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WO2013035192A1 - Procédé et dispositif pour traiter un symptôme de rhinite de façon chirurgicale - Google Patents

Procédé et dispositif pour traiter un symptôme de rhinite de façon chirurgicale Download PDF

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Publication number
WO2013035192A1
WO2013035192A1 PCT/JP2011/070585 JP2011070585W WO2013035192A1 WO 2013035192 A1 WO2013035192 A1 WO 2013035192A1 JP 2011070585 W JP2011070585 W JP 2011070585W WO 2013035192 A1 WO2013035192 A1 WO 2013035192A1
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Prior art keywords
fluid
nasal cavity
nasal
gap
endoscope
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Ceased
Application number
PCT/JP2011/070585
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English (en)
Japanese (ja)
Inventor
徹 黄川田
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Association of Advent Medical Corp
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Association of Advent Medical Corp
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Priority to PCT/JP2011/070585 priority Critical patent/WO2013035192A1/fr
Publication of WO2013035192A1 publication Critical patent/WO2013035192A1/fr
Anticipated expiration legal-status Critical
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/233—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/24—Surgical instruments, devices or methods for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers

Definitions

  • the present invention relates to a method and apparatus for surgically treating rhinitis symptoms such as nasal congestion, and more particularly, swollen mucosa without disrupting the normal structure of the nose and retaining its structure and function. It is intended to improve the symptoms of rhinitis.
  • Sinusitis is a medical treatment of rhinitis, but there is little effect in such conservative treatment (drug and desensitization treatment), and if left untreated, it becomes chronic and the quality of daily life (QOL) is increased. And various problems are secondary.
  • surgical treatment for chronic sinusitis includes the insertion of a rigid endoscope into the nostril and the removal of pus, excision of the inflamed mucosa, and enlargement of the excretory mouth under the observation of the rigid endoscope Or, intranasal surgery is being performed to establish a new facility.
  • an operator inserts the distal end portion into a nostril while holding the rigid endoscope with the left hand, and performs an operation on the surgical site while holding a surgical instrument such as a forceps or a laser probe with the right hand.
  • a surgical instrument such as a forceps or a laser probe with the right hand.
  • An observation system using a rigid endoscope irradiates light from a light source in the vicinity of a surgical site through a light guide, and this irradiation region is provided in the insertion portion through an objective lens provided at the distal end of the insertion portion of the rigid endoscope.
  • the light received by the optical fiber and the light transmitted to the optical fiber is observed with a finder provided at the base of the rigid endoscope, or the light incident on the optical fiber is image-processed without looking through the finder, and an appropriate CRT display device is obtained. The displayed image is observed.
  • mucus mucus, blood, or pus (hereinafter also referred to as mucus) in the nasal cavity, which exists as a contaminant around the rigid endoscope
  • mucus obstructs the field of view of the rigid endoscope.
  • this visual field is obstructed, there is a risk that a part other than the target surgical part is accidentally damaged by a surgical probe such as forceps.
  • Patent Document 1 discloses an endoscope apparatus in which a liquid or a gas is ejected from an objective observation front surface of an optical visual tube to remove dirt and fogging on the objective observation front surface.
  • Patent Document 2 an endoscope and an electric handpiece piece that drives an ablation assembly for removing tissue are configured separately, and a cleaning liquid is sprayed from the ablation assembly to the front of the endoscope for cleaning.
  • a cleaning system has been proposed.
  • Patent Document 3 shows that the liquid is supplied and the liquid in the nasal cavity is discharged.
  • the liquid supply and liquid discharge paths are the same, mucus and blood mixed in the waste liquid remain in the discharge path, and then when the cleaning liquid is supplied, There is a possibility that blood mixes with the cleaning liquid, contaminates the target observation site, and obscure the field of view.
