RU177470U1 - Device for the treatment of adenorinosinusitis - Google Patents

Abstract

The utility model relates to medicine, in particular to otorhinolaryngology, to ultrasound therapy of exudative adenoiditis, adenorinosinusitis. The objective of the utility model is good mechanical and antibacterial cleaning of tissues of the nasopharynx, nasal cavity and paranasal sinuses due to the effect of cavitation. This task is achieved by the fact that in the device for method of treating adenorinosinusitis containing a body, a waveguide-tool, connected by an end face through a threaded hole to an acoustic unit of an ultrasonic generator, a nozzle for feeding the drug solution and the waste drug solution removal system, including the outlet fitting and the medical suction device, the waveguide tool is made fixed in the housing using a fluoroplastic sleeve with a narrowed hemispherical working end having an open window and a tightly movable first obturator made of medical plastic in the form olive and designed for tight closure of the threshold of the sore half of the nose, the outlet fitting is equipped with a tap valve and a system of plastic per walkers, one of which, located on the side of the end, is connected to a medical aspirator, and the other, located on the side of the working part, is made by a plastic ending second obturator for the vestibule of the nose, the open window is offset closer to the closure plate of the body, its height is 0.5 -0.7 mm. The case of the device can be made of tool steel. An achievable technical result is to obtain the disclosure of the natural anastomoses of the SNP and the pathological contents to be released from them due to ultrasonic microvibrations and by means of exposure to the nasal mucosa and an adenoid vegetation with an ionized antiseptic solution to prevent their contamination by pathological sinuses.

Description

The utility model relates to medicine, in particular to otorhinolaryngology, to ultrasound therapy of exudative adenoiditis, adenorinosinusitis.

Hypertrophy of adenoids, chronic adenoiditis, adenorinosinusitis according to dispensary records account for 53 to 73% of the pathology of ENT organs in children [1]. Adenoids are found in 25% of children by the first year of life [1].

Hypertrophy of adenoids, disrupting air exchange, involves the paranasal sinuses, auditory tube and middle ear in the inflammatory process, manifesting itself as a clinical picture of chronic adenorinosinusitis and forming a group of often ill children. In order to break this vicious circle, the operation of adenotomy is widely used, which accounts for from 50 to 85% of all operations performed in children's ENT departments.

At the same time, removal of tissues of the lymphopharyngeal ring can create conditions for the development of diseases, which are based on immunocomplex pathogenetic mechanisms [1]. Understanding the importance of preserving the lymphoid tissue of the nasopharynx for the formation of a system of innate and adaptive immunity stimulates a constant search for methods of adequate treatment of adenoiditis and adenorinosinusitis.

A number of authors believe that the main direction of treatment of adenorinosinusitis is elimination-irrigation therapy, which implies exposure to the pharyngeal tonsil with medicinal solutions, and more often with an isotonic sodium chloride solution, using special devices to deliver them to the upper respiratory tract or spray irrigators with sea water.

For the treatment of isolated adenoiditis (nasopharyngitis), the method of nasopharyngeal suction washing with mineral water, saline or medicinal solutions of the nasopharynx and nasal cavities is known, when the treatment fluid is injected into one nostril and aspirated from another. The procedure is as follows. The patient lies on the couch, his shoulders protrude beyond the edge of the bed, and his head is strongly tilted back and hangs in space so that the sheer line drawn from the opening of the external auditory meatus passes no further than 2 cm from the chin. With this position of the head, the opening of the Eustachian tube and larynx are located above the nasopharynx, which should prevent the entry of infected washings into the latter. The doctor inserts the bulbous extension of the syringe tip loosely into one nostril and pours 50 ml of the treatment solution. In this case, the liquid enters the nasopharynx and the opposite half of the nose, from where they are aspirated through the olive, which is tightly attached to the edge of the nostrils and attached to the water pump under gauge control at a negative pressure of 1 to 3 mmHg. Art., adjusting the intensity of aspiration by lifting the index finger, clamping the upper hole of the cannula. The procedure is performed 1-2 times a day for 5-10 days (depending on the dynamics of the condition) [2, P. 50-52.]. This method allows you to rinse the nasopharynx, provides a “good outlet of the flushing fluid even when the nasal passage is narrowed,” however, it has a number of serious drawbacks: because of the difficult posture of the child, it is necessary to hold the assistant, and for adults, often having pathology of the cervical spine, this position may be contraindicated ; the procedure requires the active participation of the patient; the treatment solution is briefly in contact with the surface of the nasopharynx and pharyngeal tonsil (adenoids) and does not have a sufficient therapeutic effect, as the author himself points out and recommends that the procedure be preceded by nasopharyngeal baths, which are even more time-consuming to perform, and completed with “Pretz paranasal sinus baths” [2 , S. 52]. In addition, the method is not intended for the treatment of combined adenorinosinusts, which are more common than isolated adenoiditis (with the exception of adenoiditis in acute respiratory infections, but in the acute phase, such procedures are contraindicated).

