Classifications

• • 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
  • A61B1/267—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 respiratory tract, e.g. laryngoscopes, bronchoscopes
• • 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
  • A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body

Definitions

• the invention relates to a device for exposing the throat of a patient with a tongue depressor and with an associated handle or the like handle.
• Devices of the type mentioned at the outset are primarily used in medicine in the field of anesthesia and are also referred to as laryngoscopes. These devices are mostly used to inspect the pharynx and to insert a tube into the trachea of a regularly anesthetized patient for the purpose of artificial ventilation.
• a laryngoscope is already known from SU-1 676 590
• Tongue spatula has a longitudinal slot for the passage of a guide wire. While on the one free In the end region of the approximately U-shaped guide wire, a finger ring is provided as a handle, an intubation catheter can be attached to the other end of the guide wire, which is in the form of a circular arc.
• the guide wire penetrating the longitudinal slit on the tongue spatula of the laryngoscope facilitates precise positioning of the catheter in that the operator moves the intubation catheter held at the other end of the guide wire with a finger that engages the finger ring.
• exposing the larynx entrance itself is not additionally facilitated even with this previously known laryngoscope.
• FR-2 272 632 describes a laryngoscope which has two flat rods which are designed in the shape of a circular arc at their distal ends and bear against one another in the initial system. By sliding these two flat bars relative to each other, the arcuate bar ends are moved away from each other and the pharynx of the Patients widened to such an extent that an examination of the throat is made easier.
• a deflecting mirror can also be provided on the outer flat bars, which allows indirect observation of the pharynx.
• This previously known device according to FR-2 272 632 facilitates the examination of a patient's throat, but is neither suitable nor intended for the introduction and positioning of an intubation catheter.
• the solution to this problem according to the invention is in particular that the tongue depressor is associated with a palate spatula and that the tongue depressor and the palate spatula are pivotably held relative to one another for carrying out a spreading movement and are connected to a drive for the spreading movement.
• the device according to the invention has a palate spatula which uses the hard palate as an abutment.
• This palate spatula is pivotally connected to the tongue depressor.
• These two spatula parts can be conveniently and easily spread apart from one another by means of a drive, so that the patient's oral cavity is held open, his tongue is pressed down and the larynx entrance is exposed when the epiglottis is up.
• the tongue depressor and the palate spatula each as an outer extension
• drive for the spreading movements which are preferably designed as a handle, finger lever or the like handle.
• the device according to the invention can be operated via a manual drive.
• the two spatula parts each have an outer extension, which serve as a drive lever.
• This drive lever can be designed as a handle, finger lever or the like handle.
• an additional motor drive for the spreading movement is not necessary.
• the device is designed like scissors and that the tongue depressor and the palate spatula are preferably movable relative to one another against the restoring force of a restoring device.
• a preferred further development according to the invention provides that the device is designed like spreading pliers and that the tongue depressor with its extension is preferably arranged essentially on one side of the pivot axis and the palate spatula and its extension are arranged essentially on the opposite other side of the pivot axis.
• Such an expansion-type configuration favors the easy handling of the device according to the invention.
• the effort exerted by the operator on the drive lever can be metered well. Since the two drive levers are designed as extensions of the tongue depressor and the palate spatula, the device according to the invention is easy to operate due to its lever action even by weaker operators.
• Handle and the extension of the tongue depressor is designed as a finger grip.
• the tongue depressor and the palate spatula are detachably connected to one another at their common pivot axis.
• a preferred embodiment according to the invention provides that the one spatula part, preferably the tongue depressor, a bearing pan or similar bearing, which at least partially encompasses the pivot axis held on the other spatula part, and that this bearing for inserting and removing the pivot axis, in particular in the direction of Spatula end is partially open.
• a further development of the invention provides that the handle or the like handle connected to the tongue depressor and / or the palate spatula is also designed as a tongue and / or palate spatula and that the bearing between the tongue depressor on the one hand and the palate spatula on the other hand is arranged eccentrically on this spatula part.
• both free end regions of at least one spatula part are designed as tongue and / or palate spatulas. Both free end regions of this spatula part can thus be exchanged for one another and used as a tongue or palate spatula.
• spatula part has at least two spaced apart bearings and / or the other spatula part has at least two pivot axes spaced apart.
