RU223002U1 - Lunev cannula for bougienage and lavage of the maxillary sinus - Google Patents

Abstract

The utility model relates to devices used in otorhinolaryngology and intended for washing the maxillary (maxillary) sinus through a natural anastomosis in the process of treating inflammatory diseases. The device is a cannula made of rigid material. The cannula contains a curved tube, the bend of which is adapted for insertion into the sinus, with a sealed and oval working end. The end has through slot-like holes. Along the working end, at the base of these holes, there are olive-shaped thickenings. At the opposite end of the tube there is a flattened pavilion for attaching a syringe, which has two wide parallel edges; the plane of the pavilion is perpendicular to the direction of the bending plane of the working end of the tube. A mark indicating the direction of the working end of the tube is applied to one of the faces of the pavilion. 1 Ave., 1 Ill.

Description

The utility model relates to the field of medicine, namely to devices used in otorhinolaryngology for the treatment of inflammatory diseases of the maxillary sinus (sinus).

From patent RU 2 252 040, a device (cannula) for washing the maxillary sinus through the natural anastomosis is known, made in the form of a special S-shaped curved tube with a sealed end and side holes, having a pavilion for connecting a syringe with liquid and a pilot with a mark to facilitate positioning of the cannula . We accepted this device as a prototype.

The disadvantage of the prototype is the low efficiency when using the device in cases of narrowness of the middle nasal passage, with pronounced reactive changes in the nasal mucosa (allergic or inflammatory swelling, exudation), since in this condition there is not sufficient clearance for fluid to exit the sinus to the outside.

The proposed device overcomes the shortcomings of the prototype.

In fig. 1 shows the schematic design of the proposed device in two projections.

The device is made of rigid material, biologically and chemically inert; has an S-shaped bent tube 1, the bend of which is adapted for insertion into the maxillary sinus, with a sealed and oval working end 2. At the working end 2 there are through slot-like side holes 3. Along the working end, at the base of the holes 3, there are several thickenings in olive-shaped 4. At the peripheral end of the tube 1 there is a pavilion 5 for connecting a syringe, which has a flattened shape with two wide parallel edges, while the plane of the pavilion is perpendicular to the bending plane of the working end 2 of the tube 1. On one of the faces of the pavilion 5 there is a mark 6 in the form marks indicating the direction of the working end 2 of tube 1.

The slit-like shape of the holes at the working end of the cannula, firstly, allows you to maintain the mechanical strength of the end of the tube, and secondly, creates additional pressure for the exiting liquid, which has a beneficial effect on the efficiency of irrigation and washing the surface of the sinus mucosa.

Combining the pilot and pavilion for attaching the syringe and giving it a flat shape with wide edges allows you to comfortably carry out manipulations directly with your hands, without the use of additional tools such as tweezers, which ensures increased accuracy and efficiency.

The thickenings in the area of the working end give the cannula bougie properties, i.e. provide the ability to expand the lumen in cavities and passages that are in a state of obstruction, and as a result, facilitate the insertion of an instrument and the outflow of fluid from the sinus during rinsing. The use of several thickenings makes it possible to intensify the process of fluid drainage in case of severe obstructions of the mucous membrane ("pockets" are formed between the thickenings, into which liquid enters and is removed from the sinus when the working end of the cannula moves back and forth relative to the sinus anastomosis). Thus, the combination of a bougie and a cannula makes it possible to use one instrument for washing the maxillary sinus in conditions of mucosal obstruction.

The cannula is used as follows: after local anesthesia is performed, the working end of the cannula is inserted into the middle nasal meatus, which with its concave surface bends around the uncinate process. After this, focusing on the tactile sensation, the tip of the cannula slightly pulls the uncinate process towards itself, thereby feeling the anastomosis and with a sliding movement the tip of the cannula is carefully inserted into the anastomosis of the maxillary sinus, which creates a feeling of “falling in”. After inserting the working end of the cannula into the sinus, a syringe with a medicinal solution is attached to the pavilion and the sinus is washed. In this case, to improve the drainage of fluid from the sinus, it is possible to periodically move the cannula, changing the depth of penetration into the sinus (move the working end of the cannula back and forth relative to the sinus anastomosis).

Example 1. The cannula is made of stainless surgical steel. The total length of the cannula is 95 mm. The part containing the S-shaped bent tube with a diameter of 1.6 mm has a length of 80 mm. The pavilion for connecting the syringe has two parallel wide edges with a notch on one of them and two side rounded edges, the dimensions of the pavilion are 15 mm x 8 mm x 6 mm (length x width x height). At the working end of the tube there are through slot-like holes measuring 1.5 mm x 0.5 mm. In the area of the working end of the tube, at the base of the holes, there are three olive-shaped thickenings with a diameter of 3 mm.

The use of the described cannula is demonstrated by the following clinical example:

Patient M., 18 years old. He was admitted to the otorhinolaryngology department with a diagnosis of acute right-sided purulent sinusitis. The patient's first complaints of headache, difficulty breathing, nasal discharge and an increase in body temperature to 39° arose 6 days ago, against the background of an acute respiratory viral infection. The results of computed tomography revealed darkening of the right maxillary sinus, with the presence of a fluid component. Breathing is difficult, the nasal passage is obstructed, the use of decongestants does not give the expected effect.

While in the otolaryngology department, the patient repeatedly underwent probing and lavage of the right maxillary sinus through the natural anastomosis using the described device. The introduction of a bougie cannula through the swollen mucous ducts was accompanied by slight mechanical resistance, however, the patient did not notice any significant discomfort. During lavage, purulent contents were separated from the sinus, and fluid flowed freely from the sinus. The patient noted an improvement in his condition and the disappearance of unpleasant sensations immediately after the first manipulation. After 7 days, at the time of discharge, there are no complaints. On a control computed tomography scan of the paranasal sinuses, performed after 14 days, there was no evidence of sinusitis (sinusitis). All sinuses are pneumatized, which is the norm.

Claims (1)

Cannula for bougienage and rinsing of the maxillary sinus, made of rigid material in the form of an S-shaped bent tube, the bend of which is adapted for insertion into the maxillary sinus, with a sealed and oval working end having side holes, with a pavilion for connecting a syringe at the opposite peripheral end of the tube , characterized in that the side holes at the working end of the tube have a slot-like shape; along the working end, at the base of these holes, there are thickenings in the shape of olives; the pavilion located at the peripheral end of the tube has a flattened shape with two parallel edges, while the plane of the pavilion is perpendicular to the bending plane of the working end of the tube, and one of the faces of the pavilion has a mark indicating the direction of the working end of the tube.