WO2016002924A1 - Titanium spacer used for type ii thyroplasty and kit for same - Google Patents

Titanium spacer used for type ii thyroplasty and kit for same Download PDF

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Publication number
WO2016002924A1
WO2016002924A1 PCT/JP2015/069249 JP2015069249W WO2016002924A1 WO 2016002924 A1 WO2016002924 A1 WO 2016002924A1 JP 2015069249 W JP2015069249 W JP 2015069249W WO 2016002924 A1 WO2016002924 A1 WO 2016002924A1
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WIPO (PCT)
Prior art keywords
main body
bridge
size
titanium
kit
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PCT/JP2015/069249
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French (fr)
Japanese (ja)
Inventor
徹治 讃岐
Original Assignee
国立大学法人 熊本大学
ノーベルファーマ株式会社
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Application filed by 国立大学法人 熊本大学, ノーベルファーマ株式会社 filed Critical 国立大学法人 熊本大学
Priority to JP2016531467A priority Critical patent/JPWO2016002924A1/en
Publication of WO2016002924A1 publication Critical patent/WO2016002924A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • 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

Definitions

  • the present invention relates to a titanium spacer used in thyroid chondroplasty type 2 and a kit thereof. Specifically, the size of the bridge composed of two symmetrical holding parts and a bridging part connecting them is inserted in order to open and fix the thyroid cartilage incision part of the patient in thyroid cartilage surgery type 2.
  • the present invention relates to a titanium spacer that is accurately and quickly determined, and a kit thereof.
  • Patent Document 1 discloses a thyroid cartilage surgery type 2 that treats voice disorders by incising and expanding the midline of the thyroid cartilage to prevent vocal cord overocclusion, and a treatment tool used for thyroid cartilage surgery type 2 ( Titanium bridge).
  • Non-Patent Document 2 uses a steel spacer for deciding the size of a bridge in thyroid cartilage surgery type 2.
  • thyroid chondroplasty type 2 in order to identify the size of the bridge to be inserted into the incised thyroid cartilage, ask the patient to speak with the thyroid cartilage incised, and confirm the volume and ease of vocalization. Identify the optimal open range that will satisfy the patient's voice. In order to specify the exact size of the bridge in a short time, prepare spacers of various sizes at hand, and if the size of the first tried spacer does not fit, immediately replace one after another with another spacer, It is necessary to repeat the work of adjusting the opening degree.
  • the size of the spacer at hand is single or about 2 to 3 types, it may happen that there is no spacer of a size that can accurately determine the size of opening. In that case, fine adjustments will be made using surgical tools such as forceps in addition to the spacers at hand, and surgery cannot be completed in a short time due to the operator's skill and skill level, or the correct size due to camera shake, etc. May not be able to identify the bridge. If the size of the bridge embedded in the patient is inadequate, sufficient voice volume cannot be obtained, and the effect of treatment is insufficient, and reoperation is required.
  • the present invention relates to a titanium spacer that is a surgical aid for accurately and quickly determining the size of a bridge to be inserted in order to open and fix a thyroid cartilage incision in a patient in thyroid chondroplasty type 2. And providing kits.
  • the present invention relates to the size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to open and fix the thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2.
  • a titanium spacer that is determined accurately and in a short time, a knob part, a main body part following the knob part, two large wing parts extending symmetrically in a direction perpendicular to the knob part from the main body part, and Two small wing parts that extend from the main body part to the left and right in parallel with the large wing part and constitute the bottom surface of the titanium spacer together with the bottom surface of the main body part, the large wing part, following the large wing part
  • the main body part and the small wing part following the main body part are titanium spacers constituting a size determination part for determining the size of the sandwiching part of the bridge.
  • the present invention also provides a bridge having two symmetrical holding parts and a bridging part connecting them, which are inserted to open and fix the thyroid cartilage incision part of a patient in thyroid cartilage surgery type 2.
  • Titanium spacers that are determined accurately and in a short time, the first and second knob parts, the main body part following the first and second knob parts, and two large blades extending from the main body part to the left and right
  • two small wing parts extending from the main body part to the left and right in parallel with the large wing part and constituting the bottom surface of the titanium spacer together with the bottom surface of the main body part, the large wing part, the large wing part
  • the main body portion following the main body portion and the small wing portion following the main body portion are titanium spacers constituting a size determining portion for determining the size of the sandwiching portion of the bridge.
  • the present invention also provides a bridge having two symmetrical holding parts and a bridging part connecting them, which are inserted to open and fix the thyroid cartilage incision part of a patient in thyroid cartilage surgery type 2.
  • a kit including a plurality of titanium spacers used for accurate and short-term determination, wherein the titanium spacer constituting the kit includes a knob portion, a main body portion following the knob portion, and a main body portion to a knob portion. And two large wings that extend symmetrically in a vertical direction, and two small wings that extend from the main body to the left and right in parallel with the large wings and constitute the bottom surface of the titanium spacer together with the bottom surface of the main body portion.
  • the wing portion is provided, and the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge.
  • Tsu is a door.
  • the present invention accurately determines the size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to open and fix a thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2.
  • a kit including a plurality of titanium spacers used for determination in a short time, wherein the titanium spacers constituting the kit include first and second knob portions, and the first and second knob portions.
  • a main body part that follows, two large wing parts extending from the main body part to the left and right, and extending from the main body part to the left and right in parallel with the large wing part to form the bottom surface of the titanium spacer together with the bottom surface of the main body part.
  • the small wing portion, the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge. Kit It is.
  • a spacer and a kit thereof capable of accurately and quickly determining the size of a bridge to be embedded in order to open and fix a thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2. .
  • a titanium spacer 1 shown in FIG. 1 includes a knob part 2, a main body part 3 following the knob part 2, two large wing parts 4a and 4b extending symmetrically in a direction perpendicular to the main body part 3 and the knob part 2, and Two small wing portions 8a and 8b that extend from the main body portion 3 in parallel to the large wing portions 4a and 4b and constitute the bottom surface 6 of the titanium spacer 1 together with the bottom surface 5 of the main body portion are provided.
  • the side surface 7a of the main body part following the large wing part and the small wing part 8a following the main body part 3 constitute a size determination part 9a for determining the height B of the sandwiching part of the bridge 15 shown in FIG.
  • the knob part 2 the large wing part 4a and the large wing part 4b, the main body part 6, and the small wing part 8a and the small wing part 8b are respectively centered on the center line of the main body part (indicated by a one-dot chain line in FIG. 1A). It has a symmetrical shape. Therefore, similarly, the large wing portion 4b, the side surface 7b of the main body portion following the large wing portion, and the small wing portion 8b following the main body portion 3 determine the height B of the sandwiching portion of the bridge 15 shown in FIG.
  • the determination unit 9b is configured.
  • the height b of the size determination portion corresponds to the height B of the sandwiching portion of the bridge
  • the width a of the main body portion corresponds to the width A of the bridging portion of the bridge shown in FIG. .
  • the knob part 2 is a part for pinching with a hemostatic forceps or the like to insert a titanium spacer into a gap (thyroid cartilage incision part 12) incised through the thyroid cartilage during surgery.
  • the length of the knob portion 2 can be selected as appropriate within a range that can be easily operated with a hemostatic forceps or the like.
  • the thickness w1 of the knob portion 2, the thickness w2 of the large wing portions 4a and 4b, and the thickness w3 of the small wing portions 8a and 8b are not particularly limited, but are, for example, about 0.3 mm to about 1.0 mm, or about 0 .5mm to about 0.8mm.
  • the length c from one end of the small wing portions 8a, 8b to the other end is shorter than the length d from one end of the large wing portions 4a, 4b to the other end.
  • the main body 3 may further include a size identification hole 10 for identifying the size of the titanium spacer 1.
  • the size can be identified by the presence / absence of the size identification hole 10 or by the number of the size identification holes 10.
  • the titanium spacer can be formed using a titanium alloy for living organisms in addition to a pure metal of titanium.
  • a titanium alloy for living body Ti-6Al-4V, Ti-6Al-7Nb in which vanadium, which has been pointed out of cytotoxicity, is replaced with niobium, and the like can be used.
  • the titanium spacer can be easily imparted with a desired color by, for example, anodic oxidation. By giving different colors for each size, the size of the titanium spacer can be recognized at a glance, and a spacer having a desired size can be selected in a short time.
  • Anodization is a method of coloring by changing the refractive index of light by controlling the thickness of the oxide film on the titanium surface, and does not use a dye or the like. Therefore, it is particularly suitable as a method for imparting color to the titanium spacer of the present invention which is a medical device.
  • the titanium spacer can be formed from a material titanium by laser processing using, for example, a YAG laser or a carbonic acid laser. Therefore, it is much easier to obtain a spacer having a desired shape and size as compared with conventional materials such as steel.
  • the size of the titanium spacer is determined in light of the size of the bridge implanted in the patient.
  • the size of the bridge is determined in light of the amount of thyroid cartilage that the patient can utter and the thickness of the patient's thyroid cartilage.
