JP2010029584A - Nasal dilator and nasal protection tube insertion set - Google Patents

Abstract

[PROBLEMS] To reduce the burden on a patient during dilatation of a nasal cavity and observation with a nasal insert, for example, a nasal endoscope.
First, a first tube portion 12 at the head is inserted into a nasal cavity. Subsequently, the large-diameter next-stage tube portions 13 and 14 are inserted into the nasal cavity, and the nasal cavity is gradually expanded. After completion of the expansion, the nasal cavity protection tube 15 is slid with respect to the tube portion 14 and inserted into the nasal cavity. Then, the tube portions 12, 13, 14 (nasal cavity dilator 11) of all stages are extracted, the nasal cavity protection tube 15 remains in the nasal cavity, and the transnasal endoscope is inserted into the nasal cavity protection tube 15. The expansion of the nasal cavity can be completed with a single insertion / removal of the nasal cavity expansion tool 11. In the nasal cavity protection tube 15, the nasal cavity and the endoscope do not rub against each other.
[Selection] Figure 1

Description

  The present invention relates to a nasal dilator and a nasal protection tube insertion set used in the use of a nasal insert inserted nasally such as a nasal endoscope.

  2. Description of the Related Art A nasal endoscope that inserts an endoscope for observing the stomach or the like from the nasal cavity instead of from the oral cavity is known as a nasal insert that is inserted nasally. The insertion path of the transnasal endoscope reaches the stomach or the like through the nasal cavity, pharynx, and esophagus from the outer nostril to the posterior nostril. In the nasal cavity, it is necessary to pass through a narrowed portion such as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate. If a transnasal endoscope is inserted into such a nasal cavity suddenly, the patient may be burdened with pain and bleeding. Therefore, prepare three nasal dilation tubes with different outer diameters, insert the nasal dilation tube into the nasal cavity in order from the thin tube to the thick tube (repeat insertion and removal for each tube), and expand the nasal cavity in advance. To be done. In addition, an anesthetic such as lidocaine jelly is applied to the outer peripheral surface of the nasal dilation tube, and the anesthetic is applied into the nasal cavity as the nasal dilation tube is inserted into the nasal cavity. In both cases, the pain of the patient is reduced.

  As another device for reducing pain, an intranasal anesthetic application device for applying an anesthetic into the nasal cavity described in Patent Document 1 is known. This intranasal anesthetic application device is provided with a flexible tube having the same length as that from the outer nostril to the rear nostril, and a large number of pores are formed on the outer peripheral surface in the vicinity of the distal end of the flexible tube. It has been drilled. In addition, a connecting portion to which an anesthetic supply means is connected is connected to the proximal end side of the flexible tube, and an internal passage of the flexible tube serves as an anesthetic supply passage. Then, when the flexible tube is inserted into the nasal cavity, the anesthetic flows out from the pores of the flexible tube and is applied to the inner surface of the nasal cavity.

Further, Patent Document 2 describes a trial device for confirming whether or not a nasal endoscope can be passed through a nasal cavity. This try-through device is composed of a flexible shaft for insertion and a gripping operation portion, and the flexible shaft is the same as or thinner than the insertion portion of the endoscope and has a length extending from the outer nostril to the rear nostril. Have Before inserting the endoscope nasally, test the nasal cavity with a flexible shaft and check whether the flexible shaft can reach the nasal passage from the outer nostril to the posterior nostril or not. This makes it possible to verify and confirm whether or not an endoscope can be inserted.
JP 2006-326064 A JP 2007-156 A

However, when three nasal dilation tubes having different outer diameters are sequentially inserted into the nasal cavity, the insertion and removal of the nasal dilation tube into the nasal cavity is repeated three times. The burden increases accordingly.
In addition, since there are many stenosis in the nasal cavity, the nasal cavity and the endoscope can be operated by endoscopic operation (push and pull) performed in the observation and diagnosis after the transnasal endoscope is inserted. Rubs each other and puts a burden on the patient.

  The present invention has been made to cope with such problems, and an object thereof is to provide a nasal dilator and a nasal protection tube insertion set that ease the burden on the patient.

  In order to achieve the above-mentioned object, the structural feature of the nasal cavity dilator according to the present invention is used in the use of a nasal insert that is inserted nasally, and is sequentially inserted into the nasal cavity from the distal end portion in the axial direction. A nasal cavity dilator comprising a plurality of stages of tube sections having flexibility to be inserted and expand the nasal cavity, the plurality of stages of tube sections being changed from a tube section located on the distal end side to a tube section located on the rear side. The outer diameter is gradually increased toward the outer diameter, and the boundary of the multi-stage pipe part is continuously expanded from the pipe part side with a smaller outer diameter to the pipe part side with a larger outer diameter. In other words, the distal end surface of the tube portion at the distal end is a closed surface. Here, the nasal insert inserted transnasally refers to a nasal insert or a nasal tube (catheter) or the like inserted nasally.

