Title:
Nasal pack
United States Patent 2215126


Abstract:
This invention relates generally to surgical packs and more particularly to intra-nasal packs. After intra-nasal surgery, such as submucous resection of the nasal septum, turbinectomy or trans-nasal approach to the accessory nasal sinuses, the surgeon usually feels that the end result of his...



Inventors:
Mcmillin, John H.
Application Number:
US25051339A
Publication Date:
09/17/1940
Filing Date:
01/12/1939
Assignee:
Mcmillin, John H.
Primary Class:
Other Classes:
604/907
International Classes:
A61B17/12
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Description:

This invention relates generally to surgical packs and more particularly to intra-nasal packs.

After intra-nasal surgery, such as submucous resection of the nasal septum, turbinectomy or trans-nasal approach to the accessory nasal sinuses, the surgeon usually feels that the end result of his work will be more satisfactory if the nose is lightly packed. The packing, as is generally known, prevents hemorrhage and prevents adhesions between freshly operated surfaces. In addition, the packing keeps the two layers of mucous membrane, following submucous resection, in close but gentle opposition, preventing hematoma formation between and aiding firm union of the membrane. Hemorrhage occasionally sets in as the constricting effect of the adrenalin, a common component of the local anesthetic, wears off and may be severe enough to seriously affect the convalescense of the patient. In any event, the bleeding is inconvenient to the patient and to the surgeon for if the bleeding is only moderate the nasal cavities become filled with blood clots which later crust and when removed lead to more bleeding.

The packing material most commonly used is vaselined gauze. This gauze is laid into the nasal cavity as fingers of rolled gauze which are gradually added and packed into the nose. In an effort to keep the pressure even on opposite sides of the septum it is usually the practice to add a little of the gauze to one nasal cavity and then a little to the other, but even then the gauze gives a humpy uneven pressure and is unyielding.

When the vaselined gauze is removed in twentyfour to forty-eight hours some bleeding nearly always occurs and its frequently more severe than it would have been without the packing.

Often the septal mucous membrane is disturbed by the adherence of the gauze, seriously interfering with the healing process.

Accordingly, it is the principal object of this invention to provide a new and improved nasal pack by the use of which the above objections and undesirable results are obviated.

More specifically, it is an object of the invention to provide a nasal pack which will prevent hemorrhage, which will provide even pressure on opposite sides of the septum membrane and which will be less likely to adhere to the septal mucous membrane than former packs.

A further object of the invention is to provide a nasal pack of a character such that it may be quickly applied to and/or removed from the nasal cavities.

Other objects of the invention will become apparent from the following description taken in connection with the accompanying drawings in whichFigure 1 is a fragmentary front view of a human face showing my improved pack and how it may be applied; Fig. 2 is a side view partly in section of Fig. 1; Fig. 3 is a view in elevation of my pack; Fig. 4 is a view in section of the pack; Fig. 5 is an enlarged detail section of the pack; Fig. 6 is an enlarged fragmentary sectional view of the pack including a check valve; Fig. 7 is a view in elevation of a part of the pack structure shown removed therefrom; Fig. 8 is a view in elevation of another part of the pack structure shown removed therefrom; Fig. 9 is a view shown partly in elevation and partly in section of another form of my nasal pack; Fig. 10 is a view shown in section taken along the line 10-10 of Fig. 9, and Fig. 11 is a view in section of certain structural details of the device of Figs. 9 and 10; Fig. 12 is a view similar to Fig. 2, but including a breathing tube. Referring to the drawings by characters of reference, Figs. 1 and 2 show in part a human head to illustrate the nasal passages 10, between which is the septum membrane 11 and to illustrate further how the nasal passages are packed by my packing device, designated in general by the numeral 12. The pack device 12 includes a supporting member 13 in the form of a hollow body or casing having an air chamber 14 which is formed in part by the casing front and rear walls 15 and 16 respectively. Projecting into the chamber 14, through the casing rear wall 16, a pair of spaced tubular members IT, in the form of cannular or hollow pins, are provided having longitudinally extending bores 18 opening into the chamber 14. On their inner ends, within the chamber 14, the tubular members IT are preferably provided with heads 19 to limit outward movement of the members 17 and between the heads 19 and the casing front wall 15 a spring strip retainer 20 is provided. The retainer strip 20, as shown in Fig. 7 is provided with a pair of spaced slots 21 to receive the tubular members 17. The ends of the spring strip 20 are bent around the heads 19 of the tubular members 17 when the device is assembled.

