RU2771507C1 - Septal splint with antiseptic coating - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to the field of medicine, in particular to otorhinolaryngology, and can be used in the surgical treatment of diseases of the nasal cavity, namely curvature of the nasal septum, perforation of the nasal septum and synechiae of the nasal cavity. The septal splint in the form of a plate made of elastic material is made according to the anatomical shape of the nasal septum, the plate is equipped with a support platform in the form of an extended strip located along the lower edge of the plate at an angle from 60 to 110 degrees and made to support the structures of the bottom of the nasal cavity. The plate and strip are made in the form of a single part with a coating of the outer surface with a layer containing silver molecules with a silver of at least 99.9 wt. % with a thickness of 10 to 200 nm.EFFECT: use of a septal splint makes it possible to increase the effectiveness of surgical treatment of nasal septum curvature and reduce the time to achieve a therapeutic effect due to reliable fixation of the splint in the nasal cavity after surgical treatment in combination with antimicrobial action that reduces the risk of splint seeding and infectious complications.10 cl, 4 dwg

Description

The field of technology to which the invention belongs

The invention relates to medicine, in particular to otorhinolaryngology, and can be used in the surgical treatment of diseases of the nasal cavity, namely, curvature of the nasal septum, perforation of the nasal septum and synechiae of the nasal cavity.

State of the art

It is known to use various means of fixing the position of the nasal septum at the final stage of surgical treatment of the curvature of the nasal septum (septoplasty). In particular, the fixation of the nasal septum in the established median position can be implemented by means of sutures and tampons (latex, gauze), preventing contact between the sheets of the mucous membrane of the nasal septum (Preobrazhensky B.S., Temkin Y.S. et al. Diseases of the ear, throat and nose . - M.: Medicine, 1968). Nasal tamponade is also aimed at preventing possible postoperative complications, such as bleeding, septal hematoma, formation of adhesions between the septum and the lateral wall of the nasal cavity.

However, the use of tampons to fix the position of the nasal septum in the postoperative period is not recommended for more than 24-48 hours due to the high likelihood of postoperative complications such as inflammation of the paranasal sinuses and mucosal necrosis. In addition, tampons are impregnated with wound discharge and mucus, which provokes the growth of microflora, and the removal of tampons is an extremely painful manipulation, may be associated with trauma to the mucous membrane, accompanied by epistaxis, and cause displacement of the elements of the restored nasal septum. Thus, the use of tampons reduces the effectiveness of the treatment of deviated septum, due to the limited possibility of fixation during a longer period of wound healing, the high risk of contamination of the surgical wound with microorganisms during the use of tampons, which increases the incidence of infectious complications, and also due to the high risk displacement from the median position of the formed septum when the tampon is removed. All this increases the healing time of the nasal septum in the postoperative period.

The most preferred is the use of intranasal tires (splints), which are installed on the nasal septum after surgery. Intranasal splints, as a rule, are plates of elastic material, having a shape close to the average anatomical shape of the nasal septum (according to CT images), which, when installed close to the nasal septum, keep it in the middle position, shielding the mucous membrane of the restored septum from mechanical and chemical impact.

In particular, the internal nasal splint breathe eas, pre cut splint, endonasal splint with an additional section for the treatment and postoperative prevention of cicatricial deformity of the nasal vestibule are known from the prior art (RU 2729711). The tire is made in the form of a plate of elastic material, has a drop-shaped smoothed shape. At the anterior-lower end of the plate, an additional section of a rectangular shape is made for fixing the wing of the nose. However, the use of a tire of this design does not provide adequate pressing of the mucoperiosteal flaps to the bottom of the nasal cavity. In addition, this splint does not provide reliable fixation in the nasal cavity and may partially shift in the nasal cavity in the postoperative period, which reduces the functional effectiveness of surgical treatment of nasal septal deformities.