  • the large opening of the thyroid cartilage that allows the patient to utter a voice corresponds to the width A of the bridge bridge.
  • the opening of the thyroid cartilage varies depending on the patient's symptoms, it is about 2 mm to about 6 mm, and the width a of the main body portion of the titanium spacer corresponding to this can be about 2 mm to about 6 mm.
  • the thickness of the thyroid cartilage corresponds to the height B of the sandwiching portion of the bridge. Thickness of thyroid cartilage varies depending on gender and race, but is about 2mm to about 6mm, so the height B of the sandwiching part of the bridge is about 2mm to about 6mm, and the corresponding titanium spacer
  • the height b of the size determination unit can be about 2 mm to about 6 mm.
  • the titanium spacer of the present invention has a size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to enlarge and fix the glottis of the patient in thyroid cartilage surgery type 2. It is an auxiliary tool that can be used to determine accurately and quickly.
  • the size determination parts 9a and 9b of the titanium spacer are fitted and temporarily fixed so as to fit the end of the thyroid cartilage, and the patient speaks out.
  • the spacers are changed one after another, and the optimal opening of the thyroid cartilage that satisfies the patient's voice is searched.
  • the bridge is usually inserted in two places, the upper part (head side) and the lower part (caudal side) of the thyroid cartilage, but it may be optimal to make the opening different at the upper and lower parts of the thyroid cartilage.
  • spacers having different sizes are inserted into the upper part and the lower part in order to determine the optimum width.
  • a bridge corresponding to a titanium spacer of a size that can be uttered by the patient is selected and secured by suturing.
  • the thread can be sutured and fixed to the through hole.
  • the titanium spacer of the present invention is an auxiliary instrument used during surgery, it may be washed and sterilized in the same manner as surgical instruments such as tweezers, forceps, or scalpel, and may be discarded each time. .
  • the bridge corresponding to the titanium spacer means that the width a of the main body portion of the titanium spacer and the width A of the bridge portion of the bridge are the same, and the height of the size determination portion of the titanium spacer.
  • a bridge having the same height B of the holding part of b and the bridge is shown.
  • a titanium spacer 101 shown in FIG. 8 includes a first knob portion 102a, a second knob portion 102b, a main body portion 103 following the first and second knob portions, and two large blades extending symmetrically from the main body portion 103.
  • Two small wing parts 108a and 108b that extend from the body parts 104a and 104b and the main body part 103 in parallel with the large wing parts 104a and 104b to form the bottom surface 106 of the titanium spacer 101 together with the bottom surface 105 of the main body part,
  • the large wing portion 104a, the side surface 107a of the main body portion following the large wing portion, and the small wing portion 108a following the main body portion 103 include a size determination unit 109a for determining the height B of the sandwiching portion of the bridge 15 shown in FIG. Constitute.
  • the first knob portion 102a and the second knob portion 102b, the large wing portion 104a and the large wing portion 104b, the main body portion 106, and the small wing portion 108a and the small wing portion 108b are respectively center lines of the main body portion (FIG. 8 ( The shape is symmetrical with respect to a). Therefore, similarly, the large wing portion 104b, the side surface 107b of the main body portion following the large wing portion, and the small wing portion 108b following the main body portion 103 determine the height B of the sandwiching portion of the bridge 15 shown in FIG.
  • the size determination unit 109b is configured.
  • the height b of the size determination portion corresponds to the height B of the sandwiching portion of the bridge
  • the width a of the main body portion corresponds to the width A of the bridging portion of the bridge shown in FIG. .
  • the first knob portion 102a and the second knob portion 102b are operated by pinching with a hemostatic forceps or the like when inserting a titanium spacer into a gap (thyroid cartilage incision portion 12) incising thyroid cartilage during surgery. It is a part for. Therefore, the shape of these knobs can be made easy to pick with a hemostatic forceps or the like.
  • the first knob portion 102a and the second knob portion 102b may have an L-shaped cross section.
  • size (height) of the 1st knob part 102a and the 2nd knob part 102b can be suitably selected in the range with which operation with a hemostatic forceps etc. is easy.
  • the thickness w1 of the knob portion 102, the thickness w2 of the large wing portions 104a and 104b, and the thickness w3 of the small wing portions 108a and 108b are not particularly limited, but are, for example, about 0.3 mm to about 1.0 mm, or about 0 .5mm to about 0.8mm.
  • the length c from one end of the small wing portions 108a, 108b to the other end is shorter than the length d from one end of the large wing portions 104a, 104b to the other end.
  • the main body 103 may further include a size identification hole 110 for identifying the size of the titanium spacer 101.
  • the size can be identified by the presence / absence of the size identification hole 110 or the number of the size identification holes 110.
  • the kit shown in FIG. 4 includes a plurality of titanium spacers.
  • the titanium spacer constituting the kit is, for example, the titanium spacer shown in FIG. 1A.
  • the knob portion 2, the main body portion 3 following the knob portion 2, and the main body portion 3 to the knob portion 2 are in a direction perpendicular to the knob portion 2.
  • the determination unit 9a is configured.
  • a titanium spacer constituting the kit shown in FIG. 4 for example, a titanium spacer shown in FIG. 8 (a) can be used.
  • titanium spacers are arranged in the upper and lower stages for each height b of the size determination unit.
  • the height b of the size determination unit is 3.0 mm
  • the height b of the size determination unit is 4.5 mm.
  • spacers having different widths a of the main body are arranged in each of the upper and lower stages.
  • the width a of the main body is 2.0 mm, 3.0 mm, 4.0 mm, 5.0 mm, and 6.0 mm.
  • the upper spacer whose size determination portion height b is 3.0 mm is provided with one size identification hole 10, and the lower spacer whose size determination portion height b is 4.5 mm is Since two size identification holes 10 are provided, it is possible to recognize the height b of the size determination portion instantaneously by visual observation. Furthermore, when the kit includes spacers having different heights b of the size determination unit, the number of size identification holes may be increased to three, four, or five, for example. In order to instantly recognize the height b of the size determination unit visually, it is possible to change the diameter of the size identification hole according to the height of the size determination unit, or to give the size identification hole a color different from that of the spacer body. is there. Each spacer can also be color-coded for each width a of the main body. In this case, the height b of the size determination part is the number of the size identification holes 10, and the width a of the main body part can be identified by the color.
  • the number of titanium spacers included in the kit is not particularly limited.
  • the thickness of the thyroid cartilage determined by the height b of the size determination unit varies depending on the gender and race, and the opening of the thyroid cartilage determined by the width a of the main body varies depending on the person. It is preferable that a certain number of spacers of different sizes are accommodated.
  • one kit can contain 2 to 50, 6 to 20, or 8 to 16 spacers.
  • the sizes of the spacers included in one kit may all be different sizes, or two spacers of the same size may be included.
  • type 2 of thyroid cartilage surgery there are cases where bridges are inserted at the upper and lower parts of the thyroid cartilage (for example, Fig. 3). In this case, two spacers of the same size may be used. is there.
  • the size of the titanium spacer included in the kit is the same as that of the titanium spacer described above.
  • the kit of the present invention includes titanium spacers of different sizes. For example, it is possible to change the size b of the size determination unit between 0.5 mm and 6 mm every 0.5 mm or 1.0 mm. Similarly, the width a of the main body portion of the titanium spacer can be changed every 0.5 mm or every 1.0 mm between 2 mm and 6 mm.
  • such a kit for example, it is composed of ten different sized titanium spacers, among which five titanium spacers have the same height b of the size determination part, and the width a of the main body part is respectively Different and the heights b of the size determination parts of the other five titanium spacers are the same, and different from the previous five titanium spacers, the width a of the main body part can be different.
  • it is composed of 10 titanium spacers of different sizes, and among these, the height of the size determination part of 5 titanium spacers is 3.0 mm and the width of the main body part is 2.
  • kits that are 0.0 mm, 3.0 mm, 4.0 mm, 5.0 mm, and 6.0 mm.
  • the kit of the present invention may further include one or more “bridges corresponding to titanium spacers”.
  • a plurality of bridges having different sizes may be included.
  • the bridges included in the kit shown in FIG. 6 correspond to the individual titanium spacers of the kit shown in FIG. Therefore, when the kit shown in FIG. 4 includes the bridge shown in FIG. 5, the bridge corresponding to the titanium spacer can be accurately selected in a short time.
  • Another example is a kit 21 shown in FIG. In the kit of FIG. 7, a combination of a titanium spacer and a bridge corresponding to the titanium spacer is set. Therefore, it is possible to select the bridge corresponding to the spacer more accurately in a shorter time.
  • the bridge can be colored like a titanium spacer.
  • the bridge By assigning the same color to the titanium spacer and the corresponding bridge, the correspondence between the spacer and the bridge becomes easier to understand.
  • the bridge is made of titanium, it can be colored similarly to the titanium spacer. Furthermore, like a titanium spacer, the bridge can be marked like a size identification hole for each height B of the sandwiching portion.