  • the main object of the present invention is to surgically treat the symptoms of rhinitis, which can clarify the field of view of the target observation site and there is no stagnation of mucus or washing fluid in the nasal cavity and the procedure can proceed smoothly. It is to provide a method for doing this. Another objective is to clearly identify the presence of the posterior nasal nerve with an endoscope inserted through the nasal cavity, while cutting off only the posterior nasal nerve with a surgical probe while distinguishing it from the butterfly palatal artery, leaving the butterfly palatal artery remaining. It is to provide a highly effective method for surgically treating rhinitis symptoms, improving the swollen mucosa.
  • Another purpose is to clearly see the posterior nasal nerve (parasynthetic nerve) with an endoscope inserted through the nasal cavity, and to use a thin posterior nasal nerve (collateral exchange nerve) of only about 0.5 mm. It is to provide a system for surgical treatment of rhinitis symptoms that can be exposed from surrounding tissues.
  • the present invention that has solved the above problems is as follows.
  • a body part located outside the nasal cavity, an insertion part whose distal end side is inserted into the nasal cavity, an illumination means provided in the distal part of the insertion part, and the nasal cavity directly facing the nasal cavity and allowing light to pass therethrough A distal end portion of an endoscope having a translucent member and an optical transmission path for providing optical information in the nasal cavity passing through the translucent member to the outside, and a state surrounding an outer peripheral surface of the insertion portion Inserting a distal end portion with a tubular fluid path component provided on the nasal cavity; A space between the fluid path constituent member and the outer surface of the insertion portion is partitioned into a fluid supply gap and a fluid discharge gap, and a cleaning fluid is supplied to the fluid supply gap from outside the nasal cavity, and the cleaning fluid is supplied to the nasal cavity.
  • a method for surgically treating rhinitis symptoms characterized by comprising:
  • the posterior nasal nerve is a nerve branch that enters the nasal cavity via the butterfly palate after dividing the secretory nerve to the lacrimal gland, and not only parasympathetic secretory fibers from the pterygoid nerve (Vidian nerve) Sensory nerve fibers from the second branch of the trigeminal nerve. Therefore, cutting of the posterior nasal nerve not only has the same effect as cutting of the pterygoid nerve (Vidian nerve), but also simultaneously blocks sensory nerve fibers that are centripetals of stimulation from mucous membranes with increased hypersensitivity. Therefore, theoretically, a better effect can be expected.
  • the greatest advantage is that the secretory nerve fibers to the lacrimal gland are preserved, so that they do not cause the tear secretion disorder seen in the pterygotomy (Vidian nerve) cutting.
  • the present inventor tried a method of coagulating the posterior nasal nerve by irradiating a laser spot on the mucosa after confirming the butterfly palate using ultrasound for refractory perennial allergic rhinitis It was. Through this treatment, we were able to confirm that surgery for the posterior nasal nerve was extremely effective, but at the same time, we found that the method of damaging the mucous membrane has a high risk of causing posterior bleeding from the butterfly palate artery .
  • the optimal surgery is to seek a treatment method that targets only the posterior nasal nerve without causing damage to the mucous membrane, expose the posterior nasal nerve under the periosteum at the butterfly palate, and cut it. I found out.
  • This surgery is effective not only for watery nasal discharge and sneezing but also for nasal congestion. In this case, it is more effective to use an operation in which a part of the inferior turbinate bone under the inferior turbinate mucosa is excised.
  • an endoscope it is important to expose the posterior nasal nerve from surrounding tissues.
  • the space between the fluid path constituent member and the outer surface of the insertion portion of the endoscope is divided into a fluid supply gap and a fluid discharge gap, and the cleaning fluid is supplied from outside the nasal cavity to the fluid supply gap. Since the cleaning fluid is guided into the nasal cavity and the cleaning fluid in the nasal cavity is discharged out of the nasal cavity through the fluid discharge gap together with the contaminant in the nasal cavity, the posterior nasal nerve is clearly visible and the posterior nasal nerve is Therefore, it becomes easy to cut only the nasal nerve with the surgical probe after the exposure.