• Such an embodiment offers several hanging options for the two spatula parts of the device according to the invention, with which the provision of several spatulas of different lengths could be avoided and limited to, for example, two tongue and / or palate spatulas, namely an adult spatula and a child spatula.
• Such an embodiment also offers good adaptability to different anatomical conditions.
• the palate spatula In order to be able to restrict disinfection to the spatula end region of the palate spatula inserted into the patient's mouth after use of the laryngoscope according to the invention and to not also have to disinfect the handle of this palate spatula, for example connected to an energy source, it may be expedient if the palate spatula is replaced has a coupling point in its free spatula end region. Such a coupling point can also be advantageous in order to be able to replace the free spatula end area at this coupling point with a spatula end area with a different spatula length. In this way, the distance between the pivot axis of the two spatula parts and the free spatula end of the palate spatula can be adapted to the individual anatomical conditions of the respective patient.
• Palate spatula has a lighting device at its free end region and if the Accumulators, batteries or similar power supply assigned to the lighting device are arranged in the extension of the palate spatula designed as a handle.
• the free end of the palate spatula is bent in the direction of the tongue spatula and if the palate spatula is preferably formed like a spoon.
• the lighting device provided on the free end of the palate spatula bent in the direction of the tongue depressor is able to illuminate the revenge particularly well.
• a spoon-like configuration of the palate spatula it adapts particularly well to the anatomical conditions of the hard palate of a patient. Exposure to the incisors of the patient by the device according to the invention is also avoided in a particularly simple manner.
• Fig. 1 shows a device for exposing the pharynx
• FIG. 2 shows the device from FIG. 1 in its initial position in the oral cavity of a patient
• FIG. 3 shows the device from FIGS. 1 and 2 in its schematically illustrated spreading position
• 4 shows a known, practically L-shaped device which has a handle and a tongue depressor connected to it at about a right angle
• Fig. 5 the palate spatula connected to a handle of a device according to the invention, the two
• Fig. 6 the tongue depressor of a device according to the invention connected with a finger lever, two spaced apart on the tongue depressor
• Bearing pans are provided for receiving the swivel axes of a palate spatula
• FIG. 7 shows the handle of the device shown in FIG. 4,
• FIGS. 4 and 7 shows the tongue depressor of the device shown in FIGS. 4 and 7,
• FIG. 9 shows a device, similar to that from FIGS. 1 to 3, for exposing the throat area of a patient when it is introduced into the oral cavity, the handle from FIG. 7 being used for the extension of the tongue depressor serving as a handle,
• FIGS. 9 and 10 show the tongue depressor of the device from FIGS. 9 and 10,
• the palate spatula of the device from FIGS. 9 to 11, 13 shows a device, similar to that from FIGS. 9 to 12, when inserted into the oral cavity, the handle from FIG. 7 being provided here as an extension of the palate spatula,
• FIGS. 1 to 3 show a device for exposing the throat of a patient, which is also referred to here as a laryngoscope.
• the laryngoscope in FIGS. 1 to 3 is designed in the manner of expanding pliers and has a tongue depressor 11 and a palate spatula 9 assigned to the tongue depressor 11. These two spatula parts 9, 11 are held so as to be pivotable relative to one another in order to carry out a spreading movement and are connected to a drive for the spreading movement.
• the laryngoscope according to FIGS. 1 to 3 can be operated by hand.
• the tongue depressor 11 and the palate spatula 9 each have an outer extension, which serve as drive levers 7, 10.
• the extension of the palate spatula 9 is designed as a handle 7, while the tongue depressor 11 is connected in one piece to the finger lever 10.
• the tongue depressor 11 with its extension 10 is arranged essentially on one side of the pivot axis 8a and the palate spatula 9 and its extension 7 essentially on the opposite other side of the pivot axis 8a.
• the tongue depressor 11 and the palate spatula 9 are detachably connected to one another at their common pivot axis 8a.
• the tongue depressor 11 has an approximately semicircular bearing pan 8b which is open at its spatula end and into which the pivot axis 8a held on the palate spatula 9 can be inserted or inserted. Due to the detachable connection of the two spatula parts 9, 11, the tongue depressor 11 can be exchanged quickly and easily for another tongue depressor 11 in order to adapt the laryngoscope to the anatomical conditions of the respective patient.