  • the kit of the present invention can be used to more accurately and quickly determine the size of a bridge to be inserted in order to open and fix a patient's thyroid cartilage incision in thyroid chondroplasty type 2. During the operation, the titanium spacers of different sizes are replaced one after another, and the utterance is adjusted. When the spacer size is determined, the bridge prepared separately or the bridge included in the kit is immediately applied.
  • the kit of the present invention may be disposable.
  • thyroid chondroplasty type 2 was performed using a titanium spacer.
  • a male patient has a spacer with a height determination part height b of 4.5 mm
  • a female patient has a spacer with a size determination part height b of 3.0 mm.
  • several spacers having the same height and different main body widths a were prepared.
  • FIG.1 (a) is sectional drawing which shows the structure of the titanium spacer of one Embodiment of this invention.
  • FIG.1 (b) is sectional drawing which shows the structure of the titanium spacer of one Embodiment of this invention.
  • FIG.1 (c) is a perspective view which shows the structure of the titanium spacer of one Embodiment of this invention. It is a figure which shows the state which is using the titanium spacer of this invention during an operation. It is a figure which shows the state which has inserted the titanium spacer of this invention in two places, the upper part and the lower part of a thyroid cartilage incision part. It is a figure which shows the structure of the kit of one embodiment of this invention.
  • FIG.5 (a) is a perspective view which shows the bridge
  • FIG.5 (b) is sectional drawing which shows the bridge
  • FIG. 8A is a cross-sectional view showing a configuration of a titanium spacer according to an embodiment of the present invention.
  • FIG.8 (b) is a perspective view which shows the structure of the titanium spacer of one embodiment of this invention.

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Abstract

A titanium spacer for accurately and quickly determining the size of a bridge inserted to dilate and fix a thyroid cartilage incision in a patient in type II thyroplasty, wherein the titanium spacer is provided with a knob part, a body part continuing from the knob part, two large wing parts extending from the body part in a laterally symmetrical shape perpendicular to the knob part, and two small wing parts extending laterally from the body part so as to be parallel to the large wing parts, the small wing parts constituting the bottom surface of the titanium spacer together with the bottom surface of the body part. The large wing parts, the body part continuing from the large wing parts, and the small wing parts continuing from the body part constitute a size-determining part for determining the size of a clamping part of the bridge. In addition, a kit.

Description

甲状軟骨形成術２型に用いるチタン製スペーサー及びそのキットTitanium spacer used for thyroid chondroplasty type 2 and kit
本発明は、甲状軟骨形成術２型に用いるチタン製のスペーサー及びそのキットに関する。詳しくは、甲状軟骨形成術２型において患者の甲状軟骨切開部を左右に開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを、的確かつ短時間に決定するチタン製のスペーサー、及びそのキットに関する。 The present invention relates to a titanium spacer used in thyroid chondroplasty type 2 and a kit thereof. Specifically, the size of the bridge composed of two symmetrical holding parts and a bridging part connecting them is inserted in order to open and fix the thyroid cartilage incision part of the patient in thyroid cartilage surgery type 2. The present invention relates to a titanium spacer that is accurately and quickly determined, and a kit thereof.
痙攣性発声障害に対して外科的手術による治療が行われている。
例えば特許文献１には、甲状軟骨の正中を切開、開大し、声帯の過閉塞を防ぐことによって発声障害を治療する甲状軟骨形成術２型、及び甲状軟骨形成術２型に用いる治療具（チタン製ブリッジ）が記載されている。
また、例えば非特許文献２には、甲状軟骨形成術２型において、ブリッジのサイズを決めるための鋼製のスペーサーが用いられている。 Surgery is being treated for spastic vocal disturbances.
For example, Patent Document 1 discloses a thyroid cartilage surgery type 2 that treats voice disorders by incising and expanding the midline of the thyroid cartilage to prevent vocal cord overocclusion, and a treatment tool used for thyroid cartilage surgery type 2 ( Titanium bridge).
For example, Non-Patent Document 2 uses a steel spacer for deciding the size of a bridge in thyroid cartilage surgery type 2.
甲状軟骨形成術２型においては、切開した甲状軟骨に挿入すべきブリッジのサイズを特定するため、甲状軟骨を切開した状態で患者に発声してもらい、声量や発声のしやすさを確認し、患者が自分の声に満足する最適な開大幅を特定する。的確なブリッジのサイズを短時間で特定するためには、種々のサイズのスペーサーを手元に準備し、最初に試したスペーサーのサイズが合わなければ、即座に別のサイズのスペーサーに次々置き換えて、開大幅を調整する作業を繰り返す必要がある。 In thyroid chondroplasty type 2, in order to identify the size of the bridge to be inserted into the incised thyroid cartilage, ask the patient to speak with the thyroid cartilage incised, and confirm the volume and ease of vocalization. Identify the optimal open range that will satisfy the patient's voice. In order to specify the exact size of the bridge in a short time, prepare spacers of various sizes at hand, and if the size of the first tried spacer does not fit, immediately replace one after another with another spacer, It is necessary to repeat the work of adjusting the opening degree.
手元のスペーサーのサイズが単一、あるいは２～３種類程度の場合、的確な開大幅を判定するサイズのスペーサーが無いことが起こりうる。その場合、手元にあるスペーサーに加えて鉗子等の手術器具を用いて微調整を行うことととなり、手術者の技術や熟練度により短時間に手術を終えられない、あるいは手振れなどにより的確なサイズのブリッジを特定できないというおそれがある。
患者に埋め込んだブリッジのサイズが不適格である場合、十分な声量が得られない等、治療による効果が不十分となり再手術が必要となる。 When the size of the spacer at hand is single or about 2 to 3 types, it may happen that there is no spacer of a size that can accurately determine the size of opening. In that case, fine adjustments will be made using surgical tools such as forceps in addition to the spacers at hand, and surgery cannot be completed in a short time due to the operator's skill and skill level, or the correct size due to camera shake, etc. May not be able to identify the bridge.
If the size of the bridge embedded in the patient is inadequate, sufficient voice volume cannot be obtained, and the effect of treatment is insufficient, and reoperation is required.
特許４１５３３７２号公報Japanese Patent No. 4153372
本発明は、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大・固定するために挿入するブリッジのサイズを、的確かつ短時間に決定するための手術用補助具であるチタン製スペーサー、及びキットを提供することである。 The present invention relates to a titanium spacer that is a surgical aid for accurately and quickly determining the size of a bridge to be inserted in order to open and fix a thyroid cartilage incision in a patient in thyroid chondroplasty type 2. And providing kits.
すなわち本発明は、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを、的確かつ短時間に決定するチタン製のスペーサーであって、ツマミ部、前記ツマミ部に続く本体部、前記本体部からツマミ部とは垂直な方向に左右対称に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成するチタン製スペーサーである。 That is, the present invention relates to the size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to open and fix the thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2. A titanium spacer that is determined accurately and in a short time, a knob part, a main body part following the knob part, two large wing parts extending symmetrically in a direction perpendicular to the knob part from the main body part, and Two small wing parts that extend from the main body part to the left and right in parallel with the large wing part and constitute the bottom surface of the titanium spacer together with the bottom surface of the main body part, the large wing part, following the large wing part The main body part and the small wing part following the main body part are titanium spacers constituting a size determination part for determining the size of the sandwiching part of the bridge.
また本発明は、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを、的確かつ短時間に決定するチタン製のスペーサーであって、第１及び第２のツマミ部、前記第１及び第２のツマミ部に続く本体部、前記本体部から左右に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成するチタン製スペーサーである。 The present invention also provides a bridge having two symmetrical holding parts and a bridging part connecting them, which are inserted to open and fix the thyroid cartilage incision part of a patient in thyroid cartilage surgery type 2. Titanium spacers that are determined accurately and in a short time, the first and second knob parts, the main body part following the first and second knob parts, and two large blades extending from the main body part to the left and right And two small wing parts extending from the main body part to the left and right in parallel with the large wing part and constituting the bottom surface of the titanium spacer together with the bottom surface of the main body part, the large wing part, the large wing part The main body portion following the main body portion and the small wing portion following the main body portion are titanium spacers constituting a size determining portion for determining the size of the sandwiching portion of the bridge.
また本発明は、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを的確かつ短時間に決定するために用いる、複数のチタン製スペーサーを含むキットであって、前記キットを構成するチタン製スペーサーが、ツマミ部、前記ツマミ部に続く本体部、前記本体部からツマミ部とは垂直な方向に左右対称に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成しているキットである。 The present invention also provides a bridge having two symmetrical holding parts and a bridging part connecting them, which are inserted to open and fix the thyroid cartilage incision part of a patient in thyroid cartilage surgery type 2. A kit including a plurality of titanium spacers used for accurate and short-term determination, wherein the titanium spacer constituting the kit includes a knob portion, a main body portion following the knob portion, and a main body portion to a knob portion. And two large wings that extend symmetrically in a vertical direction, and two small wings that extend from the main body to the left and right in parallel with the large wings and constitute the bottom surface of the titanium spacer together with the bottom surface of the main body portion. The wing portion is provided, and the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge. Tsu is a door.