A pair of inflatable, or expansible-contractible bags 22 are provided for packing the nasal passages 10 and have open ends which fit over and communicate respectively with the pair of tubular members 17. These inflatable bags 22 are preferably formed of a good thin rubber, such as, thin "latex" rubber. A plug 23, Fig. 5, is provided for the neck of each of the rubber bags. 22 and the end portions of the necks are each provided with a metallic cap 24. Preferably, the plugs 23 are formed of soft or sponge rubber, each having a central opening or bore 24a leading into the respective bag, to receive the tubular connecting members 17 which also extend through apertures in the caps 24. The bores 24a may be of less diameter than the diameter of the tubular members I 7 so that the bores will expand upon insertion of the tubular members thereinto whereby the inherent contractural force of the rubber will maintain a tight seal around the tubular members 17. Between the outer wall surfaces of the plugs 23 and the inner surfaces of the bag necks a suitable sealing cement, indicated at 25, may be provided to insure a leak proof joint and similarly the cement may be provided, as at 26, between the inner wall surfaces of the caps 24 and the outer wall surfaces of the bag necks to insure an air tight seal between these surfaces. The body or casing 13 may be attached to and between the ends of a strip or band of material 27, which may be sheet rubber and the opposite ends of the rubber strip 27 may be attached to a patient's face by adhesive strips (not shown) or by other suitable means. The casing 13 may be made of any suitable material, for example it could be cast of a light weight, plastic material, but to facilitate manufacture and reduce cost thereof, the casing may be formed, as shown, of rubber tubing having its ends closed and sealed by metallic clamps 28, one of which is shown in blank form in Fig. 8. These clamps 28 are bent substantially along the dot and dash lines indicated in Fig. 8 and have ears 29 which wrap around the end portions of the rubber casing tube, a portion 30 which is bent over the end of the tube, ears 31 which are bent to extend longitudinally of the tube and anotherear or flange 32 which pierces the supporting band 27 and is bent back thereagainst. These clamps 28 close and seal the ends of the rubber tube casing 13 and also secure the casing to its supporting band 27.

Secured in and to the casing front wall 15, an air check valve 33 is provided having a body 34 which has an air passage 34a therethrough, opening into the air pressure chamber 14. The casing wall 15 is provided with an aperture 35 therethrough to receive the valve body 34 which may have an external annular recess or groove 36 into which the wall around the opening 35 may tightly fit and the joint therebetween be sealed by any suitable sealing material. The valve body 34 projects slightly into the air pressure chamber 14 and its inner end is recessed, as at 36, to: receive and o6 retain a loosely disposed valve member or disc 37 which controls the air flow passage 34a. A leaf spring or metallic strip 38 has one end anchored and secured to the valve body 34, the other or free end, as at 39, of the spring overlying and retaining 5g the valve member 37 in its recess 36. The valve member 37, overlying the inner end of the air passage 34a, is adapted to check back flow of air through the passage 34a from the air pressure chamber 14, the valve being held on its seat by the pressure in the chamber.

In applying the pack to a patient, the inflatable rubber bags 22 are first placed deflated in the opposite nasal cavities 10 and the device attached in place to the patient by means of the rubber sheet strip 27 which may be held to the patient's cheeks by adhesive. To inflate the bags 22 an ordinary bulb or syringe type hand pump (not shown) may be employed, the nipple of which pump is received in the tapered air passage 34a.

By means of the pump, pressure is increased in the chamber ý4 inflating the bags, which, since they have or communicate with a common pressure chamber 14 will be equally inflated. The bags 22 will, when inflated to the proper degree, conform to the irregularly shaped surfaces of the nasal cavities 0 and will exert equal pressure in all directions against these surfaces of the nasal cavities. This equal exertion of pressure in all directions by the inflatables 22 is particularly advantageous with respect to the septum membrane I since the equal, opposed pressures on opposite sides thereof will support the septum membrane in its proper central position instead of pushing it to one side or the other as is likely to happen when other types of nasal pack such as gauze are employed. When it is thought that the inflatable bags 22 may be removed from the nasal cavities, a suitable instrument (not shown) may be inserted in the valve passage 34a and lift the valve 37 from its seat to permit a little of the air to escape from the chamber 14 to deflate the bags 22 slightly. After slightly deflating the bags 22, if for any reason, bleeding should occur, the bags may again be inflated to obtain the proper pressure to stop the bleeding. However, the possibility of restarting bleeding by deflation of the bags is remote since the bags are not absorbent and will not adhere to the operated surfaces, particularly if the bags are lubricated externally with, for example, vaseline. The retainer strip 20 while serving to limit movement of the tubular connecting members 17 relative to the body 13 also serves to give shape to the rubber body. That is, the strip 20 may be bent or bowed to retain such form to the body 13 that the body will fit or conform to the contour of the portion of the patient's face to which the device is attached.

