Em processamento

Aguarde...

Configurações

Configurações

1. WO1991007201 - BLIND OROLARYNGEAL AND OROESOPHAGEAL GUIDING AND AIMING DEVICE

Nota: O texto foi obtido por processos automáticos de reconhecimento ótico de caracteres.
Para fins jurídicos, favor utilizar a versão PDF.

1. A medical device receivable through the mouth and into the back of the throat for blindly intubating an animal's trachea through the animal's mouth and larynx, the medical device including a guide element with a channel wall extending longitudinally along one portion of the guide element, characterized in that the guide element has anatomically contoured surfaces which, upon insertion of the guide element into the throat, cooperate with anatomical features of and adjacent the larynx to blindly position the guide element such that the channel wall is contiguous with at least the posterior portion of the tubular wall of the laryngeal opening to define an upward extension thereof and along which a tube may be advanced
directly into the larynx.

2. The medical device of claim 1 further characterized in that the guide element further includes an annulus upper portion with a channel therethrough defined by the channel wall.

3. The medical device of claim 2 further characterized in that the upper annulus portion of the guide element is anatomically contoured so as to cooperate with anatomical features of and surrounding the larynx to position the channel against the
laryngeal opening such that the upward extension of the laryngeal wall defined by the channel wall constitutes an airway path extension atop and coaxial the laryngeal lumen.

4. The medical device of claim 2 further characterized in that the channel includes an anterior portion adapted to substantially surround the anterior portion of the airway path extension.

5. The medical device of claim 2 further characterized in that the guide element further includes a body portion coupled to the annulus portion posteriorly of the channel and further characterized in that the guide element includes at least one of (a) an anterior portion of the channel shaped to receive thereagainst the epiglottis as the guide element is inserted into the back of the throat, (b) valleculae mating means anteriorly of the channel for mating with at least one vallecula as the guide element is
inserted into the back of the throat, and (c) tip means at a terminal end of the body portion for stopping the guide element against the posterior pharyngeal wall to prevent over-advancement of the guide element into the throat.

6. The medical device of claim 1 further comprising inserting means coupled to the guide element for blindly inserting the guide element into the back of the throat by manipulation from outside the mouth.

7. The medical device of claim 6 further characterized in that the inserting means includes a handle member coupled to the guide element and curved to conform generally to the curvature between the mouth and the larynx, the handle member having a lumen therethrough with a lumen wall continuous with the channel wall.

8. The medical device of claim 7 further characterized in that an upper arcuate portion of the handle member is removed from a proximal end thereof to expose a lower arcuate portion into which an orotracheal tube may be laid for insertion through the handle lumen.

9. The medical device of claim 7 further characterized in that the guide element further includes an annulus upper portion with a channel therethrough defined by the channel wall.

10. The medical device of claim 9 further characterized in that the guide element further includes cutout means at the junction of the guide element and the handle member and above an anterior portion of the annulus portion for receiving therethrough from within the channel the tip of the epiglottis.

11. The medical device of claim 7 further characterized in that the guide element includes slant tunnel means through the guide element and terminating in the channel wall, the slant tunnel means extending through the handle member, for defining a tubular path accessible through the handle member and pointing obliquely into the laryngeal opening from its
posterior aspect.

12. The medical device of claim 11 further characterized in that entrance hole means are provided on an exposed edge of the handle lumen for providing access to the slant tunnel means.

13. The medical device of claim 6 further characterized in that the inserting means includes a blade member curved to conform generally to the curvature between the mouth and the larynx and coupled at a distal end to the guide element.

14. The medical device of claim 13 further characterized in that the guide element further includes an annulus upper portion with a channel therethrough defined by the channel wall.

15. The medical device of claim 13 or 14 further characterized in that it further includes tube clip means for releasably holding an orotracheal tube or the like to the blade member.