本発明は、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを的確かつ短時間に決定するために用いる、複数のチタン製スペーサーを含むキットであって、前記キットを構成するチタン製スペーサーが、第１及び第２のツマミ部、前記第１及び第２のツマミ部に続く本体部、前記本体部から左右に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成しているキットである。 The present invention accurately determines the size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to open and fix a thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2. A kit including a plurality of titanium spacers used for determination in a short time, wherein the titanium spacers constituting the kit include first and second knob portions, and the first and second knob portions. A main body part that follows, two large wing parts extending from the main body part to the left and right, and extending from the main body part to the left and right in parallel with the large wing part to form the bottom surface of the titanium spacer together with the bottom surface of the main body part. The small wing portion, the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge. Kit It is.
本発明により、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大・固定するために埋め込むブリッジのサイズを的確かつ短時間に決定可能なスペーサー及びそのキットを提供することが可能となる。 According to the present invention, it is possible to provide a spacer and a kit thereof capable of accurately and quickly determining the size of a bridge to be embedded in order to open and fix a thyroid cartilage incision portion of a patient in thyroid chondroplasty type 2. .
本発明のチタン製スペーサーの一実施形態について、図１を参照しながら説明する。
図１に示すチタン製スペーサー１は、ツマミ部２、ツマミ部２に続く本体部３、本体部３からツマミ部２とは垂直な方向に左右対称に伸びる二つの大翼部４ａ、４ｂ、及び本体部３から大翼部４ａ、４ｂと並行して左右に伸び本体部の底面５と共にチタン製スペーサー１の底面６を構成する二つの小翼部８ａ、８ｂを備え、大翼部４ａ、前記大翼部に続く本体部の側面７ａ、及び本体部３に続く小翼部８ａが、図５に示すブリッジ１５の挟持部の高さＢを判定するサイズ判定部９ａを構成する。 An embodiment of the titanium spacer of the present invention will be described with reference to FIG.
A titanium spacer 1 shown in FIG. 1 includes a knob part 2, a main body part 3 following the knob part 2, two large wing parts 4a and 4b extending symmetrically in a direction perpendicular to the main body part 3 and the knob part 2, and Two small wing portions 8a and 8b that extend from the main body portion 3 in parallel to the large wing portions 4a and 4b and constitute the bottom surface 6 of the titanium spacer 1 together with the bottom surface 5 of the main body portion are provided. The side surface 7a of the main body part following the large wing part and the small wing part 8a following the main body part 3 constitute a size determination part 9a for determining the height B of the sandwiching part of the bridge 15 shown in FIG.
ツマミ部２、大翼部４ａと大翼部４ｂ、本体部６、並びに小翼部８ａと小翼部８ｂは、それぞれ本体部の中心線（図１（ａ）に一点鎖線で表示）を中心として左右対称の形状をしている。よって、同様に大翼部４ｂ、前記大翼部に続く本体部の側面７ｂ、及び本体部３に続く小翼部８ｂが、図５に示すブリッジ１５の挟持部の高さＢを判定するサイズ判定部９ｂを構成する。 The knob part 2, the large wing part 4a and the large wing part 4b, the main body part 6, and the small wing part 8a and the small wing part 8b are respectively centered on the center line of the main body part (indicated by a one-dot chain line in FIG. 1A). It has a symmetrical shape. Therefore, similarly, the large wing portion 4b, the side surface 7b of the main body portion following the large wing portion, and the small wing portion 8b following the main body portion 3 determine the height B of the sandwiching portion of the bridge 15 shown in FIG. The determination unit 9b is configured.
チタン製スペーサー１は、サイズ判定部の高さｂが、ブリッジの挟持部の高さＢと対応し、本体部の幅ａが、図５に示すブリッジの架橋部の幅Ａと対応している。 In the titanium spacer 1, the height b of the size determination portion corresponds to the height B of the sandwiching portion of the bridge, and the width a of the main body portion corresponds to the width A of the bridging portion of the bridge shown in FIG. .
ツマミ部２は、手術中に、甲状軟骨を切開した隙間（甲状軟骨切開部１２）にチタン製スペーサーを挿入する際に、止血鉗子等でつまんで操作するための部分である。ツマミ部２の長さは、止血鉗子等による操作がしやすい範囲で適宜選択することができる。 The knob part 2 is a part for pinching with a hemostatic forceps or the like to insert a titanium spacer into a gap (thyroid cartilage incision part 12) incised through the thyroid cartilage during surgery. The length of the knob portion 2 can be selected as appropriate within a range that can be easily operated with a hemostatic forceps or the like.
ツマミ部２の厚さｗ１、大翼部４ａ、４ｂの厚さｗ２、小翼部８ａ、８ｂの厚さｗ３は特に限定されないが、例えば、約０．３ｍｍ～約１．０ｍｍ、または約０．５ｍｍ～約０．８ｍｍとすることができる。
小翼部８ａ、８ｂの一方の端から他方の端までの長さｃは、大翼部４ａ、４ｂの一方の端から他方の端までの長さｄより短い。 The thickness w1 of the knob portion 2, the thickness w2 of the large wing portions 4a and 4b, and the thickness w3 of the small wing portions 8a and 8b are not particularly limited, but are, for example, about 0.3 mm to about 1.0 mm, or about 0 .5mm to about 0.8mm.
The length c from one end of the small wing portions 8a, 8b to the other end is shorter than the length d from one end of the large wing portions 4a, 4b to the other end.
本体部３は、さらにチタン製スペーサー１のサイズを識別するためのサイズ識別穴１０を備えていてもよい。例えば、サイズ識別穴１０の有無により、あるいはサイズ識別穴１０の数により、サイズを識別することができる。サイズ識別穴１０を設けることで、チタン製スペーサーの色が同一の場合も、目視により即座にサイズの違いを認識することができる。 The main body 3 may further include a size identification hole 10 for identifying the size of the titanium spacer 1. For example, the size can be identified by the presence / absence of the size identification hole 10 or by the number of the size identification holes 10. By providing the size identification hole 10, even when the color of the titanium spacer is the same, the difference in size can be immediately recognized visually.
チタン製スペーサーは、チタンの純金属の他、生体用チタン合金を用いて構成することができる。生体用チタン合金としては、Ｔｉ－６Ａｌ－４Ｖや細胞毒性の指摘があるバナジウムをニオブに置き換えたＴｉ－６Ａｌ－７Ｎｂなどを用いることができる。 The titanium spacer can be formed using a titanium alloy for living organisms in addition to a pure metal of titanium. As a titanium alloy for living body, Ti-6Al-4V, Ti-6Al-7Nb in which vanadium, which has been pointed out of cytotoxicity, is replaced with niobium, and the like can be used.
チタン製スペーサーは、例えば陽極酸化等により、容易に所望の色を付与することができる。サイズごとに異なる色を付与することで、一見してチタン製スペーサーのサイズを認識することができ、所望のサイズのスペーサーを短時間で選択することができる。陽極酸化は、チタン表面の酸化皮膜の厚さをコントロールして光の屈折率を変化させることにより発色させる方法であり染料等を用いない。そのため医療用具である本発明のチタン製スペーサーに色を付与する方法として特に適している。 The titanium spacer can be easily imparted with a desired color by, for example, anodic oxidation. By giving different colors for each size, the size of the titanium spacer can be recognized at a glance, and a spacer having a desired size can be selected in a short time. Anodization is a method of coloring by changing the refractive index of light by controlling the thickness of the oxide film on the titanium surface, and does not use a dye or the like. Therefore, it is particularly suitable as a method for imparting color to the titanium spacer of the present invention which is a medical device.
チタン製スペーサーは、材料のチタンを、例えばＹＡＧレーザーや炭酸レーザー等を用いたレーザー加工により成形することができる。そのため、従来の鋼等の材料に比べ、所望の形状やサイズのスペーサーを得ることが格段に容易である。 The titanium spacer can be formed from a material titanium by laser processing using, for example, a YAG laser or a carbonic acid laser. Therefore, it is much easier to obtain a spacer having a desired shape and size as compared with conventional materials such as steel.
チタン製スペーサーのサイズは、患者に埋め込むブリッジのサイズに照らして決定する。ブリッジのサイズは、患者が満足する発声ができる甲状軟骨の開大幅と、患者の甲状軟骨の厚さに照らして決定する。
患者が満足する発声ができる甲状軟骨の開大幅は、ブリッジの架橋部の幅Ａに対応する。かかる甲状軟骨の開大幅は患者の症状により異なるが、約２ｍｍ～約６ｍｍ程度となり、これに対応するチタン製スペーサーの本体部の幅ａも約２ｍｍ～約６ｍｍ程度とすることができる。 The size of the titanium spacer is determined in light of the size of the bridge implanted in the patient. The size of the bridge is determined in light of the amount of thyroid cartilage that the patient can utter and the thickness of the patient's thyroid cartilage.