  • rhinitis symptoms that are extremely effective, in which only the posterior nasal nerve is cut with a surgical probe while distinguishing it from the butterfly palatal artery, leaving the butterfly palatal artery and improving the swollen mucosa it can.
  • a surgical probe is appropriately inserted while inserting a suction / cleaning device combining an endoscope and a fluid path constituent member into the nasal cavity and bringing the tip of the endoscope close to the target tissue by about 1 to 3 mm.
  • the fluid path constituent member is, for example, a thin plastic tube and is discarded every time surgery is completed, it is excellent in disposable hygiene management.
  • a body part located outside the nasal cavity, an insertion part whose distal end side is inserted into the nasal cavity, an illumination means provided in the distal part of the insertion part, and the nasal cavity directly facing the nasal cavity and allowing light to pass therethrough In a state of surrounding the outer peripheral surface of the insertion portion of the endoscope having a translucent member and an optical transmission path for providing optical information in the nasal cavity passing through the translucent member to the outside, Removably assembling the fluid path component; Inserting the endoscope and the tip of the fluid path component into the nasal cavity; A space between the fluid path constituent member and the outer surface of the insertion portion is partitioned into a fluid supply gap and a fluid discharge gap, and a cleaning fluid is supplied to the fluid supply gap from outside the nasal cavity, and the cleaning fluid is supplied to the nasal cavity.
  • a method for surgically treating rhinitis symptoms characterized by comprising:
  • the fluid path constituent member can be made disposable. Disposable is extremely effective in preventing patient viral infections.
  • the insertion portion of the endoscope having a translucent member and an optical transmission path that provides optical information in the nasal cavity passing through the translucent member to the outside is inserted into the fluid path constituent member and assembled.
  • a cleaning fluid inlet / outlet holder is provided, and a flow path for supplying and discharging the cleaning fluid can be formed through the holder, and the operator can hold the holder to stabilize the fluid path component and the endoscope.
  • the observation site can be observed stably.
  • the endoscope and the fluid path constituent member are integrally combined with a cleaning fluid entrance / exit holder, and the operator has a step of supplying, discharging and stopping the cleaning fluid while holding the holder. For surgical treatment of symptoms of rhinitis in children.
  • a holder that is held by the operator while holding the observation device main body and the fluid path constituent member is provided, and in this holder, a hand switch for operating the operator is provided.
  • the operator can operate the hand switch with the left hand while holding a surgical probe such as forceps with the right hand, and the mucus can be eliminated. Therefore, the operator can perform a smooth operation without losing concentration.
  • a tubular fluid path component A body part located outside the nasal cavity, an insertion part inserted into the nasal cavity, an illumination means provided in the distal part of the insertion part, and a translucent light passing directly through the nasal cavity
  • An endoscope having a member and an optical transmission path for providing optical information in the nasal cavity passing through the translucent member to the outside, and wherein the insertion portion is detachably inserted into the fluid path constituent member;
  • a fluid supply gap and a fluid discharge gap are defined between the fluid path component and the outer surface of the insertion portion, and the fluid supply gap and the fluid discharge gap are respectively located outside and inside the nasal cavity.
  • Fluid supply means is connected to the fluid supply gap to supply cleaning fluid from outside the nasal cavity and guide the cleaning fluid into the nasal cavity
  • Fluid discharge means is connected to the fluid discharge gap to discharge the cleaning fluid in the nasal cavity together with the contaminant in the nasal cavity to the outside of the nasal cavity
  • the outlet of the cleaning fluid in the fluid supply gap opens in the vicinity of the translucent member
  • ⁇ Invention of Claim 7> Furthermore, it has a fluid inlet / outlet holder, and the fluid path constituting member is relatively detachably provided in the through hole of the holder, A gap between the through hole of the holder and the outer surface of the fluid path constituent member is partitioned in a liquid-tight manner in the longitudinal direction to form a fluid supply path and a fluid discharge path, In a state where the fluid path constituent member is inserted into the through hole of the holder, the supply port and the exhaust port have walls in positions corresponding to the fluid supply path and the fluid discharge path in the longitudinal direction. 7. The method for surgically treating a symptom of rhinitis according to claim 6, wherein the fluid supply path and the fluid discharge path are communicated with the fluid supply gap and the fluid discharge gap, respectively. apparatus.