16. The medical device of claim 1, 2, 3, 4, 5,

6, 7, 8, 9, 10, 13, 14, or 15 further characterized in that the guide element further includes slant tunnel means through the guide element and terminating in the channel wall for defining a tubular path pointing obliquely into the laryngeal opening from its
posterior aspect.

17. The medical device of claim 1, 2, 3, 4, 5,

6, 7, 8, 9, 10, 13, 14, or 15 further characterized in that the guide element further includes occluding means posteriorly of the channel wall for overlying and substantially occluding the esophageal opening.

18. The medical device of claim 17 further characterized in that the guide element further includes a body portion posteriorly of the channel -wall and supporting the channel wall, the body portion carrying the occluding means.

19. The medical device of claim 17 further characterized in that the guide element further includes esophageal tunnel means through the occluding means for defining a tubular path aimed at the esopha-geal opening .

20. The medical device of claim 17 further characterized in that the guide element further includes slant tunnel means through the guide element and terminating in the channel wall for defining a tubular path pointing obliquely into the laryngeal opening from its posterior aspect.

21. The medical device of claim 9, 11, or 12 further characterized in that the guide element further includes occluding means posteriorly of the channel wall for overlying and substantially occluding the esophageal opening and further includes esophageal tunnel means through the occluding means, the esophageal tunnel means extending through the handle member, for defining a tubular path accessible through the handle member and aimed at the esophageal opening.

22. The medical device of claim 21 further characterized in that entrance hole means are provided on an exposed edge of the handle lumen for providing access to the esophageal tunnel means.

23. The medical device of claim 1 further characterized in that the channel wall is arcuate so as to extend arcuately up through the throat toward the mouth.

24. The medical device of claim 1 further characterized in that the channel wall has an edge adapted to abut the posterior or lateral edge of the laryngeal opening.

25. The medical device of claim 24 further characterized in that the guide element includes a recessed surface bordering the channel wall edge and adapted to lie against the posterior or lateral edge of the laryngeal opening.

26. The medical device of claim 1, 24 or 25 further characterized in that the guide element includes a projecting cusp extending from the channel wall and adapted to be received in the interarytenoid incisure of the larynx.

27. The medical device of claim 6, 7, 8, or 13« further characterized in that it includes means for releasably coupling the inserting means to the guide element.

28. The medical device of claim 6, 7, 8, 9, 10, 13 or 14 further characterized in that the guide element further includes slant tunnel means through the guide element and terminating in the channel wall for defining a tubular path pointing obliquely into the laryngeal opening from its posterior aspect, the medical device further characterized in that it includes support means attached to the inserting member for supporting a fiberoptic laryngoscope.

29. A medical device comprising a guide element receivable through the mouth and into the back of the throat, and characterized in that the guide element has:
an annulus portion with a channel therethrough, the channel having an anterior wall and a posterior wall ;
a body portion coupled to the annulus portion posteriorly of the channel and supporting a surface defining an extension of the channel posterior wall;

means cooperating with anatomical features** of and adjacent the larynx for blindly positioning the guide element about the larynx such that the channel walls effectively form a continuation of the tubular wall of the laryngeal lumen into an airway path extension around, atop and coaxial the laryngeal lumen, the cooperating means defined by at least one of (a) the anterior wall in the channel being shaped to receive thereagainst the epiglottis when the guide element is inserted into the back of the throat, (b) valleculae mating means anteriorly of the channel for mating with at least one vallecula when the guide element is inserted into the back of the throat, (c) tip means at a terminal end of the body portion for stopping advancement of the guide element against the posterior pharyngeal wall as the guide element is being inserted into the throat, (d) a central notch in the annulus portion anteriorly of the channel , shaped and positioned to fit over the median glosso-epiglottic fold when the guide element is inserted into the back of the throat, (e) lateral notches in the annulus portion anteriorly of the channel, shaped and positioned to fit over the lateral glosso- and the pharyngo- epiglottic folds when the guide element is inserted into the back of the throat, (f) cusp means projecting from the body portion to fit into and above the interarytenoid incisure when the guide element is inserted into the back of the throat, (g) first edge means associated with a posterior wall of the channel for abutting the posteriorly beveled edge of the larynx when the guide element is inserted into the back of the throat, and (h) second edge means associated with the body portion for fitting around and against the posteriorly beveled edge of the larynx when the guide element is inserted into the back of the throat.