The large opening of the thyroid cartilage that allows the patient to utter a voice corresponds to the width A of the bridge bridge. Although the opening of the thyroid cartilage varies depending on the patient's symptoms, it is about 2 mm to about 6 mm, and the width a of the main body portion of the titanium spacer corresponding to this can be about 2 mm to about 6 mm.
甲状軟骨の厚さは、ブリッジの挟持部の高さＢに対応する。甲状軟骨の厚さは、性別や人種により差があるが、約２ｍｍ～約６ｍｍ程度であるので、ブリッジの挟持部の高さＢは約２ｍｍ～約６ｍｍと、これに対応するチタン製スペーサーのサイズ判定部の高さｂも約２ｍｍ～約６ｍｍとすることができる。 The thickness of the thyroid cartilage corresponds to the height B of the sandwiching portion of the bridge. Thickness of thyroid cartilage varies depending on gender and race, but is about 2mm to about 6mm, so the height B of the sandwiching part of the bridge is about 2mm to about 6mm, and the corresponding titanium spacer The height b of the size determination unit can be about 2 mm to about 6 mm.
本発明のチタン製スペーサーは、甲状軟骨形成術２型において患者の声門を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを的確かつ短時間に決定するために使用することができる補助用具である。 The titanium spacer of the present invention has a size of a bridge composed of two symmetrical sandwiching portions and a bridging portion connecting them, which are inserted to enlarge and fix the glottis of the patient in thyroid cartilage surgery type 2. It is an auxiliary tool that can be used to determine accurately and quickly.
甲状軟骨形成術２型手術中に甲状軟骨を切開した後、チタン製スペーサーのサイズ判定部９ａ，９ｂが甲状軟骨の端にフィットするように嵌め込んで仮固定し、患者に声を出してもらいながら、次々にスペーサーを取り換えて、患者が自分の声に満足する最適な甲状軟骨の開大幅を探る。 After incising the thyroid cartilage during the thyroid cartilage surgery type 2 operation, the size determination parts 9a and 9b of the titanium spacer are fitted and temporarily fixed so as to fit the end of the thyroid cartilage, and the patient speaks out. However, the spacers are changed one after another, and the optimal opening of the thyroid cartilage that satisfies the patient's voice is searched.
ブリッジは通常甲状軟骨の上部（頭側）と下部（尾側）の二か所に挿入するが、甲状軟骨の上部と下部とで異なる開大幅とするのが最適な場合がある。この様な場合、最適な開大幅を見つけるためには、上部と下部に、順次サイズの異なるスペーサーを挿入して最適な幅を判定する。続いて、患者が満足する発声ができるサイズのチタン製スペーサーに対応するブリッジを選択し、縫合により固定する。ブリッジが貫通孔２０を有する場合は貫通孔に糸を通して縫合し固定することができる。 The bridge is usually inserted in two places, the upper part (head side) and the lower part (caudal side) of the thyroid cartilage, but it may be optimal to make the opening different at the upper and lower parts of the thyroid cartilage. In such a case, in order to find the optimum widening, spacers having different sizes are inserted into the upper part and the lower part in order to determine the optimum width. Subsequently, a bridge corresponding to a titanium spacer of a size that can be uttered by the patient is selected and secured by suturing. When the bridge has the through hole 20, the thread can be sutured and fixed to the through hole.
本発明のチタン製スペーサーは、手術中に用いる補助器具であるので、例えばピンセット、鉗子、あるいはメス等の手術器具と同様に洗浄殺菌して繰り返し使用しても良いし、都度廃棄しても良い。 Since the titanium spacer of the present invention is an auxiliary instrument used during surgery, it may be washed and sterilized in the same manner as surgical instruments such as tweezers, forceps, or scalpel, and may be discarded each time. .
本明細書において、「チタン製スペーサーに対応するブリッジ」とは、チタン製スペーサーの本体部の幅ａとブリッジの架橋部の幅Ａが同じであり、かつチタン製スペーサーのサイズ判定部の高さｂとブリッジの挟持部の高さＢが同じブリッジを示す。 In this specification, “the bridge corresponding to the titanium spacer” means that the width a of the main body portion of the titanium spacer and the width A of the bridge portion of the bridge are the same, and the height of the size determination portion of the titanium spacer. A bridge having the same height B of the holding part of b and the bridge is shown.
本発明のチタン製スペーサーの他の実施態様について、図８を参照しながら説明する。
図８に示すチタン製スペーサー１０１は、第１のツマミ部１０２ａ、第２のツマミ部１０２ｂ、第１及び第２のツマミ部に続く本体部１０３、本体部１０３から左右対称に伸びる二つの大翼部１０４ａ、１０４ｂ、及び本体部１０３から大翼部１０４ａ、１０４ｂと並行して左右に伸び本体部の底面１０５と共にチタン製スペーサー１０１の底面１０６を構成する二つの小翼部１０８ａ、１０８ｂを備え、大翼部１０４ａ、前記大翼部に続く本体部の側面１０７ａ、及び本体部１０３に続く小翼部１０８ａが、図５に示すブリッジ１５の挟持部の高さＢを判定するサイズ判定部１０９ａを構成する。 Another embodiment of the titanium spacer of the present invention will be described with reference to FIG.
A titanium spacer 101 shown in FIG. 8 includes a first knob portion 102a, a second knob portion 102b, a main body portion 103 following the first and second knob portions, and two large blades extending symmetrically from the main body portion 103. Two small wing parts 108a and 108b that extend from the body parts 104a and 104b and the main body part 103 in parallel with the large wing parts 104a and 104b to form the bottom surface 106 of the titanium spacer 101 together with the bottom surface 105 of the main body part, The large wing portion 104a, the side surface 107a of the main body portion following the large wing portion, and the small wing portion 108a following the main body portion 103 include a size determination unit 109a for determining the height B of the sandwiching portion of the bridge 15 shown in FIG. Constitute.
第１のツマミ部１０２ａと第２のツマミ部１０２ｂ、大翼部１０４ａと大翼部１０４ｂ、本体部１０６、ならびに小翼部１０８ａと小翼部１０８ｂは、それぞれ本体部の中心線（図８（ａ）に一点鎖線で表示）を中心として左右対称の形状をしている。よって、同様に大翼部１０４ｂ、前記大翼部に続く本体部の側面１０７ｂ、及び本体部１０３に続く小翼部１０８ｂが、図５に示すブリッジ１５の挟持部の高さＢを判定する、サイズ判定部１０９ｂを構成する。 The first knob portion 102a and the second knob portion 102b, the large wing portion 104a and the large wing portion 104b, the main body portion 106, and the small wing portion 108a and the small wing portion 108b are respectively center lines of the main body portion (FIG. 8 ( The shape is symmetrical with respect to a). Therefore, similarly, the large wing portion 104b, the side surface 107b of the main body portion following the large wing portion, and the small wing portion 108b following the main body portion 103 determine the height B of the sandwiching portion of the bridge 15 shown in FIG. The size determination unit 109b is configured.
チタン製スペーサー１０１は、サイズ判定部の高さｂが、ブリッジの挟持部の高さＢと対応し、本体部の幅ａが、図５に示すブリッジの架橋部の幅Ａと対応している。 In the titanium spacer 101, the height b of the size determination portion corresponds to the height B of the sandwiching portion of the bridge, and the width a of the main body portion corresponds to the width A of the bridging portion of the bridge shown in FIG. .
第１のツマミ部１０２ａ及び第２のツマミ部１０２ｂは、手術中に、甲状軟骨を切開した隙間（甲状軟骨切開部１２）にチタン製スペーサーを挿入する際に、止血鉗子等でつまんで操作するための部分である。よって、これらツマミ部の形状は、止血鉗子等でつまみやすい形状とすることができる。第１のツマミ部１０２ａ及び第２のツマミ部１０２ｂは、その断面が、Ｌ字状の形状を有していてもよい。第１のツマミ部１０２ａ及び第２のツマミ部１０２ｂの大きさ（高さ）は、止血鉗子等による操作がしやすい範囲で適宜選択することができる。 The first knob portion 102a and the second knob portion 102b are operated by pinching with a hemostatic forceps or the like when inserting a titanium spacer into a gap (thyroid cartilage incision portion 12) incising thyroid cartilage during surgery. It is a part for. Therefore, the shape of these knobs can be made easy to pick with a hemostatic forceps or the like. The first knob portion 102a and the second knob portion 102b may have an L-shaped cross section. The magnitude | size (height) of the 1st knob part 102a and the 2nd knob part 102b can be suitably selected in the range with which operation with a hemostatic forceps etc. is easy.