From the foregoing description it will now be appreciated that I have provided new and improved nasal packs of a character such that equal pressures will be had on opposite sides of the septum membrane and against the irregular surfaces of the nasal cavities. Furthermore, it will be seen that the present packs may be easily and quickly applied to and/or removed from the nasal cavities of a patient and will not be likely to adhere to and disturb freshly operated surfaces.

In addition, I have provided compact, efficient pack devices which are inexpensive with respect to use and also with respect to manufacturing costs.

Referring now to the form of my invention shown in Figs. 9, 10 and 11, this device includes a supporting member or body 40 which is preferably cast of a suitable light weight plastic material and may be provided with rearwardly directed extended portions or wings 41 shaped to fit a patient's face or cheeks to aid in holding the device in place. Opening through the rear wall surface of the body 40, a pair of spaced threaded bores receive a pair of open ended tubular fittings 42 over the outer ends of which the neck portions of a pair of inflatables 43 are adapted to be fitted.

The fittings 42 are preferably provided with heads 42a which seat in counterbores 44 in the body, and the necks of the inflatables are stretched over the heads 42a after which open ended rubber sleeves 45 are stretched over the necks of the inflatables to insure against leakage of air therefrom.

Opening through the body front wall surface, centrally of the inflatable fittings 42, a threaded bore receives a fitting 46 of an air check valve, the fitting 46 having a head 47 under which a compressible washer 48 is preferably provided to insure an air tight joint between the fitting and the body. The valve fitting 46 is provided intermediate its ends and within its bore with an external annular recess or groove providing an annular space 50 and in the body 46 a pair of angularly disposed bores 49 connect the space 50 with the respective inflatable fittings 42. A recess or bore 51 is provided in the valve fitting 46 and extending longitudinally and centrally thereof is tapered, in the present instance, to receive the tapered end of a syringe type hand pump (not shown) for introducing air into the inflatables 43 although any suitable means may be provided for this purpose. This bore 53 serves both for ingress and egress of air and is connected to the annular space 50 by a passage or bore 55 which extends transversely through the portion of the valve fitting, reduced by reason of the annular space 50. Surrounding and stretched over this reduced portion, an open ended rubber sleeve 56 overlies the outer end of the connecting passage 55 and serves as a check valve member controlling flow therethrough. In the present device, when it is desired to release air from the inflatables 43 it is only necessary to partly unscrew the valve fitting 46 which loosens the compressible washer permitting egress of air under the head of the fitting 46.

In using either of the nasal packs, described above, it will be seen that the inflatables when 3inflated will close the nasal passages of a patient, requiring the patient to breathe through the mouth. In order to permit a patient to breathe through the nose, thus giving added comfort to the patient, I provide a pair of breather tubes, one of which is shown in Fig. 11 and designated by the numeral 58. In applying the nasal pack, the breather tubes are arranged one with each of the inflatables in each of the patient's nasal cavities. As generally understood, the nasal cavity is bounded medially by the nasal septum, laterally by the lateral wall or turbinated area, above by the cribiform plate and below by the superior surface of the palate, the cavity extending from the anterior nares in the front to the posterior nares or choana posteriorly. The breather tubes 58 preferably lie on the superior surface of the palate and the inflatables, when inflated, form around the breather tubes filling the cavity space not occupied by the breather tubes. In the body 40, spaced threaded bores 59, Fig. 11, receive a pair of open ended tubular fittings 60 provided to support and connect the breather tubes with the atmosphere. The necks of the breather tubes, which may be formed of rubber, may be stretched over the inner ends of the fittings 60 and in this manner be held tightly by their inherent contractural forces to the fittings. To prevent the breather tubes from be65 ing collapsed by the inflatables 43, light helical coil springs 61 are, provided one in each of the breather tubes, these springs preferably having several turns thereof threaded respectively onto end portions of the fittings 60, as shown in Fig. 11, and having their inner ends abutting the ends of the breather tubes 58. One or more apertures 62 may be provided in the breather tubes 58 to permit breathing action and the breather tubes may be sufficiently longer than the inflatables to insure against occulsion of apertures 62 by the inflatables, the inner ends of the breather tubes extending to the posterior nares.

What I claim is: 1. In an intra-nasal pack, a supporting member having a passage therethrough for air, a check valve supported on said member and having an air passage opening into said member, said member having a pair of spaced apart tubular members projecting externally of said member, and a pair of inflatable members connected to said tubular members.

2. In an intra-nasal pack, a supporting body having a passage therethrough for air, a pair of spaced apart tubular members communicating with said passage and projecting externally of said body, a pair of inflatable members attached to and communicating with said tubular members externally of said body, and air inlet means operable to retain air in said body under pressure exceeding atmospheric pressure. 3. In an intra-nasal pack, a hollow body having an air inlet, a valve member for said inlet and operable by air pressure within said body to close said inlet, a pair of spaced longitudinally bored open-ended pins projecting into said body, and a pair of inflatable members connected to said pins externally of said body.