Closest to the claimed solution is an intranasal splint containing a base of elastic material made in the form of a heptagonal plate (RU 2414180). The tire can be made of silicone rubber with a hardness of Shore A-60. In one embodiment, the splint can be made with a hollow, roller-like thickening throughout the intranasal splint at the level of the inferior turbinate and oriented to the side wall of the nasal cavity, which, according to the developers, further facilitates nasal breathing in the patient. This intranasal splint is installed in the nasal cavity from both sides along the nasal septum after surgical treatment of the curvature of the nasal septum.

However, tires of a known design are installed on a limited (curved) section of the nasal septum, and therefore there remain sections of the mucous membrane of the nasal septum that are not shielded by the tire. In addition, in the postoperative period, due to migration and displacement of the splint from its original position during installation, certain areas may be exposed, for example, adjacent to the structures of the floor of the nasal cavity. This can lead to deterioration in the healing of the nasal septum in the postoperative period and the development of postoperative complications, in particular, perforations of the nasal septum or synechia of the nasal cavity, as well as lengthening the healing time. In addition, during the formation of mucoperiosteal flaps in the area of the bottom of the nasal cavity, this splint does not provide pressing of the flaps to the bottom of the nasal cavity throughout. This can lead to poor alignment of the edges of the flaps, the appearance of complications (submucosal hematoma). In addition, the use of this tire requires special training from the doctor, because. associated with the risk of displacement of the plate during installation. In addition, when using a splint with a hollow bead, the lower edge of the bead may abut against the structures of the floor of the nasal cavity, causing tissue ischemia in this area and discomfort to the patient.

Since the nasal cavity is not sterile, but is inhabited by microorganisms, when a tire is inserted into the nasal cavity, contamination of the surface of the tire with both opportunistic bacteria from the microbiome of the nasal cavity and bacteria from the inhaled air can occur. When using intranasal tires for more than 1 day, conditions are created for the adhesion of microorganisms, the formation of colonies and biofilms on the surface of the tire. The reproduction of bacteria, in turn, can lead to the development of inflammatory reactions in the nose and infection of the postoperative wound. As a result, the effectiveness of treatment is reduced and patients experience unpleasant symptoms - nasal discharge, difficulty in nasal breathing. Also, when the infection spreads, the risk of an unfavorable outcome of surgical treatment of the nasal septum increases, and the duration of rehabilitation increases.

It is known from the prior art to use medical products coated in the form of a nanolayer containing silver molecules (see "Silver nanoparticles help create a healthy environment. Advantages of antibacterial technologies"; Found [05/26/2021] on the Internet<https://business- display.benq.com/en-us/explore/trends/silver-nanoparticles-healthy-environment.html>Published on [09/25/2020] Publication date verified by web archive:<http://web.archive.org/web /20200925125026/https://business-display.benq.com/ru-ru/explore/trends/silver-nanoparticles-healthy-environment.html>). The use of such a coating provides an antibacterial effect. Advances in nanotechnology make it possible to use the advantages of this metal in various forms - in the form of silver ions (Ag +) and silver nanoparticles (Ag NP). The latter have received close attention due to their antimicrobial, bactericidal, antifungal, antiseptic, antiviral, and anti-mould properties. Currently, silver nanoparticles are the most well-known antimicrobial agent.

In otorhinolaryngology, the use of drugs containing silver compounds in the form of nasal drops is known for the treatment of acute and chronic inflammatory diseases of the nasal cavity and paranasal sinuses. It is also known to use a gel containing silver ions for the treatment of infectious diseases of the nasal cavity. However, it is not known to use intranasal splints with a coating containing silver molecules that would provide an increase in the effectiveness of the treatment of diseases of the nasal cavity, including deviated nasal septum, due to reliable fixation of the splint in the nasal cavity with a decrease in the risk of infection of the splint in the postoperative period.

The technical problem is to increase the effectiveness of the treatment of nasal septal curvature while reducing its healing time.

Disclosure of invention

The technical result is to increase the effectiveness of treatment and reduce the time to achieve a therapeutic effect by creating an intranasal splint for use in the postoperative period, ensuring its reliable fixation after surgical treatment of nasal septal curvature, which has antimicrobial properties to reduce the risk of splinting of the splint and infectious complications.