A device for intra-ultrasonic therapy of otitis media is known, comprising a body in the form of a hollow cylinder tapering along a cone at one end, on which various interchangeable tips in the form of an ear funnel are fixed by means of a threaded connection, the narrowed part of which in the form of a hollow cylinder has at least one an opening for directing fluid flow and an outer diameter of 4.5 to 7 mm depending on the diameter of the patient’s external auditory meatus, and on the sealing cuff ultrasound waveguide, wherein the cavity of the replaceable tip externally attached nipple for supplying the drug solution to the waveguide and the ear canal to sound, and the cavity of the body casing externally attached fitting, intended for suctioning the used drug solution [3]. A disadvantage of the known device is the narrow functionality.

A device is known for ultrasonic irrigation of biological tissues with medicinal substances, comprising an ultrasonic generator and an acoustic system located in a supporting body, including an electromechanical transducer and a vibration concentrator connected to it in the form of a single-wavelength waveguide tool, the working part of which is provided with a through axial channel conjugated through a supply hole and an elastic tube with a drug solution supply system in the form of a separately located solution container [four].

However, the known device has the disadvantages associated with:

- with insufficient dynamic stability of the working part of the waveguide-tool, having a small annular cross section due to the through axial channel in the presence of high-amplitude longitudinal vibrations of the waveguide-tool, necessary for fine dispersion of a drug solution. This reduces the effectiveness of ultrasonic irrigation with medicinal substances of the foci of infection, due to a decrease in the threshold for other modes of vibration of the waveguide-tool, for example, bending vibrations that increase the level of maximum longitudinal stresses in the region of 1/4 wavelength of the waveguide-tool, causing resonance of the speaker system. In this case, the amplitude of oscillations of the waveguide tool sharply decreases, and hence the level of radiated power, which significantly affects the dispersion of the sprayed solution. In addition, the destruction of the waveguide tool in the region of the oscillation node is inevitable due to the emerging parametric resonance;

- the presence of a relatively complex electromechanical system for turning on and off the supply of a solution of a drug substance to the axial channel of the waveguide tool for its subsequent ultrasonic atomization, which is incompatible with the simplicity of the procedure for irrigation of tissues of the focus of infection;

- with the inconvenience of simultaneously manipulating the acoustic unit with the waveguide-tool and controlling the flow of the drug solution at different stages of its ultrasonic atomization onto the tissue of the infection site due to the presence of a separately located container with the drug solution. The above reduces the effectiveness of ultrasonic drug irrigation of biological tissues in the area of the focus of infection.

Closest to the proposed device is a device consisting of an ultrasonic generator, an acoustic unit, a waveguide-tool with a radiating end facing the voiced tonsil, an applicator containing a removable funnel communicating through the central channel of the applicator with a waveguide-tool, a two-position valve, a drug delivery system solution and removal of the spent solution; electric suction device. The applicator housing is made as a single element of ultrasound-reflecting polymeric material, the inlet of which is associated with the inlet cylindrical portion of the waveguide tool, while the retainer of the applicator is mounted on the applicator carrier body to insert a fixing screw from the reflective into the corresponding groove in the inlet cylindrical section of the waveguide ultrasound of a polymeric material [5].

The disadvantage of the prototype device is:

- mismatch of the removable funnel of the applicator with the anatomical and physiological characteristics of the nasal cavity, paranasal sinuses and nasopharynx;

- the absence of obturators to create a closed circulation system of the contact solution with the possibility of introducing it through one half of the nose and removing the spent portions through the other half of the nose;

- mixing the incoming and spent contact solution in the applicator body;

- lack of quality control of the passage of the contact solution into the funnel of the applicator on the palatine tonsil, i.e. with an increase in the vacuum of the electric suction, we cannot be sure that the contact solution reaches the tonsils, but is not sucked out of the housing through the second fitting.

