WO2012127435A1 - Dispositif de masque laryngé de chirurgie buccale - Google Patents

Dispositif de masque laryngé de chirurgie buccale Download PDF

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Publication number
WO2012127435A1
WO2012127435A1 PCT/IB2012/051365 IB2012051365W WO2012127435A1 WO 2012127435 A1 WO2012127435 A1 WO 2012127435A1 IB 2012051365 W IB2012051365 W IB 2012051365W WO 2012127435 A1 WO2012127435 A1 WO 2012127435A1
Authority
WO
WIPO (PCT)
Prior art keywords
vestibule
airway device
patient
distal
sealing mechanism
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2012/051365
Other languages
English (en)
Inventor
Donald Munro Miller
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from GB1104865.9A external-priority patent/GB2489407A/en
Application filed by Individual filed Critical Individual
Publication of WO2012127435A1 publication Critical patent/WO2012127435A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A61M16/0443—Special cuff-wall materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0409—Special features for tracheal tubes not otherwise provided for with mean for closing the oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0434—Cuffs
    • A61M16/0445—Special cuff forms, e.g. undulated
    • A61M16/0447—Bell, canopy or umbrella shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0411—Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0461—Nasoendotracheal tubes

Definitions

  • the present invention relates to respiratory apparatus in the form of an artificial airway device for placement into the oro-pharynx of an unconscious patient.
  • an unconscious patient may require some or all of the following objectives, namely: the maintenance of airway patency, attachment to respiratory apparatus, either spontaneous or controlled positive pressure ventilation, and prevention of inhalation into the lungs of extraneous matter such as vomitus, mucus or blood.
  • proximal near the patient
  • distal farther from the patient
  • airway management may be achieved by means of an endotracheal tube with an inflatable cuff around the proximal end of the tube, which is placed with the help of other instruments within the trachea.
  • the disadvantage is the need for accurate placement that requires specially trained skills and it is more invasive requiring the placement of a tube into a relatively sterile area and may also require a laryngoscope for placement. Its placement often requires the administration of muscle paralyzing drugs.
  • tracheal tubes Placement of tracheal tubes may cause damage to the vocal cords and permanent voice changes is a risk that can be avoided if a supraglottic airway can be used instead.
  • Inflatable cuffs in tracheal tubes themselves can cause pressure damage where the recurrent laryngeal nerve lies in close proximity to the trachea.
  • LMATM laryngeal mask airway
  • laryngeal mask There are many designs of laryngeal mask and their descriptions involve describing key components such as the actual sealing masks and how they may be manufactured. In doing so, these descriptions of the sealing components mention the part where the tube is to be attached. This part is designed for accommodating a tube to be firmly attached to the device. It is not designed to be detachable, which would constitute a potential weakness or fault. These laryngeal masks with fixed tubes are clearly not suitable for nasal intubation.
  • the primary objective of the present invention is to allow for the administration of anaesthesia and the control of the airway via a nasal tube, that preferably obviates the need for tracheal intubation.
  • an airway device comprising a proximal part and a distal part with a distal extraction means; said proximal part comprising a perilarygeal sealing mask with a sealing mechanism comprising a balloon inflated cuffed sealing mechanism, a soft solid cushion sealing mechanism or a hollow self-energizing sealing chamber, for sealing within and against the mucosal walls of the pharynx of a patient, and the proximal part defining a proximal opening on the ventral aspect of the proximal part, for communicating with the patient's lungs; and said distal part defining a distal chamber or vestibule with a vacant distal opening
  • the vestibule having longitudinal dimension sufficient for housing a cuffed inflatable tube such as a cuffed tracheal tube and short enough in projection from the dorsal aspect of the sealing mechanism for the distal opening to the vestibule to be located opposite to, i.e. be generally aligned with the patient's nasopharyx when the device is correctly placed in the patient's hypopharynx and with a distal extraction means that is long enough to extend out of the mouth.
  • the cross-sectional shape of the vestibule is approximately oval shaped with long axis in the lateral dimension.
  • oval shape is modified to be flattened in the dorsal aspect so that it lies flat against or flush with the patient's posterior pharyngeal wall to receive with ease the blind placement of a tracheal tube that is passed through the patient's nose.
  • the edge of the vestibule is shaped with an outward taper so that the flat edge lies flush against the patient's posterior pharyngeal mucosa.
  • the extracting means may comprise a strip of material extending preferably from the ventral aspect of the edge of the distal entrance to the vestibule.