• the palate spatula 9 is approximately S-shaped in side view. In this way, the palate spatula 9 is guided around the incisors 6 of the patient at a distance in its use position. Due to its spoon-shaped design, it is well adapted to the anatomical conditions. In the spread position shown in FIG. 3, the laryngoscope spreads the patient's oral cavity, depresses the patient's tongue 3 and exposes the larynx entrance 5.
• the laryngoscope shown in FIGS. 1 to 3 is inserted with the closed spatula parts 9, 11 into the open mouth of the patient, to the extent that the palate spatula 9 comes to lie in the curvature of the hard palate 12.
• the handle 7 and the finger lever 10 are practically the farthest apart from one another, while the spatula parts 9, 11 are in their approximate starting position.
• the two drive levers 7, 10 are then moved toward one another by the muscular strength of the hand of an operator, so that the perform a spreading movement in the patient's oral cavity by means of their coupling parts 8a, 8b pivotally connected spatula parts 9, 11.
• the firm palate 12 serves the palate spatula 9 as an abutment.
• the tongue 3 of the patient is pushed back, depending on the extent of the spread position and the amount of force exerted by the hand, until a clear view of the larynx entrance 5 is possible.
• a ventilation tube can then be inserted into the trachea 14 via the right or left corner of the mouth with the free hand of the operator.
• the drive levers 7, 10 are designed as extensions of the two spatula parts 9, 11, the lever action of these extensions enables a greater force to be developed as a result of the physiological development of force by the operator's hand.
• This development of force can be better implemented via the palate 12 acted on by the palate spatula 9 and serving as an abutment and thus facilitates the pushing away of the patient's tongue 3.
• a risk of incisor injury is almost excluded in the laryngoscope shown in Figures 1 to 3.
• the laryngoscope shown in FIGS. 1 to 3 has a light source at the free end region of its palate spatula, the power supply of which is accommodated in the handle 7.
• a rechargeable battery or a conventional battery can be used as the power supply.
• the lighting device or the like light source 13 is activated at the free end region of the palate spatula 9. Since the free end of the spoon-shaped palate spatula 9 towards Tongue depressor 11 is bent, the throat of the patient is particularly well illuminated.
• FIGS. 5 and 6 show two palate spatulas (FIG. 5) and a tongue depressor (FIG. 6) of a device according to the invention, the essential features of which correspond to the device according to FIGS. 1 to 3.
• the palate spatula in FIG. 5 has two pivot axes 8a spaced apart from one another in the longitudinal direction, which thus offer different suspension options for a tongue depressor 1 in order to adapt to the anatomical conditions of the patient.
• This tongue depressor can be similar to that shown in Figure 1;
• the tongue depressor can also have two hook-shaped bearing pans 8b spaced apart from one another in the longitudinal direction in order to offer further possible variations in the pivotable connection of the spatula parts 1, 9.
• spatula parts 1, 9 shown in FIGS. 5 and 6 Due to the various possibilities of hanging in the spatula parts 1, 9 shown in FIGS. 5 and 6, the provision of several spatulas of different lengths can be avoided. For example, only two tongue depressors or palate spatulas 1, 9 are required, which could be provided as an adult and child's spatula.
• the palate spatula 9 shown in FIG. 5 has a coupling point 15 which is arranged between the free spatula-shaped spatula end region and the pivot axis of the palate spatula 9.
• This coupling point 15 is used for removing or replacing the free spatula end areas, which can thus be disinfected on their own and without the handle 7 having the energy source for the lighting device 13.
• FIG. 5 shows, several spatula end regions with different spatula lengths are provided in order to adapt the palate spatula 9 to the anatomical conditions of the respective patient in a simple manner to be able to.
• the coupling point 15 of the palate spatula 9 shown in FIG. 5 can be designed, for example, as a screw coupling or as a plug-in coupling, with a light coupling for the lighting device 13 possibly also being provided therein.
• FIG. 4 A previously known laryngoscope is shown in FIG.
• This previously known laryngoscope which is approximately L-shaped, has a handle 2, which is connected approximately at right angles to a tongue depressor 1. After insertion of the tongue depressor 1 into the open mouth of the patient, the patient's tongue can be depressed and the larynx entrance 5 exposed.