  • the field of view of the target observation site can be clarified, and mucus and washing fluid can be retained in the nasal cavity, so that the treatment can proceed smoothly.
  • the endoscope inserted through the nasal cavity clearly distinguishes the posterior nasal nerve from the posterior nasal nerve, while clearly observing the presence of the posterior nasal nerve. Can effectively treat the symptoms of very effective rhinitis, improving the mucous membrane.
  • the endoscope inserted through the nasal cavity allows the posterior nasal nerve (collateral exchange nerve) to be clearly seen and the thin posterior nasal nerve (collateral exchange nerve) of only about 0.5 mm is exposed from the surrounding tissue. The symptoms of rhinitis that can be made can be effectively treated surgically.
  • FIG. 3 is a cross-sectional view of FIG. 2. It is a fragmentary perspective view of an apparatus. It is a disassembled perspective view of an apparatus.
  • FIG. 3 is a schematic diagram of a supply state of a cleaning liquid. It is the longitudinal cross-sectional view. It is a longitudinal cross-sectional view of the principal part. It is a longitudinal cross-sectional view of an inner cylinder packing. It is a front view of an endoscope front-end
  • the observation device in the nasal cavity of the present invention includes an optical observation means constituted by the observation device main body, and a supply of cleaning liquid and a discharge system for mucus in the nasal cavity.
  • FIG. 1 is an explanatory view of a nasal cavity
  • FIG. 2 is a schematic view of a surgical apparatus with a distal end inserted into the nasal cavity
  • FIG. 3 is a longitudinal sectional view of the apparatus
  • FIG. 4 is an assembled perspective view.
  • 5 is an exploded state diagram of the components.
  • An endoscope 10 that is a rigid endoscope constituting an observation apparatus has a main body portion 11 positioned outside the nasal cavity and an insertion portion 12 having a substantially circular cross section in which the distal end side is inserted from outside the nasal cavity into the nasal cavity of a living body. is doing.
  • the distal end of the insertion portion 12 is inclined, and the objective lens 13 is attached thereto.
  • a light guide 14 using an optical fiber or the like is inserted from an insertion port 11A formed on the side of the main body 11.
  • the light guide 14 passes through the insertion portion 12 and faces the tip of the insertion portion 12.
  • Light source device (not shown) light is incident on the light guide 14 and is emitted from the tip of the light guide 14 to the target part to illuminate the target part.
  • Reflected light at the target portion is incident from the objective lens 13, and is collected on, for example, an image guide 16 bundled with optical fibers, propagated through the image guide 16, and transmitted through the eyepiece 17.
  • the surgeon observes the state of the target site through the finder 11B.
  • a commercially available nasal endoscope can be used as it is.
  • those commercially available as “NASALSCOPE” series from Olympus Corporation can be used.
  • a rigid endoscope made by WOLF or STRoz can also be used.
  • the surgeon performs the operation while observing the target site through the finder 11B during the operation. If necessary, an attachment made by Olympus Kogyo Co., Ltd. is attached to the viewfinder 11B, and the target site is projected as an image, and intranasal surgery can be performed while viewing the image.
  • the light from the light source device is irradiated to the vicinity of the target part through the light guide 14, and this irradiation region is provided at the distal end of the insertion part 12 of the rigid endoscope. 13, the light is received by the image guide 16 and observed through the eyepiece 17 by the viewfinder 11 ⁇ / b> B.
  • the light incident signal to the image guide 16 can be image-processed without being looked through the finder 11B and displayed on an appropriate CRT display device 15 to observe the image.