  • the device may be placed in position by means of a cuffed tracheal tube inserted into the vestibule, with the cuff inflated. The device may then be firmly attached to the tracheal tube which is used to direct the mask into the correct position in the patient's pharynx.
  • a laryngoscope may be inserted into the vestibule and used to insert the device into the patient's hypo-pharynx. Both the tracheal tube and a laryngoscope may be used for placement, with the cuffed tracheal tube located behind the laryngoscope blade.
  • Figure 1 shows a diagonal dorsal view of a first embodiment of an airway device according to the present invention
  • Figure 2 shows a longitudinal section through the device of Figure 1 ;
  • Figure 3 shows a three dimensional view of the device of Figure 1 ;
  • Figure 4 shows a three dimensional view of the device of Figure 1 , approximately from the vestibule entrance;
  • Figure 5 shows the possible use of the device of Figure 1 with a laryngoscope
  • Figure 6 shows a longitudinal section through the device of Figure 1 that is essentially the same as Fig.2, but with the device in a shape when in position;
  • Figure 7 shows a longitudinal section through a second embodiment of an airway device according to the present invention, which is generally similar to that shown in Figure 1 , with the addition on an inflatable cuff;
  • Figure 8 shows a longitudinal section of the device of Figure 1 , in situ, with a nasotracheal tube, which has a cuff that is inflated in a vestibule of the airway device.
  • NP Naso-tracheal tube NT Naso-tracheal tube.
  • a supraglottic embodiment of an airway device in accordance with the present invention is generally indicated by reference numeral 10.
  • the airway device 10 comprises a proximal part 20 and a distal part 30 with a distal extraction means 40.
  • the proximal part 20 comprises a perilarygeal sealing mask with a sealing mechanism for sealing within and against the mucosal walls of the pharynx of a patient.
  • the sealing mechanism can be a balloon inflated cuffed sealing mechanism 22 (as shown in the second embodiment of the invention in Figure 7), a soft solid cushion sealing mechanism in place of the balloon 22 or a hollow self-energizing sealing chamber 24 (as shown in the first embodiment of the invention in Figuresl to 6, and 8) .
  • the proximal part defines a proximal opening 26 on its anterior or ventral aspect, for communicating with the patent's lungs.
  • the distal part defines a distal, approximately cylindrically shaped chamber or vestibule 30 with side walls 32 and a vacant distal opening 36.
  • the inner cavity of the vestibule 30 is open to the inside of the proximal part 20 and the distal entrance or opening 36 is approximately perpendicular to the proximal ventral opening 26.
  • the vestibule 30 has longitudinal dimension sufficient for housing a cuffed inflatable tube (as shown in Figure 8), such as a cuffed tracheal tube NT (when placed through the nose) and is short enough in projection from the dorsal aspect of the sealing mask for the distal entrance 36 to the vestibule to be located opposite to the naso-pharynx NP (as shown in Figure 8).
  • a cuffed inflatable tube as shown in Figure 8
  • NT cuffed tracheal tube
  • NT cuffed tracheal tube
  • the distal extraction means 40 is a deformable, elongate formation that is attached to the vestibule 30, adjacent the entrance 36 on the anterior or ventral side and that is long enough to extend out of the mouth M of a patient, when the device 10 is correctly placed in the hypo-pharynx as described above.
  • the cross-sectional shape of the vestibule is approximately oval shaped with long axis in the lateral dimension and with a distal wall edge 34 that is tapered so that it lies flush against the posterior pharyngeal wall.
  • oval shape of the vestibule 30 were modified to be flattened in the dorsal aspect 38 of the vestibule as shown in Figure 4, so that it lies flat against the posterior pharyngeal wall to receive with ease the blind placement of a tracheal tube NT that is passed through the nose.
  • the device 10 can be placed in position through the mouth M by means of a cuffed tracheal tube NT inserted into the vestibule. Before placing the device 10, the cuff C is inflated inside the vestibule 30, so that the device is firmly attached to the tracheal tube NT. The tracheal tube NT is used to direct the device 10 through the mouth M into the correct position in the pharynx.
  • a laryngoscope (including a handle LH and a blade LB) may be inserted into the vestibule 30 and used to insert the device 10 into the hypo- pharynx as shown in Figure 5).
  • Both the tracheal tube NT and a laryngoscope LH.LB may be used for placement of the device 10, with the cuffed tracheal tube located behind the laryngoscope blade LB.
  • the tracheal tube NT may be removed from the mouth M and then passed via the nose, through the naso-pharynx NP and inserted into the vestibule 30, where the cuff C is re- inflated, thereby securing the attachment within the vestibule, as shown in Figure 8.
  • the use of a cuffed tracheal tube NT is preferred, because inflating the cuff C ensures a firm attachment within the vestibule 30.
  • the device 10 is a supraglottic airway that is specifically designed to have a part (vestibule 30) of the sealing laryngeal mask airway opening that is designed to accommodate a tube NT that is passed blindly via the nose and to allow for the tube to be automatically directed into a passage or

