CN103976781A - Composite skull base repair fixer - Google Patents

Abstract

The invention discloses a composite cranial base repair fixer. A fixed disk is arranged at the top of a connecting rod, and a movable disk that can move on the connecting rod is arranged at the lower end of the connecting rod. The fixed disk and the movable disk are coaxial on the connecting rod to fix The opposite side of the disk and the movable disk is the inside, and the biological dura mater matching the shape of the fixed disk is pasted on the inner surface of the fixed disk, and a silicon capsule filled with water-absorbing resin is installed on the connecting rod between the fixed disk and the movable disk. A number of through holes are evenly distributed on the movable plate. The inner surface of the movable plate includes an inner ring and an outer ring. The through holes are placed between the inner ring and the outer ring. The inner ring conflicts with the silicon capsule. The needle-shaped serrations face the silicon capsule and there is a diversion groove on the needle-like serrations. When the needle-like serrations pierce the silicon capsule, one end of the diversion groove communicates with the silicon capsule, and the other end of the diversion groove connects with the bone window of the patient's skull. The gaps are connected. The prunable biological dura mater and the silicon capsule water-absorbing resin with excellent conformability of the present invention are suitable for completely repairing various defect bone windows, repairing cerebrospinal fluid leakage, and reducing the incidence rate and death rate of postoperative intracranial infection.

Description

A composite cranial base repair fixer

technical field

The invention relates to surgical tools in the medical field, in particular to a composite cranial base repair fixator.

Background technique

With the development of neurosurgical equipment and technology, a large number of skull base operations have been carried out, but minimally invasive surgery at the expense of skull base bone, due to the deep surgical site and narrow operating space, postoperative skull base reconstruction is the current cranial base reconstruction. The biggest technical bottleneck encountered in neurosurgery. Especially with the development of neuroendoscopic technology, the scope of application of transnasal endoscopic surgery has been greatly expanded, and the bone in various parts of the entire skull base can be opened almost through the double nostrils. Bone defects, dura mater defects, and soft tissue defects in the surgical field after resection of lesions increase the incidence of postoperative cerebrospinal fluid leakage, intracranial infection, brain tissue bulge, pneumocrania and other complications. Cerebrospinal fluid leakage is a common complication after skull base surgery, especially extended transsphenoidal surgery. In order to reduce complications, skull base defects must be repaired after surgery. In addition, for complex skull base bone, especially complicated craniocerebral trauma with skull defect, due to bone and dura mater defects, stubborn cerebrospinal fluid leakage after injury must also be repaired by surgery.

At present, the clinical repair method is mainly to use soft tissue for filling. For larger defects, autologous tissue or titanium mesh plus artificial dura mater are used for composite repair with bioglue bonding, which is the so-called "sandwich" method. However, due to autologous soft tissue There will be necrosis, liquefaction and other phenomena, the probability of cerebrospinal fluid leakage after operation is high, and the repair is not reliable; the autogenous bone fragments and titanium mesh used as the repair support are displaced after the operation due to the narrow operation space and cannot be fixed, which damages the peripheral optic nerve, Important structures such as the internal carotid artery directly endanger the life of the patient in severe cases; at the same time, autologous materials increase the surgical trauma of the patient, prolong the operation time, increase the chance of infection, and bring huge surgical risks to the patient. There is no cranial base repair device that is easy to operate and reliable in clinical practice. At present, there is also a device that uses a coaxial design of the upper and lower covers and the screw connection, which can lock the skull better and protect the dura mater, but there will be communication spaces between the inside and outside of the cranium and cerebrospinal fluid leakage, and it does not have the function of repairing cerebrospinal fluid leakage. Used in skull base repair.

Contents of the invention

The purpose of the present invention is to overcome the shortcomings of the above-mentioned prior art, and provide a composite skull base repair fixator, which can seal the intracranial and extracranial communication spaces, and effectively avoid the phenomenon of cerebrospinal fluid leakage.

The present invention is achieved through the following technical proposals: a composite cranial base repair fixture, comprising a connecting rod, the top of the connecting rod is provided with a fixed disk, the lower end of the connecting rod is provided with a movable disk that can move on the connecting rod, the fixed disk and The movable disk is coaxial on the connecting rod, with the opposite side of the fixed disk and the movable disk as the inside, the biological dura that matches the shape of the fixed disk is pasted on the inner surface of the fixed disk, and the connecting rod between the fixed disk and the movable disk A silicon capsule filled with water-absorbing resin is installed on the top, and a number of through holes are evenly distributed on the movable plate. The inner surface of the movable plate includes an inner ring and an outer ring, and the through holes are placed between the inner ring and the outer ring. When the disk is fixed, the inner ring is in conflict with the silicon capsule, and the outer ring is arranged with a number of needle-shaped serrations. One end of the flow channel communicates with the silicon capsule, and the other end communicates with the bone window gap of the patient's skull.