Reliable fixation of the splint in the nasal cavity reduces the risk of its migration after insertion into the nasal cavity, ensuring adequate pressing of the mucoperiosteal flaps to the bottom of the nasal cavity, which reduces the risk of complications such as septal hematoma, displacement of the mucoperiosteal flaps and reduces the healing time, while reducing the likelihood of contamination of the splint microorganisms in the postoperative period and the incidence of infectious complications.

The technical result is achieved due to the presence of a structural element of the tire, which serves as a support for the structures of the bottom of the nasal cavity, covered over the entire surface with a layer of nanosilver.

The specified technical result is achieved by using an intranasal splint in the form of a plate of elastic material, made according to the anatomical shape of the nasal septum, and equipped with a support platform in the form of an extended strip located along the lower edge of the plate at an angle α from 60° to 110° and made to rest on structures of the bottom of the nasal cavity, while the plate and the strip are made in the form of a single part with a coating of the outer surface with a layer containing silver molecules with a mass fraction of silver of at least 99.9%, with a thickness of 10 to 200 nanometers. Given the high microbial population of the nasal cavity, the problem of intranasal splint contamination is extremely relevant. Infection of the tire can lead to the development of adverse events, lengthening of the healing period and the development of complications. The entire surface of the splint is in contact with intranasal secretions, and therefore any area can become the basis for pathological growth of microflora and the formation of biofilms. For this reason, the antiseptic coating of the tire must be evenly distributed over the entire surface of the tire.

The tire is made in two versions - for installation in the right half of the nose and for installation in the left half of the nose.

The support platform can be made extended from the front to the rear edge of the plate, or located with an offset from the front edge of the plate by up to 10 mm. The support platform can be made with a varying width along its length from the anterior to the posterior edge of the plate, depending on the configuration of the inferior turbinate and the distance between the structures of the nasal septum and the lateral wall of the nasal cavity. The thickness of the supporting platform S2 can be from 0.5 to 2 mm, the width H2 is from 3 to 6 mm, the angle α can vary along the length of the basal plate.

The plate and the strip can be made in the form of a part that has an L-shape in cross section.

As a rule, the plate has the shape of a pentagon with rounded corners. In some embodiments of the intranasal splint, the maximum value of the length of the plate L1 in the longest dimension is up to 75 mm, and the maximum value of the height of the plate H1 is 25 mm.

The tire can be made of silicone with a hardness of Shore A-75, while the thickness of the plate S1 is 0.5 mm - 0.9 mm.

The implementation of the splint in the form of a plate of elastic material provides shielding of the nasal septum from adverse effects in the postoperative period, prevention of postoperative complications such as adhesions and perforation of the nasal septum. When using a plate with a supporting part on the structures of the bottom of the nasal cavity in the form of an extended strip (additional section), the risk of tire displacement during installation is reduced and the mucoperiosteal flap is additionally pressed against the structures of the bottom of the nasal cavity, which has a positive effect on the effectiveness of surgical treatment of nasal septal curvature. The entire surface of the tire is coated with a layer containing silver molecules, which prevents the growth of bacteria on the surface of the tire, thereby reducing the risk of infectious complications. The layer thickness is from 10 to 200 nanometers. A layer of silver nanoparticles less than 10 nm may not have the necessary duration of bacteriostatic properties to maintain them during the entire period of operation of the device. Also, a ply thickness of less than 10 nm may not provide adequate ply adhesion to the tire surface. A layer thickness of more than 200 nm can weaken the bacteriostatic properties of the coating, as it will promote the formation of larger agglomerates of silver particles, which have a weaker bacteriostatic effect.

In one of the embodiments of the invention, the intranasal splint may have a thinner thickness compared to prior art plates, which are typically 1-2 mm thick. In particular, the inventive plate may have a thickness of 0.9 mm or less, which makes it possible to reduce the obstruction of nasal breathing when using a splint. The strength of the proposed design with a decrease in thickness can be ensured by using, for example, silicone rubber with higher Shore hardness parameters, for example, A-70 or A-75.