  According to the nasal cavity dilator according to the present invention configured as described above, first, the leading tube portion having a small outer diameter is inserted (inserted) into the nasal cavity. Thereafter, a tube portion having a large outer diameter is sequentially inserted into the nasal cavity, and the nasal cavity is gradually expanded. When the final stage of the tube is inserted into the nasal cavity and a path for inserting a nasal insert, for example, a nasal endoscope, is secured and expansion is completed, The part is extracted outside the nasal cavity. Thereafter, a nasal insert, such as a nasal endoscope, is inserted into the expanded nasal cavity. For example, after the nasal cavity has been expanded, the nasal cavity protection tube is inserted into the nasal cavity, and then all the tube sections are extracted outside the nasal cavity, and the nasal endoscope is inserted into the nasal cavity protection tube remaining in the nasal cavity. Can be inserted. In the present invention, since a plurality of tube portions can be continuously inserted into the nasal cavity, it is not necessary to remove the tube portion of the previous step when inserting the tube portion of the next step, and the nasal cavity is expanded once. It can be finished by inserting and removing. This alleviates the burden on the patient. In addition, since the outer diameter of the boundary portion of the tube portion continuously changes and does not feel a step, smooth insertion is possible even when the tube portion having a large diameter step is inserted into the nasal cavity.

  Another structural feature of the nasal cavity dilator according to the present invention is that a plurality of stages of tube portions are integrally formed. According to this, when the next-stage tube portion is inserted into the nasal cavity, the insertion of the previous-stage tube portion proceeds accordingly. If the length of the tube part is set to an appropriate length, the tip of the tube part of the first step will be the lower nasal passage below the lower turbinates when the tube part of the last step is inserted into the nasal cavity. Or it can pass through a narrowing in the nasal cavity, such as the middle nasal passage between the middle and lower turbinates, past the pharynx and reach the esophagus. The irritation to the pharynx is small and the burden is reduced.

  Yet another structural feature of the nasal dilator according to the present invention is that the length of the tube portion having a smaller outer diameter is made longer than the length of the tube portion having a larger outer diameter. Consists of body pipe parts, and assembles multiple stages of pipe parts so that adjacent pipe parts are slidably fitted in the axial direction, from the rear side to the front end side of the outer circumference of the pipe part with a small outer diameter In addition, a pipe portion having a large outer diameter can be moved sequentially.

  According to this, after the leading step tube portion is inserted into the nasal cavity, the rear end portion of the leading step tube portion is gripped so that the leading step tube portion does not move in the axial direction with respect to the nasal cavity. (The position in the nasal cavity is maintained), and the next-stage tube portion is pushed and slid with respect to the first-stage tube portion and inserted into the nasal cavity. In this way, the large-diameter step tube portion is sequentially inserted into the nasal cavity. If the axial length of the tube part is set to an appropriate length, the tube part of any step is the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and lower turbinate The stenosis in the nasal cavity such as can pass, but can stop before the pharynx. Does not irritate the pharynx.

  Still another structural feature of the nasal cavity dilator according to the present invention is that the outer peripheral surface of the tube portion is matte. According to this, there is an effect that the slipperiness of the tube portion with respect to the nasal cavity is improved and that the anesthetic is well retained on the outer peripheral surface of the tube portion. Before inserting the tube part into the nasal cavity, apply an anesthetic to the outer surface of the tube part and follow the insertion of the tube part into the nasal cavity to apply the anesthetic applied to the outer surface of the tube part into the nasal cavity. If the anesthetic is well retained on the outer peripheral surface of the tube part, the tube part is located in the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate. The anesthetic remains sufficiently on the outer peripheral surface of the tube until the stenosis in the nasal cavity is reached, and the anesthetic can be sufficiently applied to the stenosis.

  Still another structural feature of the nasal cavity dilator according to the present invention lies in that the tube portion at the distal end is provided with an anesthetic application hole for communicating the inside and outside of the tube on the peripheral wall. According to this, the anesthetic is applied to the rear end of the tube portion with the rear end located at the rear end (if the tube portion is formed integrally, the last step communicating with the first step tube portion). If the tubes are separated from each other, or if the tubes are separated from each other, the anesthesia is supplied to the inside of the first tube. It is applied through the anesthetic application hole and into the nasal cavity. For example, anesthetic is supplied when the top tube reaches the nasal stenosis, such as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and lower turbinate Then, the anesthetic can be applied intensively to the stenosis. An anesthetic can be reliably applied to a predetermined location in the nasal cavity.