4. In an intra-nasal pack, a hollow rubber body having an opening thereinto, an air check valve closing said opening, a pair of spaced apart open ended hollow pins extending into said body, an attachment member through which said pins extend, and a pair of rubber inflatable members attached to said pins externally of said body.

5. In a nasal pack having a pair of inflatable bags for insertion in opposite nasal passages, a casing having a pressure chamber for said bags, said casing comprising a resilient tube, metallic clamps closing and sealing the opposite ends of the tube, an air passage into said chamber, and 0a a check valve mounted on said casing and controlling said passage.

6. In a nasal pack, a flexible open ended casing having an air chamber, a mounting strip for said casing, clamps closing and sealing the ends of said casing and securing said casing to said strip, said chamber having an air passage, a check valve controlling said air passage, a pair of tubular members communicating with said chamber and extending externally of said casing, inflatable bags connected to said tubular members externally of said casing, and a bendable retainer strip limiting movement of said tubular members relative to said casing and for giving added rigidity to said casing. 7. In a device of the character described, a supporting member having a recess, a removable fitting in said recess and cooperable therewith to provide a chamber, said fitting having an air passage communicating with said chamber and opening to outside atmosphere, a pressure responsive valve member surrounding said fitting within said chamber and controlling said passage, and a pair of inflatable members carried by said supporting member and communicating with said chamber.

8. In a device of the character described, a supporting member, a valve fitting cooperable with said supporting member to provide an air chamber therewithin, said fitting having an air passage connecting said chamber to outside atmosphere, a pressure responsive tubular valve surrounding said fitting within said chamber and normally acting to close said passage, and a pair of inflatable members communicating with said chamber, said fitting being movable relative to said supporting member to open said chamber to atmosphere irrespective of the operation of said valve.

9. In an intra nasal pack, a supporting member having an air chamber, a check valve controlling flow through said chamber, a pair of inflatable members connected to said chamber, and a pair of breather tubes connected to said supporting member and communicating with outside atmosphere.

10. In an intra nasal pack, a supporting member having an air chamber, a check valve controlling flow through said chamber, a pair of inflatables for positioning in the nasal passages and connected to said supporting member in communication with said chamber, a pair of breather tubes for positioning in the nasal passages and connected to said supporting member in communication with outside atmosphere, and means within said breather tubes to prevent complete collapsing thereof by said inflatables.

11. In an intra nasal pack, a supporting member having an air chamber, a check valve controlling flow through said chamber, a pair of inflatables for positioning in the nasal passages and connected to said supporting member in communication with said chamber, a pair of breather tubes for positioning in the nasal passages and connected to said supporting member in communication with outside atmosphere, and resilient means within said breather tubes to prevent complete collapsing thereof by said inflatables.

12. In an intra nasal pack, a supporting member having an air chamber, a check valve controlling flow through said chamber, a pair of inflatables for positioning in the nasal passages and connected to said supporting member in communication with said chamber, a pair of breather tubes for positioning in the nasal passages and connected to said supporting member in communication with outside atmosphere, and spring means within said breather tubes to prevent complete collapsing thereof by said inflatables.

13. In a nasal pack, an inflatable member for positioning in the nasal cavity of a patient, a breathing tube associated with said inflatable member for positioning therewith in the nasal cavity so that the patient can breathe through the nose when said member is inflated, a valve body attaching said inflatable member and said breathing tube together and including a chamber communicating with said inflatable member, said chamber having an air port, and valve means controlling said port.

14. In a nasal pack, a valve body having a chamber provided with a port, a pair of inflatable members for positioning respectively in the nasal cavities of a patient and communicating with said chamber, valve means controlling said port for releasably retaining air under pressure in said members, and a pair of flexible breathing tubes connected to said valve body and juxtaposed respectively with said members for positioning therewith respectively in the nasal cavities so that the patient can breathe through the nose when said members are inflated. 15. In a nasal pack, a body having a chamber and a port therefor, a pair of inflatable members for positioning in the nasal cavities of a patient and communicating with said chamber, valve means for releasably retaining said members inflated, a pair of rubber breathing tubes juxtaposed respectively with and externally of said members for positioning therewith in the nasal cavities, said valve body having a pair of spaced apertures through a wall thereof and laterally of said chamber, said breathing tubes having corresponding ends communicating respectively with said apertures so that a patient may breathe through the nose when said members are inflated in the nasal cavities, and a coiled wire associated with each of said tubes to prevent complete collapsing thereof by said inflatable members.

JOHN H. McMILLIN.