Landscapes

  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Endoscopes (AREA)

Abstract

Un dispositif formant voie respiratoires (10) comprend un masque d'étanchéité périlaryngé (20) avec un mécanisme d'étanchéité (22) et une ouverture proximale (26) conçue pour communiquer avec les poumons, un vestibule distal (30) possédant une ouverture distale vacante (36), suffisamment long pour loger un tube gonflable à manchon et suffisamment court pour permettre l'alignement de l'ouverture distale (36) donnant dans le vestibule avec le nasopharynx, et un moyen d'extraction distal (40) suffisamment long pour s'étendre jusqu'à l'extérieur de la bouche. Le vestibule (30) peut recevoir une canule trachéale qui peut être placée à l'aveugle par le nez. Ledit dispositif formant voies respiratoires (10) est positionné au moyen d'une canule trachéale à manchon (NT) insérée dans le vestibule (30) et/ou avec un laryngoscope.
PCT/IB2012/051365 2011-03-23 2012-03-22 Dispositif de masque laryngé de chirurgie buccale Ceased WO2012127435A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB1104865.9 2011-03-23
GB1104865.9A GB2489407A (en) 2011-03-23 2011-03-23 Laryngeal mask and tracheal tube airway devices

Publications (1)

Publication Number Publication Date
WO2012127435A1 true WO2012127435A1 (fr) 2012-09-27

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2012/051365 Ceased WO2012127435A1 (fr) 2011-03-23 2012-03-22 Dispositif de masque laryngé de chirurgie buccale

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014058840A3 (fr) * 2012-10-08 2014-06-05 The Cleveland Clinic Foundation Dispositif de voies respiratoires réversible et procédé associé pour oxygéner un sujet
US10675425B2 (en) 2013-10-08 2020-06-09 The Cleveland Clinic Foundation Reversible airway device and related method for ventilating a subject

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0448878A2 (fr) * 1990-02-27 1991-10-02 Archibald Ian Jeremy Dr. Brain Dispositif de voie aérienne artificielle
US5937859A (en) * 1996-10-16 1999-08-17 Augustine Medical, Inc. Laryngeal airway device
US20060162730A1 (en) * 2005-01-26 2006-07-27 Raymond Glassenberg Video-assisted laryngeal mask airway devices

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0448878A2 (fr) * 1990-02-27 1991-10-02 Archibald Ian Jeremy Dr. Brain Dispositif de voie aérienne artificielle
US5937859A (en) * 1996-10-16 1999-08-17 Augustine Medical, Inc. Laryngeal airway device
US20060162730A1 (en) * 2005-01-26 2006-07-27 Raymond Glassenberg Video-assisted laryngeal mask airway devices

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
RODENSTEIN D O ET AL: "PHARYNGEAL SHAPE AND DIMENSIONS IN HEALTHY SUBJECTS SNORERS AND PATIENTS WITH OBSTRUCTIVE SLEEP APNEA", THORAX, vol. 45, no. 10, 1990, pages 722 - 727, XP002678705, ISSN: 0040-6376 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014058840A3 (fr) * 2012-10-08 2014-06-05 The Cleveland Clinic Foundation Dispositif de voies respiratoires réversible et procédé associé pour oxygéner un sujet
US10556077B2 (en) 2012-10-08 2020-02-11 The Cleveland Clinic Foundation Reversible airway device and related method for ventilating a subject
US10675425B2 (en) 2013-10-08 2020-06-09 The Cleveland Clinic Foundation Reversible airway device and related method for ventilating a subject

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