30. A medical device for blind aiming of a flexible fiberoptic laryngoscope into the larynx comprising a guide element receivable through the mouth and into the back of the throat, characterized in that the guide element has an annulus portion with a channel defined by a channel wall extending through the annulus portion, contour means cooperating with anatomical features of and adjacent the larynx for blindly positioning the guide element about the larynx such that the channel wall forms an upward extension of at least the posterior aspect of the tubular wall of the laryngeal opening whereby the channel provides an airway path extension around, atop and coaxial the laryngeal lumen, and slant tunnel means through the guide element and terminating in the airway path extension for defining a separate tubular path pointr-ing obliquely into the laryngeal opening from its posterior aspect.

31. A medical device for blind orotracheal intubation comprising a guide element receivable through the mouth and into the back of the throat, the guide element characterized in that it has:
(1) an annulus portion and a body portion depending from the annulus portion, a channel having a posterior wall extending through the annulus portion and along a surface of the body portion and terminating in a projecting cusp;
(2) contour means defined on the annulus and body portions cooperating with anatomical features at the back of the throat for stabilizing the guide element against the larynx such that the channel is contiguous with at least the posterior aspect of the edge of the laryngeal opening and surrounds the posterior and laterial aspects of the laryngeal lumen to define an airway path extension around, atop and coaxial the laryngeal lumen, the contour means including (a) an anterior wall in the channel shaped to receive thereagainst the epiglottis as the guide element is inserted into the back of the throat, (b) valleculae mating means anteriorly of the channel for mating with at least one vallecula as the guide element is inserted into the back of the throat, and. (c) tip means at a terminal end of the body portion for stopping advancement of the guide element against the posterior pharyngeal wall as the guide element is being inserted into the throat; and
(3) surrounding means including the channel walls, the surface of the body portion and the terminating cusp for substantially surrounding the posterior and laterial aspects of the laryngeal opening and embracing the larynx when the channel is aligned with the laryngeal lumen.

32. The medical device of claim 31 further characterized in that the body portion is positioned relative the channel to define a barrier which
prevents orally introduced tubular members passing downward through the channel from entering the esophageal opening.

33. The medical device of claim 32 further characterized in that the body portion is also positioned relative the channel such that the tip means substantially occludes the esophageal opening.

34. The medical device of claim 29 or 31 further characterized in that the guide element further includes tunnel means through the body portion for defining a tubular path aimed at the esophageal opening when the channel is aligned with the laryngeal lumen.

35. The medical device of claim 29 or 31 further characterized in that the guide element further has slant tunnel means through the guide element and terminating in the airway path extension for defining a tubular path pointing obliquely into the laryngeal opening from its posterior aspect when the channel is aligned with the laryngeal lumen.

36. A medical device comprising a guide element sized and shaped to be inserted blindly into the throat, the guide element characterized in that it has an annulus portion having anterior arc means for engaging the epiglottis and posterior arc means for substantially surrounding the upper axial portion of the laryngeal opening, body portion means adjacent said posterior arc means for substantially enclosing and isolating from surrounding anatomical spaces the lower axial portion of the laryngeal opening, and channel means extending through the annulus portion and along the body portion for guiding an orotracheal tube into the laryngeal opening.

37. The medical device of claim 36 further characterized in that the guide element further has slant tunnel means therein for stabilizing and aiming the fiberbundle of a fiberoptic laryngoscope.

38. The medical device of claim 36 further characterized in that the guide element further has esophageal tunnel means through the body portion for aiming a tubular-type member substantially exclusively into the esophagus .

