Instrument for repositioning fractures of front and lower walls of frontal sinuses

FIELD: otolaryngology.

SUBSTANCE: instrument can be used in maxillofacial surgery and traumatic surgery. Instrument for repositioning fractures of front and lower walls of front sinuses has handle and working part in form of blade. Blade is made for introduction in front sinus along line of fracture and it is bent at angle of 30° to handle. Window for passing cutter through is made in blade and for forming holes in bone fractures for seam material. Higher aesthetic and functional results can be achieved due to low traumatism and due to reliability of reposition of bone fractures.

EFFECT: improved efficiency of operation.

2 cl, 1 dwg

 

The invention relates to medicine, namely to otolaryngology, and can be used in maxillofacial surgery and traumatology.

Reposition the depressed fragments of the front and bottom walls of the frontal sinus after their fracture is a necessary condition to achieve the normal architecture of the upper zone of the facial skeleton, it helps to prevent post-traumatic frontal sinusitis, osteomyelitis of the frontal bone, inflammatory processes in the orbit.

Known Elevator Unwalla to reposition the bones of the nose, which some of the authors used for endonasal reposition of bone fragments of the frontal sinus (Uwian., Wiglusz., Nffbn. Therapeutic tactics in combined deforming closed fracture of nasal bone and frontal sinus // Russian rhinology. - 1993. Application 1. - P.27-28).

This Elevator has a number of disadvantages, such as:

- Inability to move the bone fragments at the time of reset in all directions.

- Does not reposition of bone fragments in the correct anatomical position.

- Has a devastating effect on the naso-frontal channel.

- Retention of fragments of the frontal sinus, with this method, is inflatable balloon, which causes additional trauma to the mucous membrane of the sinuses.

Known perforating, cutting, dissecting and scalping tools designed to remove abnormal tissue from the nasal cavity and paranasal sinuses. The tools are made from an alloy based on titanium nickelide brand T-20. The main advantage of the tools is sufficient plasticity of the working part, allowing impart necessary for operative intervention form at high cutting properties and wear resistance. The tools consist of a handle, a neck and a working part in the form of a sickle cutting part or loop-like knife (kN. Medical materials and implants with shape memory. - Publishing house of Tomsk University, Tomsk, 1998. - S.401-404).

The disadvantage of these tools:

- The impossibility of their use to reposition the bone fragments of the front and bottom walls of the frontal sinus.

A well-known tool to reposition the zygomatic arches and bones, selected as a prototype (Cassiolato, patent No. 2187260, MCI And 61 In the 17/24, 17/56, publishing BI No. 23, 20.08.2002).

The tool includes a handle and a working part in the form of a rod and two teeth. The working part is made of titanium nickelide with the effect of thermoplate.

Disadvantages of tool to reposition the bone fragments of the front and bottom walls of the frontal sinus:

- use causes significant trauma of the fragments of the frontal sinus, as working part consists of two pointed subulate teeth;

- provides reliable retention of the fragment during the formation therein rasevych holes;

effect of thermoplate titanium nickelide when these fractures are not relevant.

The objective of the invention is low-impact and safe reposition of fragments of the front and bottom walls of the frontal sinus in the correct anatomical position, keeping them from sinus during the formation of rasevych holes, creating conditions for obtaining favorable functional and aesthetic outcomes.

The problem is achieved in that the device is made in the form of an instrument containing the handle and the working part. Made the instrument of titanium. On the handle caused roughening. The working part is made in the form of blades and bent to an angle of 30 degrees relative to the handle and contains inside a window for the passage of the cutters in the formation rasevych holes in the bone fragments.

Conform to the technical solution of the criterion of "novelty" is confirmed by the presence of the signs that are missing from the prototype:

1. The working part is made in one broad shoulder.

2. The angle of inclination of the working parts of 30 degrees is comfortable for the instrument along the lines of fracture under the depressed fragments.

3. The presence in the working part of the window provides passing the cutter down through the window, while holding off the bone fragments in the correct position.

The significance of differences between allaamah device to achieve the objectives, confirmed by the absence in the patent and scientific literature, information about similar devices that have the same set of features.

The device illustrated in the drawing (kind of tool on the side and front view).

The tool consists of a handle 1 printed on it repeatable and working part 2, made in the form of blades, bent at an angle of 30 degrees relative to the handle. The blade is a window 3.

The device operates as follows. The working part 2 is introduced into the frontal sinus along the line of fracture and a small force of arms is the reposition of bone fragments in the correct position. Continue to hold the bone fragments in the correct position, from the top are formed preseve holes, with cutter, passing from top to bottom, is within the window of the blades of the tool. Formed by the cutter openings are provided for the suture material for fixation of bone fragments.

Thus, the tool to reposition the fragments of the front and bottom walls of the frontal sinus helps to achieve good aesthetic and functional results by malotravmatichnosti and reliability reposition of bone fragments, keeping them from sinus during the formation of rasevych holes.

1. Tool to reposition the fragments of the front and bottom walls of the frontal sinus containing stream is at and the working part, characterized in that the working part is made in the form of blades to enter the inside of the frontal sinus in the line of fracture and bent at an angle of 30° in relation to the handle, with the blade made a window for the passage of the cutter and forming in the bone fragments holes suture.

2. The tool according to claim 1, characterized in that the handle has a pattern.



 

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