  • a tubular fluid path component 30 made of, for example, flexible plastic is attached to the outer peripheral surface of the insertion portion 12.
  • the fluid path constituting member 30 is held by a holder 40. Therefore, the operator can hold the fluid path constituting member 30 and the endoscope 10 by holding the holder 40.
  • a supply joint 44 and a discharge joint 45 are fixed to the side of the holder 40.
  • the supply joint 44 is connected to a reservoir 60 of physiological saline as a cleaning fluid via a supply line 61, and the discharge joint 45 is discarded via a discharge line 64 having a vacuum pump 63 in the middle. It is connected to the temporary storage tank 62.
  • An operation hand switch 43 is provided on the upper portion of the holder 40.
  • Reference numeral 65 denotes a flow rate adjusting knob.
  • the supply pipe 61 communicates between the supply joint 44, the inside of the holder 40, the hand switch 43, and the wall of the fluid path component 30, and the endoscope 10. , And finally communicate with the nasal cavity.
  • the drainage pipe 64 communicates between the drainage joint 45, the inside of the holder 40, the wall of the fluid path constituting member 30, and the endoscope 10, and finally communicates with the nasal cavity. ing.
  • the physiological saline as the cleaning liquid is supplied into the nasal cavity from between the fluid path constituting member 30 and the endoscope 10 through the path, and is sucked into the nasal cavity by the suction force of the vacuum pump 63.
  • the fluid is passed from the nasal cavity between the fluid path component 30 and the endoscope 10 and is discharged to the temporary storage tank 62 for disposal through the path.
  • FIGS. 3 shows a state where the insertion portion 12 of the endoscope 10 is further inserted into the fluid path constituting member 30.
  • the holder 40 has an outer cylinder 41 and an inner cylinder packing 42 inside thereof, and further has a hand switch 43 for operation.
  • a supply joint 44 and a discharge joint 45 are integrated into a hole formed through the outer cylinder 41.
  • a longitudinal through hole 42A is formed at the center of the inner cylinder packing 42, the fluid path constituting member 30 is inserted into the through hole 42A, and the insertion section 12 is inserted into the fluid path constituting member 30.
  • the structure is such that the surgeon holds it integrally.
  • the fluid path constituting member 30 has a distal end portion 31 having an elliptical cross section and a proximal end portion 32 having a cylindrical shape.
  • the base end portion 32 is press-fitted into the inner cylinder packing 42 and inserted until the flange portion of the base end portion 32 abuts against the end of the inner cylinder packing 42.
  • a narrowing rib 32a having an inner diameter smaller than the outer diameter of the insertion portion 12 is formed at the base end portion 32, so that when the insertion portion 12 of the endoscope 10 is inserted, it is sealed in a liquid-tight manner. .
  • An annular groove 42B is formed on the outer peripheral surface of the inner cylinder packing 42 corresponding to the supply joint 44, and a communication hole 42C is formed toward the center.
  • An annular groove 42D is formed at a position corresponding to the discharge joint 45, and a communication hole 42E toward the center is formed.
  • three annular narrowing ribs 32a are formed at intervals in the longitudinal direction, and these ribs come into liquid-tight contact with the outer peripheral surface of the fluid path constituting member 30.
  • a fluid supply partition 42F and a fluid discharge partition 42G that are liquid-tightly partitioned in the longitudinal direction are formed.
  • the fluid path component member 30 is on the upper side at a position corresponding to the fluid supply partition path 42F and the fluid discharge partition path 42G in the longitudinal direction.
  • a supply port 32A and a discharge port 32B are formed on the lower side through the wall.
  • the tip 31 of the fluid path component 30 has an elliptical tubular cross section.
  • the short diameter of the inner surface of the ellipse is smaller than the outer diameter of the insertion portion 12 of the endoscope 10, and as a result, when the insertion portion 12 of the endoscope 10 is inserted into the distal end portion 31 while being deformed, the distal end
  • the short-diameter portion of the portion 31 is in close contact with the outer peripheral surface of the insertion portion 12, and this is defined as a partition portion.