• the doctor or similar operator must pull the handle 2 of the laryngoscope shown in FIG. 4 away from him towards the patient's body. There is a risk that the hand of the operator acting on the handle 2 slips on the free end area of the handle 2 as a result of the tensile force exerted. Also, the pull exerted on the handle sometimes requires considerable effort, which weaker people often cannot do with sufficient strength. If the incisors 6 of the patient are used as an abutment for the tongue depressor 1 to exploit leverage, this can lead to tooth damage.
• the laryngoscope according to the invention shown in FIGS. 1 to 3 can also be operated comfortably and with little effort by weaker people, the risk of incisor injury to the patient being virtually excluded.
• FIGS. 7 and 8 The individual parts of the laryngoscope from FIG. 4 are shown again in FIGS. 7 and 8.
• this conventional handle 2 is used instead of the tongue depressor shown in FIG. 8, the tongue spatula 11 shown in FIG. 9 is coupled in a known manner.
• the tongue spatula 11 from FIG. 9 is constructed such that it shows approximately in the extended direction of this handle 2 when it is attached and coupled to the handle 2.
• the tongue depressor 11 shown in FIG. 11 of the laryngoscope from FIGS. 9 and 10 has for this purpose a longitudinal slit 20, in its upper area and the handle 2 facing area, the pivot axis 8a cooperating with the bearing socket 8b on the palate spatula 9 (see FIG. 12) is arranged.
• the tongue depressor 11 can be connected to the palate spatula 9 of the laryngoscope shown in FIGS. 9 to 12.
• the oral cavity is illuminated by a light source which, like in the conventional spatula, is located near the tip of the tongue depressor 11 and is supplied by an energy source located in the handle 2.
• FIGS. 13 to 16 A comparable laryngoscope is shown in FIGS.
• the handle 2 of a conventional device is also used in the laryngoscope according to FIGS. 13 to 16.
• an approximately S-shaped palate spatula 9 with a suitable coupling part is hooked onto the conventional laryngoscope handle 2.
• the handle 2 is thus provided as an extension of this palate spatula 9.
• a further coupling option for the tongue depressor 11 is provided near the coupling provided between the palate spatula 9 and the handle 2.
• the pivot axis 8a between the spatula parts 9, 11 is also arranged in the upper region of the longitudinal slot 20 facing the handle 2, which is provided on the palate spatula 9.
• This pivot axis 8a which is also arranged transversely to the longitudinal extension of the longitudinal slot 20 and the palate spatula 9 in the embodiment shown in FIGS. 13 to 16, cooperates with a bearing socket 8b which is provided on the tongue depressor 11.
• the tongue depressor 11 has, above the bearing socket 6b, an extension which is arranged outside the patient's mouth and serves as a drive lever 10.
• the mechanism of the mouth opening in the laryngoscope shown in FIGS. 13 to 16 corresponds to that described for FIGS. 1 to 3.
• the oral cavity is illuminated by a licnt source 13 which is provided in the spoon-shaped palate spatula 9 and which is fed via the energy source located in the handle 2.
• the laryngoscopes shown in FIGS. 1 to 3, 5, 6 and 9 to 16 can also be operated comfortably and with little effort by chess persons for introducing an intubation catheter into the oral cavity of a patient, without the patient's teeth when using these laryngoscopes are at risk.
• the insertion area of the palate or tongue spatula 9, 11 in the oral cavity of the patient is approximately the same or shorter than the distance from the bearing 8 provided between these spatula parts to the corresponding distal spatula end facing the patient. Since the storage of the spatula parts is thus arranged outside the mouth of the patient, the greatest possible development of force and leverage can be achieved with the laryngoscope according to the invention with comparatively little effort.

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• 1994
  • 1994-06-01 BR BR9406806A patent/BR9406806A/pt not_active Application Discontinuation
  • 1994-06-01 AU AU69307/94A patent/AU6930794A/en not_active Abandoned
  • 1994-06-01 CA CA 2164224 patent/CA2164224A1/en not_active Abandoned
  • 1994-06-01 EP EP94917682A patent/EP0703749A1/de not_active Ceased
  • 1994-06-01 JP JP7501266A patent/JPH08510938A/ja active Pending
  • 1994-06-01 WO PCT/EP1994/001781 patent/WO1994028785A1/de not_active Ceased

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