  Still another structural feature of the nasal cavity dilator according to the present invention is that the tube portion of the step whose rear end is located at the rearmost end includes a connector portion for connecting a syringe for anesthetic injection to the rear end portion. There is. According to this, the rear end portion of the tube portion of the step whose rear end is located at the rear end (if the tube portions are all formed integrally, the tube portion of the last step communicating with the tube portion of the first step For example, if the tube part is a separate body, the tip part of the syringe fits into the connector part of the tube part at the top stage), for example. Connected and anesthetic is injected into the tube. Conveniently, the anesthetic can be injected with a syringe.

  The structural feature of the nasal cavity protection tube insertion set according to the present invention is that the nasal cavity expander is inserted into the nasal cavity by being slidably fitted in the axial direction on the outer periphery of the tube portion at the last stage. When the nasal dilator is removed, the nasal insert can be inserted inside the nasal cavity, leaving the distal end continuous with the outer diameter of the last stage tube And a nasal cavity protection tube formed on a curved surface that is expanded in diameter.

  According to this, when the last stage tube part is inserted into the nasal cavity and the expansion of the nasal cavity is completed, the nasal cavity protection tube is then slid with respect to the last stage tube part and inserted into the nasal cavity. . After that, the last stage tube part slides against the nasal protection tube, and all the stage tube parts (nasal dilators) are extracted from the nasal protection tube, that is, from the nasal cavity, and the nasal protection tube is inserted into the nasal cavity. Remains. Then, a nasal insert that is inserted nasally, for example, a nasal endoscope, is inserted into the remaining nasal cavity protection tube. In the nasal protection tube, insertion of a nasal insert, for example, a nasal endoscope, does not cause the nasal cavity and the endoscope to rub against each other. Endoscopic operations (pushing and pulling) performed during observation and diagnosis with a nasal endoscope also do not cause friction between the nasal cavity and the endoscope, thereby reducing the burden.

  Moreover, since the diameter of the distal end portion of the nasal cavity protection tube is continuously increased, smooth insertion is possible when the nasal cavity protection tube is inserted into the nasal cavity. Furthermore, if the insertion length of the nasal cavity protection tube into the nasal cavity is set appropriately, the nasal cavity protection tube can be used as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate. The stenosis in the nasal cavity passes through but can stop before the pharynx. This prevents the nasal protection tube from stimulating the pharynx.

  Another structural feature of the nasal cavity protection tube insertion set according to the present invention is that the nasal cavity protection tube has a flange portion at the rear end. According to this, when the nasal cavity protection tube is inserted into the nasal cavity, the flange portion hits the outer nostril edge to prevent further insertion of the nasal cavity protection tube into the nasal cavity and prevent it from entering the back of the nasal cavity. .

  1st Embodiment of the nasal cavity protection tube insertion set which concerns on this invention is described based on FIGS. 1-3. FIG. 1 and FIG. 2 show a nasal cavity protection tube insertion set 10 including a nasal cavity dilator 11 having flexibility and a nasal cavity protection tube 15. The nasal cavity protection tube insertion set 10 is used before using a nasal endoscope (not shown), and the nasal cavity dilator 11 is inserted into the nasal cavity to expand the nasal cavity. The nasal cavity protection tube 15 is inserted into the nasal cavity following the insertion of the nasal cavity dilator 11 into the nasal cavity in a state of being fitted to the outer periphery of the nasal cavity dilator 11, and after the nasal cavity dilator 11 is extracted, It is used to insert a transnasal endoscope inside.

  The nasal cavity dilator 11 has an outer diameter (diameter) stepwise from the front side (the right side in FIGS. 1 and 2) toward the rear side (the left side in FIGS. 1 and 2) (from the front to the rear). It is composed of three-stage pipe portions 12 to 14 which are integrally formed with a large thickness. The front end (front end) tube portion 12 (the first step tube portion) is formed into a thin tube having a front end surface constituted by a convex closing surface 12a, and the rear end portion is a second step. It is connected to the pipe part 13. The distal end portion of the tube portion 13 is constituted by a diameter-enlarged portion 13a that slightly extends backward from the rear end portion of the tube portion 12 while continuously increasing the outer diameter in a tapered shape. The rear part is composed of a straight part 13b having a constant outer diameter and extending to the rear part.

  The rear end portion of the straight portion 13b is connected to the third-stage tube portion 14 which is the last step. The distal end portion of the pipe portion 14 is constituted by an enlarged diameter portion 14a that slightly extends rearward from the rear end portion of the straight portion 13b while continuously increasing the outer diameter in a tapered shape. The rear side portion is constituted by a straight portion 14b having a constant outer diameter and extending to the rear side. The enlarged diameter portions 13a and 14a are configured by a smooth curved surface with an outer diameter gradually increasing from the front side to the rear side, whereby the outer peripheral surface of the nasal cavity dilator 11 becomes a smooth surface as a whole. ing.