Brief description of the drawings

The invention is illustrated by drawings, where in Fig. 1 - 3 schematically shows the claimed tire: front view, side view, top view, respectively; in fig. 4 shows the layout of the tire in the nasal cavity, front view.

А,

В,

С,

D,

Е. - углы в вершинах базальной пластины.The positions in the figures indicate: 1 - a plate of elastic material (basal plate, splint), 2 - a support platform of the basal plate, 3 - nasal septum, 4 - the bottom of the nasal cavity. L1 - length of the basal plate (tire), H1 - height of the basal plate, S1 - thickness of the basal plate, L2 - length of the base plate base plate, H2 - width of the base plate base plate, S2 - thickness of the base plate base plate, α - plane inclination angle support platform to the plane of the basal plate;

BUT,

AT,

WITH,

D,

E. - angles at the tops of the basal plate.

Implementation of the invention

The intranasal splint is made in the form of a plate 1 made of an elastic material (basal plate), from the lower edge of which an additional section extends at an angle - a support platform 2, made in the form of an extended strip (figure 1 - 3). The entire surface of the tire is covered with an antimicrobial layer (from 10 to 200 nanometers) containing silver molecules.

The shape of the plate was obtained from the results of a CT study of the anatomical structures of the nasal cavity, the boundaries of which are the nasal septum, the roof of the nasal cavity (the latter separates the cranial cavity), and the floor of the nasal cavity. A preferred embodiment of the tire is shown in FIG. 1 - 3, where the basal plate has the shape of a pentagon with smoothed corners and rounded ribs to avoid trauma to the nasal mucosa during its installation.

The shape of the intranasal splint in the form of a pentagonal plate formed by points with vertices A, B, C, D, E (Fig. 2) was determined based on a statistical analysis of computer images of the nasal septum and its projection onto the structures of the lateral wall of the nasal cavity. Point B is located 10 mm above the projection point of the anterior margin of the inferior turbinate; point C - corresponds to the anterior end of the middle turbinate; point D - corresponds to the upper edge of the choana, point E is determined by the intersection of the perpendicular extending from the body of the main (sphenoidal) bone to the free (choanal) edge of the hard palate k, the position of point A corresponds to the anterior edge of the mucous membrane of the nasal septum. Basal plate 1 made of elastic material has a thickness S1 from 0.5 to 2 mm, a pentagonal shape in plan with pentagon vertices A, B, C, D, E, while the length of the sides of the pentagon is: AB=20-22 mm, BC= 16-18 mm, CD=43-45; DE=11-13mm, EA=49-51mm. In a preferred embodiment, the lengths of the sides of the pentagon are related as follows AB/BC/CD/DE/EA=1/0.8/2.1/0.6/2.4.

А=60° - 85°.

В=130° - 160°,

С=155° - 170°,

D=100° - 120°,

Е=80° - 100°. В одном из варианов выполнения пластина может быть выполнена с углами

А=65°,

В=145°,

С=160°,

D=110°,

Е=90°. Для внутриносовой шины, подходящей для большинства пациентов, внутренние углы пятиугольника составляют: ∠A=75°, ∠B=125°, ∠С=163°, ∠D=113°, ∠Е=90°. Углы базальной пластины скруглены для большей атравматичности. Положение вершин пятиугольника определяется в соответсвии с фиг.2.In a preferred embodiment, the basal plate has a thickness S1 from 0.5 mm to 0.9 mm, the same throughout. In lateral projection, the plate has the shape of an irregular pentagon (Fig. 2.) with corners

A=60° - 85°.

H=130° - 160°,

С=155° - 170°,

D=100° - 120°,

E=80° - 100°. In one of the embodiments, the plate can be made with corners

A=65°,

H=145°,

С=160°,

D=110°,

E=90°. For an intranasal splint suitable for most patients, the internal angles of the pentagon are: ∠A=75°, ∠B=125°, ∠C=163°, ∠D=113°, ∠E=90°. The corners of the basal plate are rounded for greater atraumaticity. The position of the vertices of the pentagon is determined in accordance with Fig.2.