ツマミ部１０２の厚さｗ１、大翼部１０４ａ、１０４ｂの厚さｗ２、小翼部１０８ａ、１０８ｂの厚さｗ３は特に限定されないが、例えば、約０．３ｍｍ～約１．０ｍｍ、または約０．５ｍｍ～約０．８ｍｍとすることができる。
小翼部１０８ａ、１０８ｂの一方の端から他方の端までの長さｃは、大翼部１０４ａ、１０４ｂの一方の端から他方の端までの長さｄより短い。 The thickness w1 of the knob portion 102, the thickness w2 of the large wing portions 104a and 104b, and the thickness w3 of the small wing portions 108a and 108b are not particularly limited, but are, for example, about 0.3 mm to about 1.0 mm, or about 0 .5mm to about 0.8mm.
The length c from one end of the small wing portions 108a, 108b to the other end is shorter than the length d from one end of the large wing portions 104a, 104b to the other end.
本体部１０３は、さらにチタン製スペーサー１０１のサイズを識別するためのサイズ識別穴１１０を備えていてもよい。例えば、サイズ識別穴１１０の有無により、あるいはサイズ識別穴１１０の数により、サイズを識別することができる。サイズ識別穴１１０を設けることで、チタン製スペーサーの色が同一の場合も、目視により即座にサイズの違いを認識することができる The main body 103 may further include a size identification hole 110 for identifying the size of the titanium spacer 101. For example, the size can be identified by the presence / absence of the size identification hole 110 or the number of the size identification holes 110. By providing the size identification hole 110, even when the color of the titanium spacer is the same, the difference in size can be immediately recognized visually.
本発明のキットの一実施形態について、図４を参照しながら説明する。
図４に示すキットは、複数のチタン製スペーサーを含む。キットを構成するチタン製スペーサーは、例えば図１（ａ）に記載するチタン製スペーサーであり、ツマミ部２、ツマミ部２に続く本体部３、本体部３からツマミ部２とは垂直な方向に左右対称に伸びる二つの大翼部４ａ、４ｂ、及び本体部３から大翼部４ａ、４ｂと並行して左右に伸び本体部の底面５と共にチタン製スペーサー１の底面６を構成する二つの小翼部８ａ、８ｂを備え、大翼部４ａ、前記大翼部に続く本体部の側面７ａ、及び本体部３に続く小翼部８ａが、ブリッジ１５の挟持部の高さＢを判定するサイズ判定部９ａを構成する。
図４に示すキットを構成するチタン製スペーサーとして、例えば図８（ａ）に示すチタン製スペーサーを用いることもできる。 One embodiment of the kit of the present invention will be described with reference to FIG.
The kit shown in FIG. 4 includes a plurality of titanium spacers. The titanium spacer constituting the kit is, for example, the titanium spacer shown in FIG. 1A. The knob portion 2, the main body portion 3 following the knob portion 2, and the main body portion 3 to the knob portion 2 are in a direction perpendicular to the knob portion 2. Two large wings 4a and 4b that extend symmetrically and two small wings that extend from the main body 3 to the left and right in parallel with the large wings 4a and 4b and the bottom 6 of the titanium spacer 1 together with the bottom 5 of the main body. Size including a wing portion 8a, 8b, and a large wing portion 4a, a side surface 7a of the main body portion that follows the large wing portion, and a small wing portion 8a that follows the main body portion 3 determine the height B of the sandwiching portion of the bridge 15. The determination unit 9a is configured.
As a titanium spacer constituting the kit shown in FIG. 4, for example, a titanium spacer shown in FIG. 8 (a) can be used.
図４に示すキットは、サイズ判定部の高さｂごとに、上段、下段にチタン製スペーサーが並んでいる。上段はサイズ判定部の高さｂが３．０ｍｍ、下段はサイズ判定部の高さｂが４．５ｍｍである。上段、下段のそれぞれには、本体部の幅ａがそれぞれ異なるスペーサーが並んでいる。図４のキットでは、本体部の幅ａは、２．０ｍｍ、３．０ｍｍ、４．０ｍｍ、５．０ｍｍ、及び６．０ｍｍである。
上段の、サイズ判定部の高さｂが３．０ｍｍのスペーサーには、サイズ識別穴１０が１つ施されており、下段の、サイズ判定部の高さｂが４．５ｍｍのスペーサーには、サイズ識別穴１０が２つ施されているので、目視により瞬時にサイズ判定部の高さｂを認識することが可能である。さらに、キットがサイズ判定部の高さｂの異なるスペーサーを含む場合は、例えばサイズ識別穴の数を３つ、４つ、または５つと増やしてもよい。
目視により瞬時にサイズ判定部の高さｂを認識するために、サイズ判定部の高さによってサイズ識別穴の直径を変えること、あるいはサイズ識別穴にスペーサー本体とは異なる色を施すことも可能である。また、それぞれのスペーサーを本体部の幅ａごとに色分けすることもできる。この場合、サイズ判定部の高さｂはサイズ識別穴１０の数で、本体部の幅ａは色により識別することが可能である。 In the kit shown in FIG. 4, titanium spacers are arranged in the upper and lower stages for each height b of the size determination unit. In the upper row, the height b of the size determination unit is 3.0 mm, and in the lower row, the height b of the size determination unit is 4.5 mm. In each of the upper and lower stages, spacers having different widths a of the main body are arranged. In the kit of FIG. 4, the width a of the main body is 2.0 mm, 3.0 mm, 4.0 mm, 5.0 mm, and 6.0 mm.
The upper spacer whose size determination portion height b is 3.0 mm is provided with one size identification hole 10, and the lower spacer whose size determination portion height b is 4.5 mm is Since two size identification holes 10 are provided, it is possible to recognize the height b of the size determination portion instantaneously by visual observation. Furthermore, when the kit includes spacers having different heights b of the size determination unit, the number of size identification holes may be increased to three, four, or five, for example.
In order to instantly recognize the height b of the size determination unit visually, it is possible to change the diameter of the size identification hole according to the height of the size determination unit, or to give the size identification hole a color different from that of the spacer body. is there. Each spacer can also be color-coded for each width a of the main body. In this case, the height b of the size determination part is the number of the size identification holes 10, and the width a of the main body part can be identified by the color.
キットに含まれるチタン製スペーサーの数は、特に限定されない。サイズ判定部の高さｂで判断する甲状軟骨の厚さは、性別や人種によって異なること、及び本体部の幅ａにより判断する甲状軟骨の開大幅は人によって異なることから、１つのキットには、ある程度の数のサイズの異なるスペーサーが収納されていることが好ましい。 The number of titanium spacers included in the kit is not particularly limited. The thickness of the thyroid cartilage determined by the height b of the size determination unit varies depending on the gender and race, and the opening of the thyroid cartilage determined by the width a of the main body varies depending on the person. It is preferable that a certain number of spacers of different sizes are accommodated.
具体的には例えば、１つのキットに、２～５０個、６～２０個、または８～１６個のスペーサーを含むことができる。１つのキットに含まれるスペーサーのサイズはすべてが異なるサイズであってもよいし、同じサイズのスペーサーを二つ含んでいてもよい。甲状軟骨形成術２型において、甲状軟骨の上部・下部の２箇所にブリッジを挿入することがあり（例えば図３）、この場合に同じ大きさのスペーサーを二つ使用する可能性があるからである。 Specifically, for example, one kit can contain 2 to 50, 6 to 20, or 8 to 16 spacers. The sizes of the spacers included in one kit may all be different sizes, or two spacers of the same size may be included. In type 2 of thyroid cartilage surgery, there are cases where bridges are inserted at the upper and lower parts of the thyroid cartilage (for example, Fig. 3). In this case, two spacers of the same size may be used. is there.
キットに含まれるチタン製スペーサーのサイズは、上述のチタン製スペーサーの場合と同様である。 The size of the titanium spacer included in the kit is the same as that of the titanium spacer described above.
本発明のキットは、サイズの異なるチタン製スペーサーを含む。例えば、サイズ判定部の高さｂを、２ｍｍ～６ｍｍの間で、０．５ｍｍごとあるいは１．０ｍｍごとにサイズを変えることが可能である。同様に、チタン製スペーサーの本体部の幅ａについても２ｍｍ～６ｍｍの間で、０．５ｍｍごとあるいは１．０ｍｍごとにサイズを変えることが可能である。
このようなキットの一態様として、例えば１０個の異なるサイズのチタン製スペーサーから構成され、このうち５つのチタン製スペーサーのサイズ判定部の高さｂがいずれも同一で本体部の幅ａはそれぞれ異なり、かつ他の５つのチタン製スペーサーのサイズ判定部の高さｂがいずれも同一で先の５つのチタン製スペーサーとは異なり、本体部の幅ａはそれぞれ異なるキットを挙げることができる。また他の一態様として、例えば１０個の異なるサイズのチタン製スペーサーから構成され、このうち５つのチタン製スペーサーのサイズ判定部の高さがいずれも３．０ｍｍ、本体部の幅がそれぞれ２．０ｍｍ、３．０ｍｍ、４．０ｍｍ、５．０ｍｍ、及び６．０ｍｍであり、かつ他の５つのチタン製スペーサーのサイズ判定部の高さがいずれも４．５ｍｍ、本体部の幅がそれぞれ２．０ｍｍ、３．０ｍｍ、４．０ｍｍ、５．０ｍｍ、及び６．０ｍｍであるキットを挙げることができる。 The kit of the present invention includes titanium spacers of different sizes. For example, it is possible to change the size b of the size determination unit between 0.5 mm and 6 mm every 0.5 mm or 1.0 mm. Similarly, the width a of the main body portion of the titanium spacer can be changed every 0.5 mm or every 1.0 mm between 2 mm and 6 mm.