The setting of biological dura mater and silicon capsules filled with water-absorbing resin can seal the internal and external intracranial and extracranial communication spaces to avoid leakage of cerebrospinal fluid; The gap of the bone window and the setting of the through hole can allow excess water-absorbing resin to flow out.

The inner ring is convex towards the silicon capsule. When pushing the movable plate on the connecting rod to push the silicon capsule to the fixed plate, the protruding inner ring can fully flatten the silicon capsule, which is beneficial to the piercing of the needle-like sawtooth.

The silicon capsule is an ellipsoid, and the two ends where the semi-major axis is located are provided with through holes, and the connecting rod is passed through the through holes. The radially longer connecting ends are arranged on the connecting rod in the same direction, so that the operating field of view will not be blocked, and the needle-like serrations can be prevented from piercing the silicon capsule before being pushed.

A circular hole with the same diameter as the connecting rod is provided in the center of the biological dura mater, and the biological dura mater is sleeved on the connecting rod through the circular hole and attached to the inner surface of the fixed plate. The opening of the round hole facilitates the fixed placement and replacement of the biological dura mater.

When in use, after placing the fixed plate of the fixer into the skull, push the movable plate on the connecting rod to lock the skull. During the pushing process, the inner circle pushes the silicon capsule to the fixed plate at the same time. When pushing further, the silicon capsule is The bone window is compressed and conformally filled, and at the same time, the outer side of the capsule wall is scratched by the needle-like serrations on the movable disk, and the water-absorbent resin in the capsule flows into the gap of the bone window that is not tightly filled along the diversion groove. At this time, the biological dura mater on the fixed disk has completely Fitted on the base of the skull to prevent excess resin from entering the skull, the outer edge of the movable disc tilted inward blocks the outer edge of the defect bone window so that the resin can fill the bone suture more tightly, further push the movable disc inward, and the fixator goes up and down Two discs lock the skull.

This product is mainly used in patients with extended nasal endoscopic surgery and cerebrospinal fluid leakage from skull defects, and is suitable for the repair of complex skull base defects. The double-disk fixation system provides sufficient support strength for the defect bone window, and the fixation is reliable, preventing the displacement of repair materials. The biologic dura mater and water-absorbing resin on the inner side of the fixed plate seal the intracranial and extracranial communication spaces. The artificial meninges under the fixed plate are supported by the fixed plate to ensure that the water-absorbing resin flowing out of the silicon capsule does not enter the cranium. The fixed plate blocks the brain. The stress transmitted by the pulsation to the defect bone window can avoid the loosening of the repair material, resulting in another cerebrospinal fluid leakage; at the same time, the biological dura mater can grow and fuse with the surrounding residual dura mater after a period of time without tension, and completely seal the defect; the absorbent water flowing out of the capsule Under the extrusion of the silicone capsule, the resin fills the small gap where cerebrospinal fluid may leak at the edge of the defect bone window. After absorbing water, the gap is tightly sealed to ensure the firm repair of complex skull base defects. The outer edge of the movable disc is tilted inward to form a circular groove and the serrations are evenly distributed, which can firmly lock the skull and prevent the loosening of repair materials after surgery. The inner resin flows along the outer guide groove to the outer edge of the bone window, and the annular groove catches the water-absorbing resin flowing out of the capsule, and the water-absorbing resin fills the small gaps under the extrusion of the silicon capsule, and at the same time forms the third edge of the bone window in the groove. A waterproof ring ensures the repair effect. The through-holes on the movable disc allow excess water-absorbing resin to flow out, so that the upper and lower discs of the fixer can closely fit the skull inside and outside the defect bone window and be firmly fixed.

The advantages of the present invention are: the design adopts the coaxial double disc connecting rod structure, and the position of the fixed disc can be placed and adjusted without visual obstruction, fast fixing can be realized by pushing the movable disc to fix, the operation is convenient and fast, and a large amount of operation time is saved. The prunable biological dura mater and the highly conformable silicon capsule water-absorbing resin system can be applied to various complex shapes of defect bone windows. Through this design, various complex defect bone windows can be completely repaired, cerebrospinal fluid leakage can be repaired, the dural and bone defects can be repaired at the same time, the normal biological state of the defect can be restored, the recurrence of cerebrospinal fluid leakage can be avoided to the greatest extent, and the Incidence and mortality of intracranial infection after nasal sphenoid surgery.