  • a fluid supply gap 33 on one side and a fluid discharge gap on the opposite side. 34 is formed between the tip portion 31 and the insertion portion 12.
  • the fluid supply gap 33 and the fluid discharge gap 34 open to the vicinity of the objective lens 13 in a state where the gap is secured to the tip, and communicate with the nasal cavity.
  • mucus such as mucus, blood, or pus is present as a contaminant in the nasal cavity, obstructing the operator's field of view with a rigid endoscope. If the operator's visual field is obstructed, there is a risk of damaging a portion other than the target surgical site with forceps. Therefore, if there is mucus in the target site, it is necessary to remove the mucus.
  • the vacuum pump 63 is activated in order to remove mucus at an appropriate time point under the observation apparatus having the above-described configuration. This activation can be performed by connecting the vacuum pump 63 and a foot switch (not shown) and operating them. It can also be activated by an assistant.
  • the vacuum pump 63 When the vacuum pump 63 is activated, the negative pressure acts, and as a result, mucus in the nasal cavity is discharged from the discharge joint 45 through the fluid discharge gap 34, the discharge port 31B, the fluid discharge partition 42E, and the communication hole 42C in this order. It enters the pipe 64 and is discharged to the temporary storage tank 62 for disposal.
  • a cleaning solution (physiological saline) is supplied from the storage bag 60.
  • a positive pressure is applied in the supply pipe 61 from the liquid storage bag 60.
  • This cleaning operation is performed whenever necessary during the surgical process.
  • the whole is extracted from the nasal cavity, and the endoscope 10 is extracted from the holder 40 and the fluid path component 30 and disinfected. Thereafter, the fluid path constituting member 30 is removed from the holder 40 and discarded and disinfected.
  • the sterilized endoscope 10 is inserted into a new fluid path component 30.
  • the tip 31 has a substantially elliptical cross section.
  • a fluid path constituent member 300 having a circular cross section can be used from the beginning.
  • partition projections 35 and 35 extending in the axial direction are formed on the inner surface of the fluid path component 300.
  • the partition projections 35 and 35 can be formed with the same material when the fluid path constituting member 300 is formed.
  • the fluid path constituting member 300 can be integrated.
  • the fluid supply gap 33 and the fluid discharge gap 34 can be partitioned by the presence of the partition-like protrusions 35 and 35.
  • the intranasal observation apparatus can be applied not only to intranasal surgery but also to surgery for various nasal cavities. Therefore, in the above example, a rigid endoscope for intranasal surgery has been described. However, an endoscope having another structure can be used depending on the type of surgery, and the structure of the fluid path constituent member is changed accordingly. be able to.
  • the insertion part of the endoscope can be rigid or flexible.
  • a flexible member is used as the fluid path constituent member.
  • the fluid path constituent member hard materials such as acrylic and polycarbonate can be used in addition to various plastics.
  • the approach to the foramen ostium preferably utilizes the posterior end of the middle nasal passage that allows sufficient working space for operation of the surgical probe.
  • the butterfly palate is located at the canopy level at the rear end of the middle nasal passage side wall, that is, immediately behind the rear end of the horizontal part of the middle turbinate substrate.
  • An incision is made in the posterior end mucosa of the middle nasal passage.
  • an incision can be made using a semiconductor laser by passing a quartz fiber having a diameter of 400 ⁇ m through a Rosen suction tube having an outer diameter of 2 mm with the tip bent.
  • the weakened Rosen's ear canal skin exfoliator used in otologic surgery was used, from the incision line to the level of the middle turbinate substrate in the form of a valve on the upper pelvic membrane Raise.
  • a U-shaped notch with an open top is usually observed. This is the butterfly palate hole (the butterfly palate notch), in which the butterfly palate artery wrapped in the periosteum runs.
  • the periosteum is cut off along the butterfly palate arterial ridge with a flexible blunt needle for otologic surgery, and running underneath the periosteum while supplying and discharging the cleaning fluid.