  The outer diameter of the tube portion 12 is 12 Fr (French) (4 mm), the outer diameter of the straight portion 13 b is 16 Fr (≈5.3 mm), and the outer diameter of the straight portion 14 b is 19 Fr (≈6.3 mm). Yes. Fr is a unit used to indicate the thickness of the catheter, and 3Fr = 1 mm. The outer diameter of the straight portion 14b is set to be substantially the same as the outer diameter of the nasal endoscope. In addition, the thickness of the nasal cavity dilator 11 is formed to 0.5 to 2.0 mm over the whole (in addition, 0.5-2. A thin part and a thick part may be formed within a range of 0 mm.) The inner diameter of each part of the nasal cavity expander 11 changes so as to have the thickness of the nasal cavity expander 11 over the entire length.

  As for the axial length of each part constituting the nasal cavity expander 11, the length L1 of the tube portion 12 and the length L2 of the tube portion 13 are each about 90 mm, and the length L3 of the tube portion 14 is It is about 240 mm. The length L5 of the enlarged diameter portion 13a is 20 to 50 mm, and the length L6 of the enlarged diameter portion 14a is 20 to 50 mm. According to this, when the entire length of the tube part 12 is inserted into the nasal cavity, the tube part 12 is connected to the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate. It passes through the stenosis in the nasal cavity. Subsequently, when the tube portion 13 is inserted for the entire length, and when the tube portion 14 is further inserted for about 50 mm (the length indicated by L4 in FIGS. 1 and 2), the distal end of the tube portion 12 extends from the outer nostril. Proceed 230mm and pass the pharynx to reach the esophagus.

  In addition, as a material which comprises the nasal cavity expansion tool 11, polyvinyl chloride (PVC), a polyurethane (PUR), a polyamide-type elastomer, etc. are mentioned. Moreover, the outer peripheral surface of the nasal cavity dilator 11 is formed in the shape of ground glass (satin finish). When the nasal cavity expander 11 is inserted into the nasal cavity, the nasal cavity is rubbed against the outer peripheral surface of the nasal cavity expander 11 accordingly. In order to reduce the pain at this time, it is effective to apply an anesthetic such as lidocaine jelly in the nasal cavity. For this purpose, the outer periphery of the nasal cavity expander 11 is inserted before the nasal cavity expander 11 is inserted into the nasal cavity. It is preferable to apply an anesthetic to the surface. For this reason, the retainability of the anesthetic on the outer peripheral surface of the nasal cavity expander 11 is improved by making the outer peripheral surface of the nasal cavity expander 11 into a satin finish. Moreover, the effect that the slidability with respect to the nasal cavity of the nasal cavity expansion tool 11 improves is also produced.

  A nasal cavity protection tube 15 is fitted on the outer periphery of the tube portion 14. The nasal cavity protection tube 15 is formed of a cylindrical body that is slidable in the axial direction relative to the tube portion 14, and has a diameter-enlarged portion 15a formed at the front end portion and a flange at the rear end portion. A portion 16 is formed. The enlarged diameter portion 15a is a curved surface that is gradually and gradually enlarged from the front side toward the rear side so as to smoothly connect the outer peripheral surface of the body portion of the nasal cavity protection tube 15 and the outer peripheral surface of the tube portion 14. Is formed. When the nasal cavity protection tube 15 is inserted into the nasal cavity, the flange portion 16 prevents further insertion of the nasal cavity protection tube 15 against the hole edge of the outer nostril. As shown in FIG. The nasal cavity protection tube 15 is formed in a shape extending longer to the left and right than to the upper and lower sides when viewed from the axial direction.

  A pair of string holes 16a and 16a for attaching a string are provided in the left and right side portions of the flange part 16, and the flange part 16 can be fixed to a patient using the string attached to the string hole 16a. That is, by fixing the flange portion 16 to the patient in a state where the nasal cavity protection tube 15 is inserted into the nasal cavity, the nasal cavity protection tube 15 is prevented from coming out of the nasal cavity. The outer peripheral surface of the corner portion 16b located at the boundary between the main body portion of the nasal cavity protection tube 15 and the flange portion 16 gradually increases in outer diameter from the main body portion of the nasal cavity protection tube 15 toward the flange portion 16. It is composed of curved surfaces.