As an embodiment of such a kit, for example, it is composed of ten different sized titanium spacers, among which five titanium spacers have the same height b of the size determination part, and the width a of the main body part is respectively Different and the heights b of the size determination parts of the other five titanium spacers are the same, and different from the previous five titanium spacers, the width a of the main body part can be different. As another aspect, for example, it is composed of 10 titanium spacers of different sizes, and among these, the height of the size determination part of 5 titanium spacers is 3.0 mm and the width of the main body part is 2. 0 mm, 3.0 mm, 4.0 mm, 5.0 mm, and 6.0 mm, and the heights of the other five titanium spacers are 4.5 mm, and the width of the main body is 2 respectively. Mention may be made of kits that are 0.0 mm, 3.0 mm, 4.0 mm, 5.0 mm, and 6.0 mm.
本発明のキットは、さらに「チタン製スペーサーに対応するブリッジ」を１つ以上含んでもよい。または、図６に示すように、異なるサイズのブリッジを複数含んでいても良い。図６に示すキットに含まれるブリッジは、図４に示すキットの個々のチタン製スペーサーに対応する。したがって、図４に示すキットが図５に示すブリッジを含む場合、チタン製スペーサーに対応するブリッジを短時間で正確に選び出すことができる。
また、他の例として、図７に示されるキット２１が挙げられる。図７のキットでは、チタン製スペーサーと前記チタン製スペーサーに対応するブリッジの組合せがセットされている。そのためより短時間でかつ正確にスペーサーに対応するブリッジを選択することが可能である。
ブリッジは、チタン製スペーサーと同様に色を付与することが可能である。チタン製スペーサーとそれに対応するブリッジに同じ色を付与することで、スペーサーとブリッジとの対応関係がよりわかりやすくなる。ブリッジがチタン製である場合は、チタン製スペーサーと同様に色付けすることが可能である。
さらに、ブリッジにもチタン製スペーサーと同様に、挟持部の高さＢごとに、サイズ識別穴のような印を付けることができる。 The kit of the present invention may further include one or more “bridges corresponding to titanium spacers”. Alternatively, as shown in FIG. 6, a plurality of bridges having different sizes may be included. The bridges included in the kit shown in FIG. 6 correspond to the individual titanium spacers of the kit shown in FIG. Therefore, when the kit shown in FIG. 4 includes the bridge shown in FIG. 5, the bridge corresponding to the titanium spacer can be accurately selected in a short time.
Another example is a kit 21 shown in FIG. In the kit of FIG. 7, a combination of a titanium spacer and a bridge corresponding to the titanium spacer is set. Therefore, it is possible to select the bridge corresponding to the spacer more accurately in a shorter time.
The bridge can be colored like a titanium spacer. By assigning the same color to the titanium spacer and the corresponding bridge, the correspondence between the spacer and the bridge becomes easier to understand. When the bridge is made of titanium, it can be colored similarly to the titanium spacer.
Furthermore, like a titanium spacer, the bridge can be marked like a size identification hole for each height B of the sandwiching portion.
本発明のキットは、甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入するブリッジのサイズを、より的確かつ短時間に決定するために使用することができる。
術中に、異なるサイズのチタン製スペーサーを次々取り換えて発声の調整を行い、スペーサーのサイズが確定したら、別途用意したブリッジ、あるいはキットに含まれるブリッジを即座に適用する。
本発明のキットはディスポーサブルであっても良い。 The kit of the present invention can be used to more accurately and quickly determine the size of a bridge to be inserted in order to open and fix a patient's thyroid cartilage incision in thyroid chondroplasty type 2.
During the operation, the titanium spacers of different sizes are replaced one after another, and the utterance is adjusted. When the spacer size is determined, the bridge prepared separately or the bridge included in the kit is immediately applied.
The kit of the present invention may be disposable.
痙攣性発声障害の患者２０名それぞれについて、チタン製スペーサーを用いて甲状軟骨形成術２型を行った。
切開した甲状軟骨（声門）の開大幅を決めるため、男性患者にはサイズ判定部の高さｂが４．５ｍｍのスペーサーを、女性患者にはサイズ判定部の高さｂが３．０ｍｍのスペーサーを、それぞれ準備した。さらに、高さが同じで本体部の幅ａが異なるスペーサーをいくつか準備した。 For each of the 20 patients with convulsive dysphonia, thyroid chondroplasty type 2 was performed using a titanium spacer.
To determine the opening of the incised thyroid cartilage (glottis), a male patient has a spacer with a height determination part height b of 4.5 mm, and a female patient has a spacer with a size determination part height b of 3.0 mm. Were prepared respectively. Further, several spacers having the same height and different main body widths a were prepared.
まず、二つのスペーサーを甲状軟骨切開部の上部と下部に挿入して（図３）、患者に発声してもらい、サイズが合わない場合は、別のサイズのスペーサーを使用した。この作業を患者が自分の声に満足するまで何度か繰返して、最適なスペーサーを決定した。決定した最適なスペーサーのサイズに対応するブリッジを、甲状軟骨の切開部に挿入して縫合により固定した。 First, two spacers were inserted into the upper and lower portions of the thyroid cartilage incision (FIG. 3), and the patient uttered. If the sizes did not match, spacers of different sizes were used. This process was repeated several times until the patient was satisfied with his voice and the optimal spacer was determined. A bridge corresponding to the determined optimal spacer size was inserted into the incision of thyroid cartilage and fixed by suture.
サイズの異なる複数のスペーサーを準備して声の調整を行ったため、迅速に最適な開大幅を決定することができた。また、ブリッジのサイズと正確に対応するサイズのスペーサーを用いたことにより、的確な開大幅を決定することができ適正なサイズのブリッジを選択することができた。 We prepared multiple spacers of different sizes and adjusted the voice, so we were able to quickly determine the optimal opening. In addition, by using a spacer having a size that exactly corresponds to the size of the bridge, it was possible to determine an appropriate opening degree and to select a bridge of an appropriate size.
図１（ａ）は、本発明の一実施形態のチタン製スペーサーの構成を示す断面図である。図１（ｂ）は、本発明の一実施形態のチタン製スペーサーの構成を示す断面図である。図１（ｃ）は、本発明の一実施形態のチタン製スペーサーの構成を示す斜視図である。Fig.1 (a) is sectional drawing which shows the structure of the titanium spacer of one Embodiment of this invention. FIG.1 (b) is sectional drawing which shows the structure of the titanium spacer of one Embodiment of this invention. FIG.1 (c) is a perspective view which shows the structure of the titanium spacer of one Embodiment of this invention. 本発明のチタン製スペーサーを手術中に使用している状態を示す図である。It is a figure which shows the state which is using the titanium spacer of this invention during an operation. 本発明のチタン製スペーサーを、甲状軟骨切開部の上部と下部の二か所に挿入している状態を示す図である。It is a figure which shows the state which has inserted the titanium spacer of this invention in two places, the upper part and the lower part of a thyroid cartilage incision part. 本発明の一実施態様のキットの構成を示す図である。It is a figure which shows the structure of the kit of one embodiment of this invention. 図５（ａ）は、本発明の一実施態様のチタン製スペーサーキットに含まれるブリッジを示す斜視図である。図５（ｂ）は、本発明の一実施態様のチタン製スペーサーキットに含まれるブリッジを示す断面図である。Fig.5 (a) is a perspective view which shows the bridge | bridging contained in the titanium spacer kit of one embodiment of this invention. FIG.5 (b) is sectional drawing which shows the bridge | bridging contained in the titanium spacer kit of one embodiment of this invention. 本発明の一実施態様のキットに含まれるブリッジを示す図である。It is a figure which shows the bridge | bridging contained in the kit of one embodiment of this invention. 本発明の一実施態様のキットを示す図である。It is a figure which shows the kit of one embodiment of this invention. 図８（ａ）は、本発明の一実施態様のチタン製スペーサーの構成を示す断面図である。図８（ｂ）は、本発明の一実施態様のチタン製スペーサーの構成を示す斜視図である。FIG. 8A is a cross-sectional view showing a configuration of a titanium spacer according to an embodiment of the present invention. FIG.8 (b) is a perspective view which shows the structure of the titanium spacer of one embodiment of this invention.
