even if the bite block 1 in this embodiment is used for a long time, there is no occurrence of ulcers in the oral mucosa and the inside of the lip, and it can be used safely.

And since the area | region (space S, S ') pinched | interposed into the flange part 12a for upper jaws and the flange part 12b for lower jaws is formed in the tube accommodating part, the said endotracheal intubation tube is followed along the cylindrical main body 11. FIG. And can be inserted through either the left or right side.

Next, a second embodiment of the present invention will be described.
2A and 2B are diagrams showing the configuration of the byte block 2 in the second embodiment of the present invention, where FIG. 2A is a top view and FIG. 2B is a side view. As in the first embodiment, the illustrated vertical direction (z direction) indicates the vertical direction when the bite block 2 is used. Further, it is assumed that the axial direction (one-dot chain line) of the cylindrical main body coincides with the longitudinal direction (x direction) of the bite block 2.

The bite block 2 in this embodiment is different from the bite block 1 in the previous first embodiment in that the upper jaw flange portion 22a and the lower jaw flange portion 22b are slidable in the axial direction of the cylindrical main body 21. It is a point that is formed. 2 is a concave groove provided on the outer surface 21a of the cylindrical main body 1 for supporting the

flange portions

22a and 22b so as to be slidable. Reference numeral 21f is a

flange portion

22a and 22b. It is a multi-stage part for positioning (temporarily fixing) in the axial direction.

By making each

flange portion

22a, 22b slidable in the axial direction in this way, it is possible to deal more closely with "individual differences" in the meshing of the maxillary anterior teeth and mandibular anterior teeth, that is, individual differences in the lip shape and intraoral shape. It becomes possible to do. Therefore, the bite block 2 can more easily fix the endotracheal intubation tube along the bite block 1 and can further reduce the risk of ulcer occurrence in the oral cavity.

Further, another feature of the bite block 2 in the present embodiment is that, as shown in FIG. 2 (b), the above-mentioned sliding upper jaw flange portion 22a is curved along the outer shape of the upper front teeth row. The lower jaw flange 22b is formed in a shape that curves along the outer shape of the lower jaw front teeth row. That is, the upper jaw flange portion 22a and the lower jaw flange portion 22b are inclined toward the insertion detail side as shown in FIG. 2 and wrap around in the left-right direction of the mouth along the shape of the oral vestibule. Is formed. With this configuration, the pressure on the oral vestibule and the inside of the lip of the upper jaw flange portion 22a and the lower jaw flange portion 22b is further alleviated, and the bite block 2 in the present embodiment further suppresses the occurrence of ulcers at this site. Can do.

In the above two embodiments, the materials constituting the cylindrical

main bodies

11 and 21 and the

flange portions

12a, 12b, 22a, and 22b of the bite blocks 1 and 2 are silicon rubber, butyl rubber, styrene butadiene, and the like. Those having both a certain degree of hardness and elasticity such as rubber and nitrile rubber are preferable. Of course, in addition to other rubbers, flexible resins such as soft vinyl chloride, polyethylene (PP), polypropylene (PE), polyamide (PA), PET, PEN, vinyl chloride resin, etc. It is possible to use plastics that are harmless to the human body.

Furthermore, when rubbers such as the above-mentioned silicon rubber are used as a material, the hardness (measured with Shore A hardness durometer-type A in accordance with JIS K 6253) may be changed depending on the part to be formed. For example, each flange portion that contacts the human body and the surface layer (outer layer) of the cylindrical main body are formed of silicon rubber having a hardness of 20 to 40 ° (Shore A), and the inner layer of the cylindrical main body is subjected to the pressure of crushing teeth. It may be formed from silicon rubber having a hardness of 60 to 80 ° (Shore A).

The bite block of the present invention is suitable for use in protecting an endotracheal intubation tube inserted from the mouth of a patient or the like toward the trachea.

1 Bite block 2 Bite block 11 Tubular body 11a Outer surface 11b Hollow part 11c Tip 11d Recess 12a Maxilla flange part 12a ₁ Root part 12a ₂ Tip part 12b Mandibular flange part 12b ₁ Root part 12b ₂ Tip part 21 Cylindrical body 21a outer surface 21b hollow portion 21c tapered portion 21d recessed portion 21e recessed groove 21f multi-stepped portion 22a upper jaw flange portion 22b lower jaw flange portion 30 bite block 31 cylindrical body 31a outer peripheral surface 31b hollow portion 31c tapered portion 32 flange portion 32a tube housing portion 40 Tube S, S 'Tube holder M mark

Claims

A bite block for preventing occlusion of the endotracheal intubation tube at the lip and preventing displacement of the insertion position, a cylindrical main body extending in the axial direction, and an upper jaw flange disposed on the outer surface of the cylindrical main body A flange portion for the lower jaw and the flange portion for the upper jaw, the flange portion for the upper jaw and the flange portion for the lower jaw, when viewed from the axial direction of the cylindrical main body, are provided at positions facing each other across the shaft, A bite block characterized in that each flange portion is arranged at a distance from each other in the axial direction of the cylindrical main body according to a shift in meshing of the upper jaw row and the lower jaw row.
One end of the cylindrical body in the axial direction is provided with an insertion tip whose outer diameter gradually decreases toward the end, and at least one of the upper flange portion and the lower jaw flange portion is cylindrical. 2. The bite block according to claim 1, wherein the bite block is formed in a shape that inclines toward the taper side from a base part on the main body side to a tip part on the outer diameter side.
The bite block according to claim 1 or 2, wherein at least one of the upper jaw flange portion and the lower jaw flange portion is formed in a shape curved along the upper jaw front row or the lower jaw front row.
The upper flange portion and the lower flange portion are formed so that the circumferential positions of the flange portions around the tubular body do not overlap each other when viewed from the axial direction of the tubular body. A region in the circumferential direction sandwiched between the flange portion for the lower jaw and the flange portion for the lower jaw is formed in a tube housing portion for allowing the endotracheal intubation tube to be inserted in the axial direction along the cylindrical main body. The byte block according to any one of claims 1 to 3.