  The axial length L7 of the nasal cavity protection tube 15 (the length from the tip to the corner portion 16b, excluding the flange portion 16) is set to about 90 mm, and the inner diameter of the nasal cavity protection tube 15 is It is set to the minimum length within the range that can slide with the portion 14. The wall thickness of the nasal cavity protection tube 15 is set to 0.3 to 1.5 mm. Further, the length L9 in the axial direction of the enlarged diameter portion 15a is 1.0 to 3.0 mm. The inner peripheral surface of the nasal cavity protection tube 15 is provided with a lubrication coat. When the transnasal endoscope is inserted into the nasal cavity protection tube 15, or after the insertion, the endoscope operation (pushing) is performed. The sliding resistance accompanying pulling is reduced.

  Next, the operation of the first embodiment will be described. First, the tube part 12 is inserted into the nasal cavity from the outer nostril. Subsequently, the tube portion 13 and the tube portion 14 are sequentially inserted into the nasal cavity, whereby the nasal cavity is gradually expanded. In this case, it is not necessary to pull out the pipe part 12 when inserting the pipe part 13, and it is not necessary to pull out the pipe parts 12, 13 when inserting the pipe part 14. The nasal cavity can be expanded by one insertion (insertion) and one extraction (extraction). This alleviates the pain and burden on the patient. In addition, when the distal end portions of the tube portion 13 and the tube portion 14 are inserted into the nasal cavity, the diameter-expanded portions 13a and 14a are gradually thickened, so that smooth insertion without causing a step difference is possible.

  Further, since the axial lengths of the tube portions 12, 13, and 14 are set to the above-described lengths, when the tube portion 14 is inserted into the nasal cavity, the distal end of the tube portion 12 is located below the lower turbinate. It reaches the esophagus past the pharynx through a narrowed part in the nasal cavity such as the nasal passage or the middle nasal passage between the middle turbinate and the lower turbinate. For this reason, the irritation | stimulation to a pharynx becomes small and a patient's burden is eased. Furthermore, since the outer peripheral surface of the nasal cavity expander 11 has a satin finish, the retention of the anesthetic on the outer peripheral surface of the nasal cavity expander 11 becomes good. According to this, the anesthetic is applied until the tube parts 12, 13, and 14 reach the constriction in the nasal cavity such as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate. A sufficient amount of anesthetic can be applied to the stenosis portion in the nasal cavity, which remains sufficiently on the outer peripheral surfaces of the tube portions 12, 13, and 14. In addition, since an anesthetic is applied to the outer peripheral surface of the nasal cavity expander 11, the slidability of the nasal cavity expander 11 with respect to the nasal cavity is improved.

  When the tube part 14 is inserted into the nasal cavity and the expansion of the nasal cavity is completed, the nasal cavity protection tube 15 is then slid with respect to the tube part 14 and inserted into the nasal cavity. In this case, the rear end of the nasal cavity expander 11 is positioned rearward from the rear end of the nasal cavity protection tube 15 by an axial length L8 (about 100 mm). In this state, the nasal cavity expander 11 is left in a position relative to the nasal cavity, and the nasal cavity protection tube 15 is pushed and inserted into the nasal cavity. Thereafter, the nasal cavity dilator 11 is removed from the nasal cavity protection tube 15 to leave the nasal cavity protection tube 15 in the nasal cavity. In this case, the nasal cavity protection tube 15 passes through the narrow nasal passage such as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate but does not reach the pharynx. .

  And the flange part 16 is fixed to a patient's nose part with the string attached to the flange part 16 of the nasal cavity protection tube 15. The flange portion 16 prevents the nasal cavity protection tube 15 from entering the nasal cavity. Then, a nasal endoscope is inserted into the nasal cavity protection tube 15 from which the nasal cavity expander 11 has been removed, and a predetermined examination or observation is performed.

  Next, a modification of the first embodiment will be described with reference to FIG. In the nasal cavity expander 11 of the nasal cavity protection tube insertion set 10 of the first embodiment, the tube portion has three stages. However, as shown in FIG. 4, the nasal cavity expander of the nasal cavity protection tube insertion set 20 of this modification example. In 21, the pipe part is made into two steps. The front end pipe part (first stage pipe part) 22 is formed in a thin tube having a front end surface constituted by a convex blocking surface 22a, and the rear end part is connected to the second stage pipe part 23. . The distal end portion of the tube portion 23 is constituted by a diameter-enlarged portion 23a that extends rearward from the rear end portion of the tube portion 22 while gradually increasing the outer diameter in a tapered shape. The portion is composed of a straight portion 23b extending to the rear side with a constant outer diameter.