The objective of the utility model is a good mechanical and antibacterial cleaning of the tissues of the nasopharynx, nasal cavity and paranasal sinuses due to the effect of cavitation.

This object is achieved in that in a device for the treatment of adenorinosinusitis containing a body, a waveguide tool connected end-by-side through a threaded hole to an acoustic unit of an ultrasonic generator, a nozzle for supplying a drug solution and a system for removing the spent drug solution, including an outlet fitting and a medical suction device, a waveguide -the tool is mounted in the housing using a fluoroplastic sleeve with a narrowed hemispherical working end having an open window and a flat a movably mounted conical first obturator made of medical plastic in the form of an olive and designed to tightly close the threshold of the diseased half of the nose, the outlet fitting is equipped with a valve valve and a system of plastic adapters, one of which is located on the side of the end and connected to the medical aspirator, and the other located on the side of the working part is made by ending with a plastic cone-shaped second obturator for the vestibule of the nose, the open window is made offset closer to the closure cn plate, its height is 0.5-0.7 mm. The housing of the device may be made of tool steel.

Achievable technical result is to obtain the disclosure of the natural anastomoses of SNPs and the release of pathological contents from them due to ultrasonic microvibrations and by preventing the nasal mucosa and adenoid vegetation with an ionized antiseptic solution to prevent their contamination by pathological sinus discharge.

The figure shows the design of the proposed device, containing a cylindrical-conical construction made of tool steel with a hollow cylindrical inner channel 1, into which through a fluoroplastic sleeve 2, a hemispherical working end 3, a nozzle for supplying the drug solution through the inner hollow cylinder into the nasal cavity 4 and a nozzle for removal of the spent portions of the solution from the device 5 with the valve-valve 7, an open window 9, obturators for anticipating the nose 6 and 8.

The proposed device operates as follows. During the procedure, the vestibule of both halves of the nose is blocked by obturators 6 and 8: one by the end obturator of the device. When the electric pump and buttons of the acoustic unit of the ultrasonic generator are turned on, the patient performs a movement ensuring the edge of the soft palate fits to the posterior pharyngeal wall, which creates a single closed cavity, including the nasal cavity on both sides, paranasal sinuses and nasopharynx with adenoid vegetation; moderate negative pressure, regulated by an electric suction pump, ensures bilateral procedure and creates a directed flow of contact solution, which is also a contact medium for the propagation of ultrasonic waves. In this case, the main physical and biological effects of low-frequency ultrasound are realized: microvibrations are created due to variable acoustic pressure, which helps to open the anastomoses of the paranasal sinuses and exit them (due to the negative pressure of the electric suction) of pathological contents (pus, mucus, etc.); due to cavitation, thorough mechanical cleaning of the entire complex relief of the nasal cavity, sinuses and nasopharynx and bactericidal effect on all types of microflora - bacteria, viruses, and fungi occur.

Information sources

1. Garashchenko T.I., Garashchenko M.V. Adenoids in children and ways of preventing pharyngeal tonsil hyperplasia // Pediatric Otorhinolaryngology. - 2013. - No. 4. - S. 73-76.

2. Kyulev A.I. Irrigation therapy of the upper respiratory tract: Trans. from Bulgarian .. - M .: Medicine, 1987, 128 p.

3. RF patent No. 26744, A61K 41/00, publ. 12/20/2002

4. RF patent No. 1801017, A61M 35/00, priority from 04/23/1990

5. RF patent No. 2358781, A61N 7/02, publ. 20.06.2009

Claims (2)

1. A device for the treatment of adenorinosinusitis, comprising a housing, a waveguide-tool connected end-by-side through a threaded hole to an acoustic unit of an ultrasonic generator, a nozzle for supplying a contact solution and a system for removing spent contact solution, including a discharge nozzle and a medical suction device, characterized in that the waveguide the tool is made fixed in the housing using a fluoroplastic sleeve with a narrowed hemispherical working end having an open window and tightly movably installed the first cone-shaped first obturator made of medical plastic in the form of olive and designed to tightly close the threshold of the diseased half of the nose, the outlet fitting is equipped with a valve valve and a system of plastic adapters, one of which is located on the side of the end and connected to the medical aspirator, and the other, located from the working part, made by ending with a plastic cone-shaped second obturator for the vestibule of the nose, an open window is made offset closer to the closure plate of the body, in Its height is 0.5-0.7 mm. 2. A device for the treatment of adenorinosinusitis according to claim 1, characterized in that the body is made of tool steel.

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