US 2215126 A
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Description (OCR text may contain errors)
Sept. 17, 1940. J. H. McMlLLxN 2,215,126
NASAL PACK Filed Jan. 12, 1959 2 sheets-sheet 1 f5 S w? f4 M if i if y 26 Ms W' l Y l l1. @ha if F2126 E gf? ,2a
:inventor sept- 17, 1940-4 J. H. McMiLLlN NASAL PACK Suventor ./7/2 Z/v.
(Ittornegs Patented Sept. 17, 1940 UNITED sTATEs PATENT osricE 15 Claims.
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 lay-ers 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 aiect 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 lled with blood clots which later crust and whenl removed lead to more bleeding.
The packing material most commonly used is vaselined gauze. This gauze is laid into the nasal cavity as fingers oi 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 (Cl. 12S- 148) parent from the following description taken in connection with the accompanying drawings in which- Figure 1 is a fragmentary front View of a human face showing my improved pack and how 5` 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; 10
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 15 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 shownin section taken along 20 the line Ill-IIJ of Fig. 9, and
Fig. 11 is a view in section of certain structural details of the device of Figs.l 9 and 10;
Fig. 12 is a' View similar to Fig. 2, but including a breathing tube. 25
Referring to the drawings by characters of rei erence, Figs.. 1 and 2 show in part a human head to illustrate the nasalpassages Ill, between which is the septum membrane I I and to illustrate further how the nasal passages are packed by'my 30 packing device, designated in general by the nu meral I2. The pack device I2 includes a supporting member yI3 in the form of a hollow body or casing having an air chamber It which is formed in part by the casing front and rear walls 35 I5 and I6 respectively. Projecting into the chamber I4, through the casing rear wall I6, ay pair of spaced tubular members Il, in the form of cannular or hollow pins', are provided having longitudinally extending bores I8 opening into 40 the chamber I4. On their inner ends, within the chamber I4, the tubular members I'I are preferably provided with heads I9 to limit outward movement of the members I'I and between the heads I9 and the casing front wall I5 a spring 45 bular members I1. 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 2li. 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 l1 which also extend through apertures in the caps 24. The bores 2li-a may be of less diameter than the diameter of the tubular members l? 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 il. 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 2li and the outer wall surfaces of the bag necks to insure an air tight seal between these surfaces.
The body or casing I3 may be attached to and between the ends of a strip or band of material 2l, which may be sheet rubber and the opposite ends of the rubber strip 21 may be attached to a patients face by adhesive strips (not shown) or by other suitable means. The casing I3 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 havingits ends closed and sealed by metallic clamps 28, one of which is shown in blank form in Fig.k 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 3i? which is bent over the end of the tube, ears 3l which are bent to extend longitudinally of the tube and anotherear or flange 32 which pierces the supporting band 2'1 and is bent back thereagainst. These clamps 28 close and seal the ends of the rubber tube casing I3 and also secure the casing to its supporting band 2l.
Secured in and to the casing front wall l5, an air check valve 33 is provided having a body 34 which has an air passage 34a therethrough, opening into the air pressure chamber lil. The casing wall l5 is provided with an aperture 35 therethrough to receive the valve body 34 which may have an externalannular recess or groove 33 into which the wall around the opening 35 may tightly nt and the joint therebetween be sealed by any suitable sealing material. The valve body 313 projects slightly into the air pressure chamber i4 and its inner end is recessed, as at 36, to receive and 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 3Q, the other or free end, as at 33, of the spring overlying and retaining the valve member 31 in its recess 36. 'xIhe valve member 3l, overlying the inner end of the air passage 35i-a, is adapted to check back flow of air through the passage 36a from the air pressure chamber Ml, 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 l@ and the device attached in placeto the patient by means of the rubber sheet strip 2l which may be held to the patients 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 l5 inflating the bags, which, since they have or communicate with a common pressure chamber Ml will be equally inilated. The
bags 22 will, when inflated to the proper degree,
conform to the irregularly shaped surfaces of the nasal cavities lil 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 septumY membrane l l 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. W'hen it is thought that the inatable bags 22 may be removed from the nasal cavities, a suitable instrument (not shown) may be inserted in the valve passage 33a', and lift the valve 3l from its seat to permit a little of the air to escape from the chamber lll to deflate the bags 22 slightly. After slightly deflating the bags 22, if for any reason, bleeding should occur, the bags may again be iniiated 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 2B while serving to limit movement of the tubular connecting members l'l relative to the body i3 also serves to give shape to the rubber body. That is, the strip 2d may be bent or bowed to retain such form to the body i3 that the body will lit or conform to the contour of the portion of the patients face to which the device is attached.
From the foregoing description it will now be appreciated that Iv have provided new and improved nasal packs of .a character such that equal pressures will be had on opposite sides of the septum membraneand against the irregular surfaces ofthenasal 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. ln 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, l0 and 11, this device includes a supporting member or body 4l) which is prefer- 5 ably cast of a suitable light Weight plastic material and may be provided with rearwardly directed extended portions or wings il shaped to lit a patients face or cheeks to aid in holding the Opening through the rear wall centrally of the inatable fittings 42, a threaded bore receives a tting 46 of an air check valve, the fitting 46 having a head 4T 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 is provided in the valve fitting 46 and extending longitudinally and centrally thereoi:` 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 ralthough 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 Ell by a passage or bore 55 which extends transversely through the portion of the valve tting, 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 inatables 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 inatables when inflated will close the nasal passages of a patient, requiring the patient to breathe through-the y 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 iniiatables in each of the patients 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 bythe breather tubes. In the body 4Q, spaced threaded bores 59, Fig. ll, receive a pair of open ended tubular iittings t@ 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. 'Io prevent the breather tubes from being collapsed by the inflatables 43, light helical coil springs 6i are,S 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 (i2A may be provided in the breather tubes 58 to permit breathing action and the breather tubes may be sumciently longer than the inflatables to ,insure against occulsion of apertures 6g 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, va supporting member having a passage therethrough for air, a check valve supported on said member and having an air passageA opening into said member, said member having a pair of spaced apart tubular members projecting externally of said member, and apair 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 iniiatable 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,l 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 '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 andextending 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 iitting 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 tting within said chamber and normally acting to close said passage, and a pair of inflatable members communicating with said chamber, said tting 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 iiow through said chamber, a pair of iniiatable 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 inatables 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.
1l. 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 innatables. l
12. In an intra nasal pack, a supporting member having an air chamber, a check valve controlling flow through said chamber, a pair of inilatables 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 pre- 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 inated, 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.
le. In a nasal pack, a valve body having a chamber provided with a port, a pair of inatable members for positioning respectively in the nasal cavities of a patient and communicating with said chamber, valve means controlling said port for releasably retainingair underv pressure in said members, and a pair of IieXib-le breathin g tubes connected to said'valve body and juxtaposed respectively with said members for positioning therewith respectively in the nasal cavities so that the patientv 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.