  The enlarged diameter portion 23a is configured by a smooth curved surface having an outer diameter gradually increasing from the front side to the rear side, whereby the outer peripheral surface of the nasal cavity dilator 21 is further further than the nasal cavity dilator 11 as a whole. It has a smooth surface. The outer diameter of the tube portion 22 is set to 12 Fr (French) (4 mm), and the outer diameter of the straight portion 23 b is set to 19 Fr (≈6.3 mm). In addition, the thickness of the nasal cavity dilator 21 is formed to 0.5 to 2.0 mm over the whole (in addition, 0.5-2. A thin part and a thick part may be formed within a range of 0 mm.) The inner diameter of each part of the nasal cavity dilator 21 changes so as to have the thickness of the nasal cavity dilator 21 over the entire length.

  In addition, regarding the axial length of each part constituting the nasal cavity dilator 21, the length L21 of the tube part 22 and the length L22 of the enlarged diameter part 23a are both set to about 90 mm, and the straight part The length L23 of 23b is set to about 240 mm. The rest of the configuration of the nasal cavity protection tube insertion set 20 is the same as that of the nasal cavity protection tube insertion set 10 described above. Therefore, the same parts are denoted by the same reference numerals and the description thereof is omitted. In this modification, the nasal cavity protection tube 15 is fitted to the straight portion 23b of the second-stage tube portion 23. Moreover, according to the nasal cavity protection tube insertion set 20 of this modification, there can exist the same effect as the nasal cavity protection tube insertion set 10 of 1st Embodiment.

  Next, 2nd Embodiment is described based on FIG. 5 and FIG. As shown in FIG. 5, in the nasal cavity protection tube insertion set 30 according to the present embodiment, the tube portion constituting the nasal cavity dilator 31 includes a tube portion 32 having a small outer diameter and a long axial length, and a tube portion. It is comprised with the pipe part 33 with the short length of the axial direction which became slidable in the outer peripheral surface of 32. The tube portion 32 is formed in a thin tubular shape having a distal end surface constituted by a convex closing surface 32a. The tube portion 33 is formed in a tubular shape having a distal end portion that is configured by a diameter-expanded portion 33a that extends rearward while gradually increasing the outer diameter in a tapered shape from the front end toward the rear side. The rear side portion of the expanded diameter portion 33a in the pipe portion 33 is configured by a straight portion 33b extending to the rear side with a constant outer diameter. The enlarged diameter portion 33a is configured by a smooth curved surface having an outer diameter gradually increasing from the front side to the rear side, whereby the outer peripheral surface of the nasal cavity dilator 31 is a smooth surface as a whole. .

  The outer diameter of the pipe portion 32 is set to 12 Fr (French) (4 mm), and the outer diameter of the pipe portion 33 (outer diameter of the straight portion 33 b) is set to 19 Fr (≈6.3 mm). In addition, each thickness of the pipe part 32 and the pipe part 33 which comprises the nasal cavity expansion tool 31 is formed in 0.5-2.0 mm over the whole (in addition, an enlarged diameter part is other parts). Compared to the outer diameter of the tube portion 32, the tube portion 32 is fitted to the outer periphery of the tube portion 32 in the axial direction. The dimensions are such that they can slide freely. In addition, regarding the axial length of each part constituting the nasal cavity expander 31, the length L31 of the tube part 32 is about 370 mm, the length L32 of the tube part 33 is about 230 mm, and the diameter of the expanded diameter part 33a The length L37 is set to 1.0 to 5.0 mm. The rest of the configuration of the nasal cavity protection tube insertion set 30 is the same as that of the nasal cavity protection tube insertion set 10 described above.

  Next, the operation of the second embodiment will be described. First, as shown in FIG. 5A, the distal end of the tube portion 32 protrudes about 90 mm (length L33) forward in the axial direction from the distal end of the tube portion 33, and the rear end of the tube portion 32 is moved to the tube portion 33. About 50 mm (length L36) is projected rearward in the axial direction from the rear end. Further, the distal end of the tube part 33 protrudes about 90 mm (length L34) axially forward from the distal end of the nasal cavity protection tube 15, and the rear end of the tube part 33 extends rearward in the axial direction from the rear end of the nasal cavity protection tube 15. About 50 mm (length L35, length including the flange portion 16) is projected.

  After the tube portion 32 of the nasal cavity protection tube insertion set 30 in this state is inserted into the nasal cavity, the rear end portion of the tube portion 32 is gripped so that the tube portion 32 does not move in the axial direction with respect to the nasal cavity. The part 33 is slid with respect to the pipe part 32 and inserted into the nasal cavity. As a result, both the tube portion 32 and the tube portion 33 are inserted into the nasal cavity by about 90 mm. That is, when the tube portion 33 is slid axially forward with respect to the tube portion 32 and inserted into the nasal cavity from the state of FIG. 5A, as shown in FIG. A portion protruding in the axial direction (a portion having a length L33) is retracted into the tube portion 33. In a state where the tube portion 33 is inserted into the nasal cavity by about 90 mm (length L34), the rear end of the tube portion 33 is about 50 mm (length L35, flange portion 16) from the rear end of the nasal cavity protection tube 15 in the axial direction. Projecting length).