39. A method for blindly and rapidly introducing an orotracheal tube from outside the mouth into a patient's trachea characterized by:
providing an artificial upward extension of the posterior laryngeal wall by aligning a channel wall contiguous with and extending upwardly from at least the posterior edge of the tubular wall of the laryngeal opening;
advancing an orotracheal tube along the channel wall whereby the tube advances into the larynx and trachea.

40. A method for blindly and rapidly introducing an orotracheal tube from outside the mouth into a patient's trachea characterized by: providing about and atop the laryngeal
■■> opening an airway path extension substantially contiguous with at least the posterior edge of the
laryngeal opening whereby to receive an orotracheal tube therethrough exclusively into the larynx; and
advancing an orotracheal tube through the lυ airway path extension whereby the tube advances into the larynx and trachea.

41. The method of claim 39 or 40 further characterized by removing the laryngeal wall extension or airway path extension from the throat without removing the orotracheal tube from the larynx.

42. The method of claim 39 or 40 further characterized by:
providing a tunnel through the laryngeal
wall extension or airway path extension pointing into *■*■ the airway path at the vocal cords whereby to permit rapid, blind, stable access of tubular instruments
into the larynx.

43. The method of claim 39 or 40 further characterized by providing an esophageal tunnel through the laryngeal wall extension or airway path extension
aimed at the esophageal opening whereby to permit

5 rapid, blind oroesophageal access.

44. The method of claim 39 or 40 further characterized by remotely inserting the laryngeal wall extension or airway path extension from outside the mouth by a handle or blade connected to the laryngeal wall extension or airway path extension such that the handle or blade extends outside the mouth.

45. The method of claim 39 or 40 further characterized by remotely manipulating the laryngeal wall extension or airway path extension from outside the mouth by a handle or blade connected to the laryngeal wall extension or airway path extension such that the handle or blade extends outside the mouth.

46. The method of claim 42 further characterized by supporting the laryngeal wall extension or airway path extension with a blade or handle connected to the laryngeal wall extension or airway path extension such that the handle or blade extends outside the mouth, and by attaching a fiberoptic laryngoscope to the handle or blade exteriorly of the mouth with the image guide thereof inserted into the tunnel, so that orotracheal intubation may be performed while simul-taneously observing the patient's vocal cords through the laryngoscope eyepiece.

47. A process for making a guide element for blindly, rapidly, and selectively guiding and aiming tubular members into the larynx of humans or animals, characterized by:
obtaining a representative larynx including adjacent anatomy of the size and species of animal which it is desired to intubate;
inserting a smooth curved tube, with as large an outer diameter as the laryngeal lumen will accommodate, into the larynx, so that the tube makes an arc from the interior of the larynx into an area defining a mid-portion of the oral cavity;
making a mold around and above the larynx with the tube inserted therein, which mold incorpo-rates an impression of the surrounding anatomy;
withdrawing the cured mold from the tube and anatomical structures ; and
making a cast of the mold to create a replica thereof in a soft, semi-flexible material.

48. The process of claim 47 further characterized by, prior to making the cast,
preserving those parts of the mold where it fits around and against the edge of the laryngeal opening, and around and above the epiglottis, and where it surrounds the tube, from the interarytenoid incisure to a level slightly above the tip of the epiglottis, and where it fits into the esophageal opening and the vallecular depressions;
trimming away other parts of the mold and thinning, rounding, and smoothing its edges and surfaces, so that it may be rapidly inserted into the throat and easily popped into its original position, in snug alignment around, against, and atop the edge of the laryngeal opening, while having an annulus above the larynx around the tubular path created by the impression of the smooth curved tube.

49. The process of claim 47 further characterized by:
drilling or casting a tubular passageway in the mold to create at least one tunnel therethrough which is directed, as desired, at the interior of the larynx or the esophagus, in conformance with the regional anatomy of the representative larynx.

50. The process of claim 47 further characterized by:
extending the mold around and along the tube outwardly of the mouth whereby to form a tubular handle, the lumen of which is an extension of the lumen of the larynx.