α, на фиг.1 и 3)=от 60° до 110°. В отдельных вариантах реализации заявляемого устройства величина угла α может изменяться по длине базальной пластины в зависимости от высоты расположения дна полости носа по отношению к перегородке носа, конфигурации нижних носовых раковин и отдаленности структур перегородки носа от латеральной стенки полости носа. В предпочтительном варианте исполнения дополнительная секция (опорная площадка базальной пластины 2 на фиг.2) отходит от нижнего края базальной пластины под углом

α=90° на всем протяжении нижнего края. Ширина Н2 опорной площадки 2 может составлять от 3 до 6 мм. При этом на всем протяжнии полоса может иметь фиксированную ширину, или изменяющуюся в зависимости от конфигурации нижних носовых раковин, отдаленности структур перегородки носа от латеральной стенки полости носа (ширины общего носового хода).The length of the busbar L1 on the largest dimension can be from 40 to 75 mm. The height of the H1 rail can reach a maximum of 25 mm. The device has a front end (left in figure 2) and a rear end (right in figure 2). Distance A from point A to point D is 60 to 63 mm. The tire support pad on the bottom of the nasal cavity (section) is made in the form of a strip with a thickness S2 from 0.5 to 2 mm, extending from the lower edge of the basal plate along its entire length, or extending from the lower edge of the basal plate with an indent from the front end up to 10 mm. The support platform 2 is located at an angle α to the plane of the basal plate 1 (

α, figure 1 and 3)=from 60° to 110°. In some embodiments of the proposed device, the value of the angle α can vary along the length of the basal plate depending on the height of the bottom of the nasal cavity in relation to the nasal septum, the configuration of the inferior turbinates and the remoteness of the structures of the nasal septum from the lateral wall of the nasal cavity. In the preferred embodiment, the additional section (base plate base plate 2 in figure 2) departs from the lower edge of the base plate at an angle

α=90° throughout the lower edge. The width H2 of the support pad 2 can be between 3 and 6 mm. At the same time, the strip can have a fixed width along its entire length, or vary depending on the configuration of the inferior turbinates, the distance between the structures of the nasal septum from the lateral wall of the nasal cavity (the width of the common nasal passage).

The device is performed in two mirror-symmetrical versions: for installation in the right and for installation in the left halves of the nose (figure 1, 4). In the version for the left half of the nose, the support section departs from the lower edge of the basal plate to the left; in the version for the right half of the nose, the support section departs from the lower edge of the basal plate to the right. The nasal splint with support section can be made of silicone rubber with a hardness of Shore A-40 to A-75. In a preferred embodiment, the intranasal splint is made of silicone rubber with a hardness of Shore A-70 or A-75.

The above specific numerical values characterizing the dimensions of the plate are average. Making intranasal splints according to these dimensions allows them to be used for most patients.

The tire can be made by any methods known from the prior art, incl. using 3D printing. The coating containing silver molecules can also be implemented by any method known from the prior art. In a preferred embodiment of the invention, a layer consisting of silver with a mass fraction of silver of at least 99.9% is applied to the product, with a thickness of 10 to 200 nanometers. Silver nanoparticles are deposited by magnetron sputtering. This coating method does not require the substrate to be heated to high temperatures. At the first stage, the surface of the nose tire is blown to remove dust particles, degreased, for example, with an aqueous solution of 70% ethyl alcohol, and dried. After creating a vacuum, the target is bombarded with ions of the working gas (Argon), as a result of which the target is sputtered. The atomized particles are deposited in the form of a uniform film on the developed tire. The operating mode of the magnetron installation is selected in such a way that the heating of the product is minimal.

In one of the embodiments of the invention, the coating can be obtained by spraying a colloidal concentrated solution of silver nanoparticles from a distance of 10-50 cm with the spray head perpendicular to the tire surface. After coating, the product is dried at a temperature of 25-40 gr. C and relative air humidity less than 50% for 20-30 minutes.