１、１０１　チタン製スペーサー
２、１０２　ツマミ部
１０２ａ　第１のツマミ部
１０２ｂ　第２のツマミ部
３、１０３　本体部
４ａ、４ｂ、１０４ａ、１０４ｂ　大翼部
５、１０５　本体部の底面
６、１０６　チタン製スペーサーの底面
７ａ、７ｂ、１０７ａ、１０７ｂ　本体部の側面
８ａ、８ｂ、１０８ａ、１０８ｂ　小翼部
９ａ、９ｂ、１０９ａ、１０９ｂ　サイズ判定部
１０、１１０　サイズ識別穴
１１　止血鉗子
１２　甲状軟骨切開部
１３　ガーゼ
１４　甲状軟骨
１５　ブリッジ
１６　挟持部
１７　架橋部
１８ａ，１８ｂ　ブリッジの大翼部
１９ａ，１９ｂ　ブリッジの小翼部
２０　貫通孔
Ａ　ブリッジの架橋部の幅
Ｂ　挟持部の高さ
ａ　本体部の幅
ｂ　サイズ判定部の高さ
ｃ　小翼部の長さ
ｄ　大翼部の長さ
ｗ１　ツマミ部の厚さ
ｗ２　大翼部の厚さ
ｗ３　小翼部の厚さ DESCRIPTION OF SYMBOLS 1,101 Titanium spacer 2,102 Knob part 102a 1st knob part 102b 2nd knob part 3,103 Main body part 4a, 4b, 104a, 104b Large wing part 5,105 Bottom face 6 of main part 6,106 Made of titanium Spacer bottom surface 7a, 7b, 107a, 107b Main body side surface 8a, 8b, 108a, 108b Small wing part 9a, 9b, 109a, 109b Size judgment part 10, 110 Size identification hole 11 Hemostatic forceps 12 Thyroid cartilage incision part 13 Gauze 14 Thyroid cartilage 15 Bridge 16 Holding part 17 Bridge part 18a, 18b Large wing part 19a, 19b Bridge small wing part 20 Through hole A Bridge bridge part width B Holding part height a Body part width b Size Determining part height c Small wing part length d Large wing part length w1 Knob part thickness w2 Large wing part thickness w3 Small wing part thickness

Claims (17)

  1. 甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを、的確かつ短時間に決定するチタン製のスペーサーであって、
    ツマミ部、前記ツマミ部に続く本体部、前記本体部からツマミ部とは垂直な方向に左右対称に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、
    前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成するチタン製スペーサー。     The size of the bridge composed of two symmetrical sandwiching parts and a bridging part connecting them is inserted to open and fix the patient's thyroid cartilage incision in thyroid chondroplasty type 2. Titanium spacer to be determined
    A knob part, a main body part following the knob part, two large wing parts extending symmetrically in a direction perpendicular to the knob part from the main body part, and extending from the main body part to the left and right in parallel with the large wing part With two wings constituting the bottom of the titanium spacer together with the bottom of the main body,
    The titanium spacer in which the said large wing part, the said main-body part following the said large-wing part, and the said small wing part following the said main-body part comprise the size determination part which determines the size of the clamping part of the said bridge | bridging.
  2. 甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを、的確かつ短時間に決定するチタン製のスペーサーであって、
    第１及び第２のツマミ部、前記第１及び第２のツマミ部に続く本体部、前記本体部から左右に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、
    前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成するチタン製スペーサー。     The size of the bridge composed of two symmetrical sandwiching parts and a bridging part connecting them is inserted to open and fix the patient's thyroid cartilage incision in thyroid chondroplasty type 2. Titanium spacer to be determined
    First and second knob parts, a main body part following the first and second knob parts, two large wing parts extending left and right from the main body part, and left and right in parallel with the large wing part from the main body part Two small wings constituting the bottom of the titanium spacer together with the bottom of the main body,
    The titanium spacer in which the said large wing part, the said main-body part following the said large-wing part, and the said small wing part following the said main-body part comprise the size determination part which determines the size of the clamping part of the said bridge | bridging.
  3. 第１及び第２のツマミ部の断面が、Ｌ字状の形状を有する請求項２に記載のチタン製スペーサー。 The titanium spacer according to claim 2, wherein the first and second knob sections have L-shaped cross sections.
  4. 前記本体部に、さらにサイズ識別穴が施されている請求項１または２に記載のチタン製スペーサー。 The titanium spacer according to claim 1, wherein a size identification hole is further provided in the main body portion.
  5. 着色が付されている請求項１または２記載のチタン製スペーサー。 The titanium spacer according to claim 1 or 2, which is colored.
  6. 陽極酸化により着色が付されている請求項５に記載のチタン製スペーサー。 The titanium spacer according to claim 5, which is colored by anodization.
  7. 甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを的確かつ短時間に決定するために用いる、複数のチタン製スペーサーを含むキットであって、
    前記キットを構成するチタン製スペーサーが、ツマミ部、前記ツマミ部に続く本体部、前記本体部からツマミ部とは垂直な方向に左右対称に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、
    前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成しているキット。     In thyroid chondroplasty type 2, the size of the bridge composed of two symmetrical sandwiching parts and a bridge part connecting them is inserted in order to enlarge and fix the thyroid cartilage incision of the patient in a short time. A kit comprising a plurality of titanium spacers used for determination,
    The titanium spacer constituting the kit includes a knob part, a main body part following the knob part, two large wing parts extending symmetrically in a direction perpendicular to the knob part from the main body part, and the large part from the main body part. In parallel with the wing part, it includes two small wing parts that extend from side to side to form the bottom surface of the titanium spacer together with the bottom surface of the main body part,
    The kit in which the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge.
  8. 甲状軟骨形成術２型において患者の甲状軟骨切開部を開大及び固定するために挿入する、二つの左右対称な挟持部とこれらをつなぐ架橋部から構成されるブリッジのサイズを的確かつ短時間に決定するために用いる、複数のチタン製スペーサーを含むキットであって、
    前記キットを構成するチタン製スペーサーが、第１及び第２のツマミ部、前記第１及び第２のツマミ部に続く本体部、前記本体部から左右に伸びる二つの大翼部、及び前記本体部から前記大翼部と並行して左右に伸び前記本体部の底面と共に前記チタン製スペーサーの底面を構成する二つの小翼部を備え、
    前記大翼部、前記大翼部に続く前記本体部、及び前記本体部に続く前記小翼部が、前記ブリッジの挟持部のサイズを判定するサイズ判定部を構成しているキット。     In thyroid chondroplasty type 2, the size of the bridge composed of two symmetrical sandwiching parts and a bridge part connecting them is inserted in order to enlarge and fix the thyroid cartilage incision of the patient in a short time. A kit comprising a plurality of titanium spacers used for determination,
    The titanium spacer constituting the kit includes first and second knob portions, a main body portion following the first and second knob portions, two large wing portions extending left and right from the main body portion, and the main body portion From two small wings that extend in parallel with the large wings and constitute the bottom of the titanium spacer together with the bottom of the main body,
    The kit in which the large wing portion, the main body portion following the large wing portion, and the small wing portion following the main body portion constitute a size determination unit that determines the size of the sandwiching portion of the bridge.
  9. 第１及び第２のツマミ部の断面が、Ｌ字状の形状を有する請求項８に記載のキット。 The kit according to claim 8, wherein the first and second knob sections have L-shaped cross sections.
  10. 異なるサイズのチタン製スペーサーを含む請求項７または８に記載のキット。 The kit according to claim 7 or 8, comprising titanium spacers of different sizes.
  11. 前記キットを構成するチタン製スペーサーが、サイズによって異なる色が付されている請求項１０に記載のキット。 The kit according to claim 10, wherein the titanium spacer constituting the kit is colored differently depending on the size.
  12. 前記サイズ判定部の高さｂが、２～６ｍｍの範囲である請求項７または８に記載のキット。 The kit according to claim 7 or 8, wherein a height b of the size determination unit is in a range of 2 to 6 mm.
  13. 前記本体部の幅ａが、２～６ｍｍの範囲である請求項７または８に記載のキット。 The kit according to claim 7 or 8, wherein the width a of the main body is in the range of 2 to 6 mm.
  14. さらに、ブリッジを含む請求項７または８に記載のキット。 The kit according to claim 7 or 8, further comprising a bridge.
  15. 前記ブリッジがチタン製スペーサーに対応するブリッジである請求項１４に記載のキット。 The kit according to claim 14, wherein the bridge is a bridge corresponding to a titanium spacer.
  16. 前記キットに含まれるブリッジに色が付与されている請求項１４に記載のキット。 The kit according to claim 14, wherein the bridge included in the kit is colored.
  17. 前記キットが、チタン製スペーサーと前記チタン製スペーサーに対応するブリッジの組合せを含み、前記組合せごとに同じ色が付与されている請求項１４に記載のキット。 The kit according to claim 14, wherein the kit includes a combination of a titanium spacer and a bridge corresponding to the titanium spacer, and the same color is given to each combination.
PCT/JP2015/069249 2014-07-04 2015-07-03 Titanium spacer used for type ii thyroplasty and kit for same WO2016002924A1 (en)

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