Description of drawings

Fig. 1 is the structural representation of the embodiment of the present invention;

Fig. 2 is a schematic structural diagram of a movable disk according to an embodiment of the present invention.

Meanings of the reference signs in the figure: 1. Fixed plate, 2. Movable plate, 3. Connecting rod, 4. Inner ring, 5. Biological dura mater, 6. Silicon capsule, 7. Sawtooth, 8. Needle-like sawtooth, 9. diversion tank.

Detailed ways

The content of the present invention will be described in further detail below in conjunction with the accompanying drawings and specific embodiments.

Example

Referring to Fig. 1 to Fig. 2, a composite cranial base repair fixture includes a connecting rod 3, a fixed disc 1 is provided at the top of the connecting rod 3, a movable disc 2 is provided at the lower end of the connecting rod 3, and the fixed disc 1 and the movable disc 2 are connected The rod 3 is coaxial, and the movable disk 2 can be pushed by external force to move on the connecting rod 3. With the opposite side of the fixed disk 1 and the movable disk 2 as the inside, a sticker in the shape of the fixed disk 1 is attached on the inner surface of the fixed disk 1. The matching biological dura mater 5 is equipped with a silicon capsule 6 filled with water-absorbing resin on the connecting rod 3 between the fixed disk 1 and the movable disk 2, and a number of through holes are evenly distributed on the movable disk 2, and the inner surface of the movable disk 2 Including the inner ring 4 and the outer ring (the inner ring and the outer ring in the present invention refer to the two areas on the inner side of the movable disc 2 and around the connecting rod 3, wherein the inner side edge is the outer ring , the opposite area is the inner ring, which can be defined by a through hole, the main purpose of the inner ring is to conflict with the silicon capsule), the through hole is placed between the inner ring and the outer ring, when the movable disk is close to the fixed disk, the inner ring The ring 4 is in conflict with the silicon capsule 6, and there are several needle-shaped serrations 8 arranged on the outer ring. At 6 o'clock, one end of the diversion groove 9 communicates with the silicon capsule 6, and the other end communicates with the bone window gap of the patient's skull. During the operation, the skull base is adjusted to an almost inverted angle through body position adjustment for the convenience of the operation. If the fixed disc is located in the cranium, there may be resin leakage into the cranium; the outer edge of the movable disc 2 is tilted inward to form a circular groove, and upwardly warped saw teeth 7 are evenly distributed. The diversion groove 9 can be grooved on the surface of the needle-like sawtooth 8 or can be grooved inside.

The setting of the biological dura mater 5 and the silicon capsule 6 filled with water-absorbing resin can seal the intracranial and extracranial communication spaces inside and outside to avoid leakage of cerebrospinal fluid; the needle-shaped serrations 8 are used to puncture the silicon capsule 6, and the water-absorbing resin flows along the diversion groove 9 flows into the bone window gap that is not tightly filled, and the setting of the through hole allows excess water-absorbing resin to flow out; the upturned serrations 7 are used to lock the skull to avoid loosening of the postoperative repair material.

Biological dura mater is a biomembrane commonly used in clinical medicine at present. It has thin film, high toughness, good tissue compatibility, and is conducive to the growth and fusion with the meninges of the recipient.

The inner ring 4 is convex towards the silicon capsule 6 . When the movable plate 2 is pushed on the connecting rod 3 to push the silicon capsule 6 to the fixed plate 1, the protruding inner ring 4 can fully compress the silicon capsule 6, which is beneficial to the piercing of the needle-shaped serrations 8 .

The silicon capsule 6 is ellipsoid, and the two ends where the semi-major axis is located are provided with through holes, and the connecting rods are passed through the through holes. The radially longer connecting end is arranged on the connecting rod 3 in the same direction, so that the operating field of view will not be blocked, and the needle-shaped serrations can be prevented from piercing the silicon capsule before being pushed.

A circular hole with the same diameter as the connecting rod 3 is provided in the center of the biological dura mater 5 , and the biological dura mater 5 is sleeved on the connecting rod 3 through the circular hole and attached to the inner surface of the fixed disk 1 . The opening of the circular hole facilitates the fixed placement and replacement of the biological dura mater 5 .

A split groove can also be opened between the round hole and the edge of the biological dura mater 5, and the connecting rod 3 is put into the round hole through the split groove. The setting of the split groove can easily set the biological dura mater 5 on the connecting rod 3 and facilitate the replacement of the biological dura mater 5 .