  In this state, the rear end portion of the tube portion 33 is gripped so that the tube portion 33 does not move in the axial direction with respect to the nasal cavity, and the nasal cavity protection tube 15 is slid axially forward with respect to the tube portion 33. When inserted into the nasal cavity, as shown in FIG. 5 (c), the protruding portion (the portion of length L 34) of the tube portion 33 is retracted into the tube of the nasal cavity protection tube 15. In this way, the expansion of the nasal cavity is completed. According to the nasal cavity protection tube insertion set 30, if the axial length of the tube part is set to an appropriate length, both the tube parts 32 and 33 and the nasal cavity protection tube 15 are located below the lower turbinate. It passes through a narrowed part in the nasal cavity such as the nasal passage or the middle nasal passage between the middle turbinate and the lower turbinate, but stops in front of the pharynx and does not irritate the pharynx.

  When the expansion of the nasal cavity is completed, the tube part 33 together with the tube part 32 is slid axially rearward with respect to the nasal cavity protection tube 15 and is extracted from the nasal cavity protection tube 15. Then, a nasal endoscope is inserted into the nasal cavity protection tube 15 remaining in the nasal cavity, and a predetermined examination is performed. The other operational effects of the nasal cavity protection tube insertion set 30 are the same as the operational effects of the nasal cavity protection tube insertion set 10 of the first embodiment described above.

  In addition, about the 1st-stage pipe parts 12, 22, and 32 with which each embodiment and modification mentioned above are provided, the modification as shown in FIG. 7 is possible. The first-stage tube portion 42 of this modification includes a plurality of small anesthetic application holes 42b that communicate between the inside and the outside of the tube on the peripheral wall. The anesthetic application holes 42b are arranged at regular intervals within a range of 80 mm (axial length L40) from the distal end of the first-stage tube portion 42 to the rear. A connector portion 49 for connecting the syringe 48 is provided at the rear end portion of the first-stage tube portion 42. The connector portion 49 has a cylindrical shape, one end is opened, and the outer periphery of the open one end is fitted to the inner periphery of the rear end portion of the first-stage pipe portion 42. The other end of the connector portion 49 is also opened, and the tip (tip portion) 48a of the syringe 48 can be fitted to the other open end portion, so that the syringe 48 is connected to the connector portion 49. The distal end surface of the tube portion 42 is configured by a convex closing surface 42a, as in the above-described embodiment.

  An anesthetic such as lidocaine jelly is accommodated in the cylinder 48b of the syringe 48, the piston 48c is pushed in, and the anesthetic is injected into the tube from the rear end of the first-stage tube portion 42 and supplied. The medicine can be applied in the nasal cavity by protruding from the medicine application hole 42b. In this case, when the distal end portion of the tube portion 42 reaches a narrow nasal cavity such as the lower nasal passage below the lower turbinate or the middle nasal passage between the middle turbinate and the lower turbinate, the anesthetic agent. Can be applied intensively to the stenosis.

  This modification can be applied to any of the first embodiment, the modification of the first embodiment, and the second embodiment. However, in the second embodiment, the first-stage tube portion is provided with an anesthetic coating hole and the connector portion is provided at the rear end of the first-stage tube portion. An anesthetic application hole is provided in the stage tube portion, and a connector portion is provided in the rear end portion of the third stage tube portion. Moreover, in the modification of 1st Embodiment, the hole for anesthetics is provided in the 1st-stage pipe part, and the connector part is provided in the rear-end part of the 2nd-stage pipe part.

  In addition, this invention is not restricted to said embodiment and modification, Various things are possible. The number of stages of the pipe portion is not limited to two stages and three stages, and the number of stages exceeding that is possible. The axial length and outer diameter are not limited to the above values. Further, the outer diameter of the tube portion is continuously increased in a tapered shape, and the outer peripheral surface of the body portion of the nasal cavity protection tube and the outer peripheral surface of the tube portion of the nasal cavity protection tube are expanded. The diameter-expanded portion is a straight line with an outline that is inclined with respect to the axial direction when viewed from the direction orthogonal to the axial direction, or a curve such as an arc, or a combination thereof. It is sufficient if the diameter is continuously expanded. Moreover, although the front-end | tip part of a syringe is fitted as a connector part in the modification of 2nd Embodiment and the syringe is connected, it is not limited to it. For example, it is possible to connect the syringe by closing the other end of the connector portion with a slitted rubber stopper and fitting the tip of the syringe to the slit portion of the slitted rubber stopper. If the tip of the syringe is removed from the slit portion of the rubber stopper with slit, the slit portion is elastically restored and closed.

