US 3420237 A
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J 7, 1969 s. o. FORITAY 3,420,231
PROCESS AND ARTICLE FOR THE TREATMENT OF SEVERE EPISTAXIS Filed Sept. 2, 1966 i 5 l f INVENTOR STEVEN A. FORTAY ATTORNEYS United States Patent Ofiflce 3,420,237 Patented Jan. 7, 1969 3,420,237 PROCESS AND ARTICLE FOR THE TREATMENT OF SEVERE EPISTAXIS Steven 0. Fortay, Woodbridge, N.J.; Martha K. Fortay,
executrix of the estate of said Steven 0. Fortay, (leceased; assignor to Martha K. Fortay (widow of Steven 0. Fortay), Woodbridge Township, NJ.
Filed Sept. 2, 1966, Ser. No. 576,944
U.S. Cl. 128325 Int. Cl. A61h 17/12 The present invention relates to a novel article and process for the treatment of severe nosebleed, i.e., severe epistaxis, and, more particularly, to a method and article for treating such severe epistaxis which employs a thin tape of rubberized material surrounded by a sleeve of gauze.
More than a century ago, a method of treating severe nosebleed by posterior packing was introduced. This method of packing the posterior chamber of the nasal passage has many shortcomings, however. First of all, it is a quite involved and delicate process to manipulate the medical packing material into the posterior chamber of the nasal passages in order to adequately pack this posterior region to supply adequate pressure so as to relieve and eliminate the problem of a severe nosebleed. Furthermore, the packing of the posterior chamber of the nasal passage is fraught with the disadvantage that the packing material easily slips from its intended area, blocking the larynx and throat opening of the patient.
In addition, postnasal packs are often applied improperly. When so applied, they may cause edema and pain, or their effects may be even more serious, such as osteomyelitis of the base of the sphenoid, ear infection, and so much edema that tracheostomy is necessary. Other complications include hemotympanurn, with or without otitis media, and lacerations of the soft palate and floor of the nose.
Although there have been various attempts made and ideas suggested for a method to employ as a quick and practical alternative to conventional posterior packing none of these have been satisfactorily adapted for the treatment of severe epistaxis. Such concepts involve both physical and chemical approaches to this problem. Such alternative procedures usually involve the employment of complicated equipment and/ or processes in which a great deal of assistance is necessary to treat the severe nosebleed. Note U.S. Patent 2,647,515. Thus, until the present invention, there has not been provided a simple and practical alternative to the treatment of severe nosebleed by posterior packing. By the present invention, however, it has now been found possible to treat a severe epistaxis in a simple and practical manner without the use of complicated devices and without the necessity for assistants. It has now been found possible to treat severe nosebleed by the use of a thin tape of rubberized material having a sleeve of gauze-like material surrounding such tape, which tape and surrounding sleeve form a firm wall across the posterior chamber of the nasal passage.
This is accomplished by drawing such tape and surrounding armored sleeve through the nasal passages by the use of a conventional nasal catheter.
It is, therefore, a principal object of the present invention to provide an article for the treatment of severe nosebleed which is free from the inherent deficiencies of previously-employed materials and techniques.
A further object of the present invention is to provide a process for the treatment of severe epistaxis which is easily and practically performed, and which eliminates the inherent deficiencies and disadvantages of prior known proceses, especially conventional posterior packing.
A still further object of the present invention is to provide an article which comprises a thin, flexible tape of Claims rubberized material surrounded by a sleeve of gamelike material, which article can be employed to easily and practically treat severe epistaxis by the process of the present invention.
A yet further object of the present invention is to provide such a process for the treatment of severe epistaxis wherein a thin, flexible, rubberized tape surrounded by a sleeve of gauze-like material is drawn through the nasal passages to form a firm wall across the posterior chamber and to provide packing of the nasal passages.
Still further objects and advantages of the process and article of the present invention will become more apparent from the following more detailed description of the present invention and the accompanying drawing, wherem:
FIGURE 1 is a view in elevation showing the tape of the present invention.
FIGU-R-ES 2 to 7 are frontal views pictorially showing various stages of the process of the present invention.
In the various figures, like numerals represent like elements.
As can be seen from FIGURE 1, the armored tape of the present invention, which is employed in the treatment of severe epistaxis, comprises, in combination, two parts. The inner portion or tape 2 comprises a thin, flexible, rubberized material. This can be either a natural or a synthetic rubber, or a flexible plastic material (i.e., polyethylene, etc.), or a fabric matrix which is impregnated with a natural or synthetic rubber or plastic. The only essential characteristic of such material is that it be sufficiently flexible so as to be able to conform itself to the contour of the nasal passage and have suflicient density so as to form a firm Wall across the posterior chamber of the nasal passages so as to prevent the how of blood.
Ordinarily, the rubberized tape 2 is in the order of one-half inch to one inch in width, although narrower or wider strips can be advantageously employed where desired, or necessary for particular patients, or appropriate medical situations.