  • the butterfly palate artery with a diameter of 1.5-2 mm is exposed.
  • the artery is detached from the surrounding tissue while taking care not to damage the artery wall, one or two white cords having a diameter of about 0.5 mm accompanying the artery are exposed. This is the posterior nasal nerve.
  • the posterior nasal nerve that has been peeled off is cut out by pulling it out using oat surgical forceps.
  • the surgical probe of the present invention is not limited to forceps, a peeler, a blunt needle, a laser probe, or the like.

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Abstract

L'invention a pour but de rendre le champ de vision pour une partie à observer net, et de permettre à l'opération d'un traitement d'évoluer sans à-coups sans entraîner l'accumulation d'un fluide mucosal ou d'un fluide de lavage dans une cavité nasale. A cet effet, l'invention concerne un procédé de traitement de symptôme de rhinite de façon chirurgicale, comprenant : une étape consistant à introduire une partie de pointe d'un endoscope (10) et une partie de pointe d'un élément constitutif d'un trajet de fluide tubulaire (30) qui est agencé sur une partie d'introduction (12) de façon à entourer la surface périphérique externe de la partie d'introduction (12) dans une cavité nasale ; une étape consistant à diviser un espace formé entre l'élément constitutif de trajet de fluide (30) et la surface externe de la partie d'introduction (12) dans un espace d'alimentation en fluide et un espace d'évacuation de fluide, à fournir un fluide de lavage à l'espace d'alimentation en fluide à partir de l'extérieur de la cavité nasale, à introduire le fluide de lavage dans l'intérieur de la cavité nasale, et à évacuer le fluide de lavage dans la cavité nasale dans l'extérieur de la cavité nasale à travers l'espace d'évacuation de fluide conjointement avec un fluide impur dans la cavité nasale ; une étape consistant à introduire une sonde chirurgicale dans la cavité nasale ; une étape consistant à exposer un nerf nasal postérieur provenant d'un tissu environnant au moyen de l'alimentation et de l'évacuation du fluide de lavage sous l'observation sur l'endoscope (10) ; et une étape consistant à couper le nerf nasal postérieur exposé à l'aide de la sonde chirurgicale tout en séparant le nerf nasal postérieur du tissu environnant.
PCT/JP2011/070585 2011-09-09 2011-09-09 Procédé et dispositif pour traiter un symptôme de rhinite de façon chirurgicale Ceased WO2013035192A1 (fr)

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Cited By (9)

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Publication number Priority date Publication date Assignee Title
WO2015048806A3 (fr) * 2013-09-30 2015-05-28 Nidus Medical, Llc Appareil et méthodes pour traiter la rhinite
US9763743B2 (en) 2014-07-25 2017-09-19 Arrinex, Inc. Apparatus and method for treating rhinitis
US10201687B2 (en) 2013-02-08 2019-02-12 Arrinex, Inc. Surgical device with integrated visualization and cauterization
US10813533B2 (en) 2013-07-24 2020-10-27 Arrinex, Inc. Direct vision cryosurgical probe and methods of use
US11026738B2 (en) 2016-06-15 2021-06-08 Arrinex, Inc. Devices and methods for treating a lateral surface of a nasal cavity
CN113908445A (zh) * 2021-09-11 2022-01-11 武汉左点科技有限公司 一种鼻炎仪激光束汇聚治疗方法及装置
US11253312B2 (en) 2016-10-17 2022-02-22 Arrinex, Inc. Integrated nasal nerve detector ablation-apparatus, nasal nerve locator, and methods of use
US11278356B2 (en) 2017-04-28 2022-03-22 Arrinex, Inc. Systems and methods for locating blood vessels in the treatment of rhinitis
US11602260B2 (en) 2016-02-11 2023-03-14 Arrinex, Inc. Method and device for image guided post-nasal nerve ablation

Citations (2)

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