  In the above-described embodiments and modifications, the nasal cavity dilator and the nasal cavity protection tube insertion set used in the use of the nasal endoscope have been described. However, the nasal endoscope (catheter) is not limited to the nasal endoscope. The present invention is applicable to any nasal insert that is inserted nasally. Furthermore, in the embodiment and the modified example, the distal end surface of the first-stage tube portion is configured by a convex occlusion surface 12a, and the convex surface is hemispherical, and the distal end portion of the nasal cavity dilator extends into the nasal cavity. Although insertion is extremely easy, the tip surface may not be hemispherical or convex. For example, the front end surface of the first-stage pipe portion may be a flat surface, and the peripheral edge of the flat surface may be edged in an arc shape between the peripheral surface of the first-stage pipe portion. The distal end surface of the first-stage pipe portion may be a closed surface.

It is a front view of the nasal cavity protection tube insertion set concerning a 1st embodiment of the present invention. It is the enlarged front view which abbreviate | omitted a part of FIG. It is a perspective view of the nasal cavity protection tube of the nasal cavity protection tube insertion set which concerns on 1st Embodiment of this invention. It is a front view of the modification of the nasal cavity protection tube insertion set which concerns on 1st Embodiment. It is a front view of the nasal cavity protection tube insertion set which concerns on 2nd Embodiment, (a) shows the initial state before insertion in the nasal cavity of a nasal cavity expansion tool, (b) is insertion of the large diameter step pipe part. The state (c) shows the insertion state of the nasal cavity protection tube. It is the enlarged front view which abbreviate | omitted a part of Fig.5 (a). It is a front view which shows the modification about a 1st-stage pipe part.

Explanation of symbols

10, 20, 30 ... Nasal cavity protection tube insertion set, 11, 21, 31 ... Nasal dilator, 12, 22, 32 ... First stage tube part, 12a, 22a, 32a, 42a ... Tip surface, 13, 23, 33: Second-stage tube portion, 13a, 14a, 23a, 33a ... Expanded portion, 13b, 14b, 23b, 33b ... Straight portion, 14 ... Third-stage tube portion, 15 ... Nasal cavity protective tube, 16 ... Flange Part, 42b ... hole for anesthetic application, 48 ... syringe, 49 ... connector part, 15a ... diameter enlarged portion of nasal cavity protection tube.

Claims (8)

Nasal dilation consisting of a multi-stage tube with flexibility to expand the nasal cavity by being inserted into the nasal cavity sequentially from the distal end in the axial direction. Tools,
The plurality of stages of pipe parts are formed so that the outer diameter gradually increases from the pipe part located on the front end side toward the pipe part located on the rear side, and a boundary portion of the plurality of stages of pipe parts is formed. A nasal cavity expansion characterized in that it is formed into a curved surface that continuously increases in diameter as it goes from a tube portion side with a small outer diameter to a tube portion side with a large outer diameter, and the distal end surface of the distal tube portion is a closed surface Ingredients.   The nasal cavity dilator according to claim 1, wherein the plurality of stages of tube portions are integrally formed.   Each of the plurality of stages of pipes is constituted by a separate pipe part in which the length of the pipe part having a smaller outer diameter is made longer than the length of the pipe part having a larger outer diameter. Assembling so that adjacent pipe parts are slidably fitted in the axial direction, the pipe parts with a large outer diameter can be moved sequentially from the rear side to the front end side of the outer circumference of the pipe part with a small outer diameter. The nasal cavity dilator according to claim 1.   The nasal cavity dilator according to any one of claims 1 to 3, wherein an outer peripheral surface of the tube portion is a satin finish.   The nasal cavity dilator according to any one of claims 1 to 4, wherein the tube portion at the distal end includes a hole for anesthetic application that communicates the inside and outside of the tube with a peripheral wall.   6. The nasal cavity dilator according to claim 5, wherein the tube portion of the step whose rear end is located at the rear end includes a connector portion for connecting a syringe for injecting anesthetic to the rear end portion.   The nasal cavity dilator according to any one of claims 1 to 6, and the nasal cavity is inserted into the nasal cavity by being slidably fitted in an axial direction on the outer periphery of the tube portion at the last stage. When the dilator is removed, the nasal insert can be inserted into the nasal cavity, and the distal end is continuous with the outer diameter of the tube portion of the last stage. A nasal cavity protection tube insertion set comprising a nasal cavity protection tube formed on a curved surface that is expanded in diameter.   The nasal cavity protection tube insertion set according to claim 7, wherein the nasal cavity protection tube includes a flange portion at a rear end portion.

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