In another embodiment of the invention, silver is applied to the tire by magnetron sputtering with simultaneous ion implantation, either by inductively coupled plasma or by RF treatment for additional ionization. This method improves the adhesion of the coating to the substrate by bombarding with high energy ions for several minutes before and after the start of deposition.

It is possible to apply a coating not of pure silver, but of composite coatings with silver in the composition. Such composite coatings can increase the adhesion of silver to the substrate and are more resistant to external mechanical stress. Composite coatings during magnetron sputtering can be produced in two ways. The first method is the simultaneous sputtering of a silver target and a target from the second coating component. The second method consists in the implantation of silver ions into the previously formed coating. Possible combinations include: HAP-Ag; TiO2-Ag; Ag-Au-PTFE; TiN-Ag; CrNAg, ZrN-Ag; TaN-Ag; DLC-Ag, TiCaPCON-Ag; TiC _0.5 -Ca ₃ (PO4) ₂ .

To improve the adhesion of the layer of silver nanoparticles to the tire surface, it is possible to preliminarily apply an additional layer to the entire surface of the tire, for example, copper by magnetron sputtering.

The application of the developed device is carried out as follows. After the operation on the nasal septum and surgical correction of other intranasal structures (if necessary), one splint is inserted into both halves of the nose. Tires are placed along the nasal septum (Fig. 4) in the nasal cavity so that the rear end of the device is in the region of the posterior part of the nasal septum, and the front end of the device is in the region of the anterior edge of the nasal septum. The basal plate is pressed against the nasal septum with its lateral part, while the support section is located at the bottom of the nasal cavity. For different halves of the nose, device options are used that are made for the right and left halves of the nose, respectively. To fix the tire in the nasal cavity, a U-shaped suture (one or more) is applied, passing through the plates on both sides and the nasal septum. If necessary, carry out postoperative tamponade of the nasal cavity. Postoperative care is carried out according to the generally accepted method (daily toilet of the nasal cavity, irrigation or applications with antibacterial and antiseptic drugs). Intranasal devices are removed from the nasal cavity 1-30 days after surgery, the duration is selected individually depending on the clinical situation.

Intranasal tires of the claimed design were tested on 100 patients with congenital and post-traumatic curvature of the nasal septum in combination with chronic vasomotor rhinitis at the age of 25 to 45 years. , 75 mm; A=60mm, H1=20mm, 25mm; and dimensions of the support pad 2: thickness S2=0.5 mm, 1 mm, 2 mm; width Н2=3 mm, 4 mm, 6 mm, with the angle of the support platform in relation to the basal one α=60°, 90°, 110°; covering the entire surface of the tire with nanosilver with a thickness of 10 nm, 100 nm and 200 nm, which have demonstrated their high efficiency. In 65% of patients (n=65), in whom the average statistical parameters of the height of the nasal cavity floor, the structure of the inferior turbinates, and the width of the common nasal passage were recorded, the supporting platform departed from the basal plate at an angle of α=90° and had a width of H2=4 mm. In 25% of patients (n=25), due to the high location of the structures of the floor of the nasal cavity, severe hypertrophy of the inferior turbinate and narrowness of the common nasal passage, a splint with a support platform was installed, which departed from the basal plate at an angle of α=60° and had a width of H2= 3 mm. In 10% (n=10), due to the relatively low location of the structures of the floor of the nasal cavity, and the great remoteness of the nasal septum from the structures of the lateral wall of the nasal cavity, a splint was installed, in which an additional support platform departed from the basal plate at an angle of α=110° and had a width H2=6 mm. The rationale for choosing one or another design for each particular patient was the preoperative endoscopic examination and CT scan of the paranasal sinuses with the measurement of the above parameters (the height of the nasal cavity floor, the configuration of the inferior turbinates, the distance from the nasal septum to the lateral wall of the nasal cavity, etc.) . The implementation of the intranasal splint in all the above ranges of values guaranteed the stability of the installed structure and reliable fixation without displacement.