When in use, push the movable disk 2 on the connecting rod 3 to lock the skull. During the pushing process, the inner ring 4 pushes the silicon capsule 6 to the fixed disk 1 at the same time. At the same time, the outer side of the capsule wall is scratched by the needle-like serrations 8 on the movable disk 2, and the water-absorbing resin in the capsule flows into the gap of the bone window that is not tightly filled along the flow guide groove 9. At this time, the biological dura mater 5 on the fixed disk 1 has been pasted. Closed on the base of the skull to prevent excess resin from entering the skull, the outer edge of the movable disc tilted inward blocks the outer edge of the defect bone window so that the resin can fill the bone suture more tightly, further push the movable disc 2 inward, and the fixator goes up and down The two discs lock the skull, and excess resin is squeezed out of the through holes.

This product is mainly used in patients with extended nasal endoscopic surgery and cerebrospinal fluid leakage from skull defects, and is suitable for the repair of complex skull base defects. The double-disk fixation system provides sufficient support strength for the defect bone window, and the fixation is reliable, preventing the displacement of repair materials. The biologic dura mater 5 and the water-absorbing resin on the inner side of the fixed plate 1 seal the extracranial and extracranial communication spaces, and the artificial meninges under the fixed plate 1 are supported by the fixed plate 1 to ensure that the water-absorbing resin flowing out of the silicon capsule 6 does not enter the cranium. The fixed disc 1 blocks the stress of the brain pulse transmitted to the defect bone window, avoiding the loosening of the repair material, resulting in another cerebrospinal fluid leakage; at the same time, the biological dura mater 5 can grow and fuse with the surrounding residual dura mater after a period of time without tension, and completely seal it Defect: The water-absorbing resin flowing out of the capsule is squeezed by the silicon capsule 6 to fill the small gap where cerebrospinal fluid may leak at the edge of the bone window of the defect. After absorbing water, the gap is tightly sealed to ensure a reliable repair of complex skull base defects. The outer edge of the movable disc 2 is tilted inward to form an annular groove and evenly distribute the serrations 7, which can securely lock the skull and prevent postoperative repair materials from loosening. The needle-shaped serrations 8 on the outer ring of the movable disc 2 will squeeze the deformed silicon capsule 6 is scratched, the resin in the capsule flows to the edge of the bone window along the diversion groove 9, and the annular groove catches the water-absorbing resin flowing out from the capsule, and the water-absorbing resin fills the small gaps under the extrusion of the silicon capsule 6, and at the same time, the water-absorbing resin in the groove The third waterproof ring on the outer edge of the bone window is formed to ensure the repair effect. The through hole on the movable disc 2 allows excess water-absorbing resin to flow out, so that the upper and lower discs of the fixer can closely fit the skull inside and outside the defect bone window and be firmly fixed.

The above detailed description is a specific description of the feasible embodiment of the present invention. This embodiment is not used to limit the patent scope of the present invention. Any equivalent implementation or change that does not deviate from the present invention should be included in the patent scope of this case. middle.

Claims (4)

1. a compound basis cranii is repaired holder, comprise connecting rod, connecting rod top is provided with fixed disk, connecting rod lower end is provided with the movable disk that can move on connecting rod, fixed disk and movable disk are coaxial on connecting rod, it is characterized in that: taking the fixed disk one side relative with movable disk as in, on fixed disk medial surface, post the biological dura mater with fixed disk form fit, on the connecting rod between fixed disk and movable disk, add the silicon capsule of filling water-absorbing resin, in movable disk, be distributed with some through holes, movable disk medial surface includes inner ring and outer ring, through hole is placed between inner ring and outer ring, when movable disk is during near fixed disk, inner ring is for inconsistent with silicon capsule, outer ring is arranged with several needle-like sawtooth, needle-like sawtooth is provided with guiding gutter towards silicon capsule and needle-like sawtooth, in the time that needle-like sawtooth punctures silicon capsule, guiding gutter one end is communicated with silicon capsule, the guiding gutter other end communicates with the bone window gap of patient's skull.

2. compound basis cranii according to claim 1 is repaired holder, it is characterized in that: described inner ring is towards silicon capsule projection.

3. compound basis cranii according to claim 1 is repaired holder, it is characterized in that: described silicon capsule is ellipsoid, and the two ends at semi-major axis place offers through hole, and described connecting rod is located in through hole.

4. compound basis cranii according to claim 1 is repaired holder, it is characterized in that: be provided with the circular hole consistent with described connecting rod diameter in described biological dura mater central authorities, biological dura mater is located on connecting rod by circle hole sleeve and is attached on described fixed disk medial surface.