An illustration of the effectiveness of the use of intranasal splints in the surgical treatment of congenital and post-traumatic deformities of the nasal septum can serve as 2 case histories.

Clinical example 1. Patient R., aged 36, was admitted with a diagnosis of deviated nasal septum, vasomotor rhinitis. The operation was performed: septoplasty, vasotomy of the inferior turbinates under the CET.

The nasal septum was fixed with original intranasal splints with an additional section with the dimensions of the basal plate Ll=50 mm, A=60 mm, H1=25 mm. The additional supporting platform departed from the basal plate at an angle α=90° and had a width H2=4 mm. The tire contained an antimicrobial layer with silver molecules 10 nm thick. When examining the nasal cavity with a rigid endoscope, intranasal splints cover the entire length of the nasal septum, separating the latter from the inflamed side wall of the nasal cavity. An additional support platform is fixed to the bottom of the nasal cavity from 2 sides. The intranasal tampon was removed on the 2nd day after surgery. On the 3rd day nasal breathing is satisfactory. The intranasal splint was removed on the 7th day after surgical treatment. The nasal septum is located in the midline, the mucous membrane is pink, without signs of inflammation. The nasal passages are free, there is no pathological discharge and synechia. Nasal breathing is free.

Clinical example 2. Patient R., 29 years old, was admitted with a diagnosis of deviated nasal septum, vasomotor rhinitis. Condition after septoplasty in 2016. The operation was performed: reseptoplasty, vasotomy of the inferior turbinates under the CETN. The peculiarity of this patient was that, due to the high location of the floor of the nasal cavity, the angle between the nasal septum and the floor of the nasal cavity was less than 90°, and therefore, at the end of the operation, an intranasal splint was installed for this patient with the dimensions of the basal plate L1=50 mm, A=60 mm , H1=25 mm and an additional support platform, which departed from the basal plate at an angle α=60° and had a width H2=3 mm. The tire contained an antimicrobial layer with silver molecules 200 nm thick.

When examining the nasal cavity with a rigid endoscope, intranasal splints cover the entire length of the nasal septum, separating the latter from the inflamed side wall of the nasal cavity. The additional section is fixed to the bottom of the nasal cavity from 2 sides. The intranasal tampon was removed on the 2nd day after surgery. On the 3rd day nasal breathing is satisfactory. The intranasal splint was removed on the 7th day after surgical treatment. The nasal septum is located in the midline, the mucous membrane is pink, without signs of inflammation. The nasal passages are free, there is no pathological discharge and synechiae. Nasal breathing is free.

Claims (10)

1. Intranasal splint in the form of an anatomically shaped plate of elastic material nasal septum, characterized in that the plate is provided with a support platform in the form of an extended strip located along the lower edge of the plate at an angle α from 60° to 110° and made to support the structures of the bottom of the nasal cavity, while the plate and the strip are made in the form of a single part with a coating of the outer surface with a layer containing silver molecules with a mass fraction of silver of at least 99.9%, with a thickness from 10 to 200 nm. 2. The tire according to claim 1, characterized in that the support area extends from the front to the rear edge of the plate. 3. The tire according to claim 1, characterized in that the support pad is located indented from the front edge of the plate by up to 10 mm. 4. The tire according to claim 1, characterized in that the plate and the strip are made in the form of a part, which has an L-shape in cross section. 5. Tire according to claim 1, characterized in that the plate has the shape of a pentagon with rounded corners. 6. The tire according to claim 1, characterized in that the maximum value of the length of the plate L1 in the largest dimension is up to 75 mm, and the maximum value of the height of the plate H1 is 25 mm. 7. Tire according to claim 1, characterized in that the thickness of the support pad S2 is from 0.5 to 2 mm, the width H2 is from 3 to 6 mm. 8. The tire according to claim 1, characterized in that it is made of silicone with a hardness of Shore A-75, while the thickness of the plate S1 is 0.5-0.9 mm. 9. Tire according to claim 1, characterized in that it is made for installation in the right half of the nose. 10. Tire according to claim 1, characterized in that it is made for installation in the left half of the nose.

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