Surrounding the tape 2 of the article of the present invention, is a sleeve 4 of gauze-like material. Such gauzelike material of the sleeve 4 surrounding the tape 2 can be any conventionally-employed gauze-like material used for medical purposes. Exemplary are the cotton and gauze materials. This gauze-like material should be soft and non-irritating to the walls of the nasal passages.
In addition to allowing the tape 2 to form a more firm wall across the posterior chamber of the nasal passages, the sleeve 4 of gauze-like material additionally can act as a carrier for a hemostatic medicament, etc. Therefore, the gauze-like sleeve 4 may be impregnated or coated with a suitable antibiotic ointment, hemostatic medicament, astringent, etc. Exemplary materials include commercial preparations of penicillin, streptomycin, aureomycin, terramycin, thrombin, fibrinogen, epinephrine, etc.
FIGURE 2 shows the insertion of the tape and sleeve of the present invention in the nasal passages. Thus, a conventional nasal catheter 6 is utilized to draw the rubberized tape-gauze-like sleeve assemblage through the mouth and down through the nostrils of the patient, the catheter having been inserted through the nostrils of the patient.
The treatment is started by first cleaning the nose of the patient and applying an aneestetic, if necessary. A rubber or plastic catheter 6 with a slit near its tip is passed through the nasal chamber and grasped as it appears in the pharynx. The rubberized tape and surrounding sleeve is now inserted and passed through the slit in the catheter.
3 This point in the process of the present inevntion is shown in FIGURE 2.
The catheter is then pulled back through the nasal passage leaving the tape and surrounding sleeve in place extending about eight inches from the nostril. The rubber or plastic catheter 6 is then inserted through the second notril in a similar manner. The other end of the tape and surrounding sleeve is thereafter inserted into the catheter as shown in FIGURE 3, and the catheter is again pulled back through the nasal passage with the attached tape and surrounding sleeve. The tape and surrounding sleeve, when removed from the catheter, now has an end extending from each nostril of the patient. This position is represented in FIGURE 4. At this point, the tape and surrounding sleeve form a firm wall across the posterior chamber of the nasal passages.
Advantageously, the two ends of the tape and surrounding sleeve which extend from the nostrils of the patient are now anchored with forceps 8, as illustrated in FIG- URES 5 and 6. The packing of the nostrils of the patient may then proceed by pushing back the gauze from the tape little by little i.e., in increments, as shown in FIG- URE 6 by use of a conventional packing instrument 10.
Optionally, after packing of the nasal passages by use of the sleeve of gauze-like material, additional packing material may be utilized. Such additional packing can comprise any suitable medical packing material conventionally used for packing of wounds. In most instances, however, the gauze-like sleeve acts as sufiicient packing material.
It is of note that because of the firm wall formed across the posterior chamber of the nasal passages by the tape and surrounding sleeve of the present invention, there is no fear of the packing material being inserted too far into the nasal cavity to cause blockage of the throat area.
Also, ease of removal of additional packing material is a distinct advantage of the process of the present invention since the tape and gauze-like sleeve acts as a barrier to the insertion of additional packing material to such a point at which its removal can no longer be accomplished with case. When both chambers are packaged, a gauze pad may be advantageously inserted in place in front of the nasal septum to act as a base for the subsequent tying of the ends of the tape and surrounding sleeve.
The ends of the tape and surrounding sleeve are tied across the pad in front of the nasal septum. At this point, the treatment is completed. This last step, or position, is shown in FIGURE 7.
As stated previously, the employment of the sleeve of gauze material surrounding the rubberized tape, serves a dual function-that of allowing the production of a more firm wall across the posterior chamber of the nasal passages, and that of simultaneously supplying antibiotic, hemostatic medicament, or astringent, to the treatment area.
It has been unexpectedly found that the use of a gauze sleeve in conjunction with the rubberized tape produces results far superior to those that could be achieved by the use of a rubberize dtape alone. In this connection, it has been found that the use of a rubberized tape alone in many instances does not satisfactorily form a firm wall across the posterior chamber of the nasal passages in that such material tends to slip and move from its intended point. In addition, employment of the gauze-like sleeve eliminates any possibility of irritation to the nasal passages which can be encountered by the use of a rubberized tape by itself.
While the present invention has beenprimarily described with respect to the treatment of severe epistaxis, that is, a severe nosebleed, it should be understood that this invention can be advantageously employed whenever nasal packing is required. Thus, the process and article of the present invention, with their accompanying advantages, can be utilized in packing of the nasal passages in case of nasal fractures, etc.
While a preferred embodiment of the present invention has been illustrated, it is to be understood that the present invention is in no way to be deemed as limited thereto, but should be construed as broadly as all equivalents thereof.
1. An article for the treatment of severe epistaxis which comprises a flexible thin tape of rubberized material surrounded by a sleeve of gauze-like material.
2. The article of claim 1 wherein said sleeve of gauzelike material is coated or impregnated with antibiotic ointment or a hemostatic medicament.
3. The article of claim 1 wherein said rubberized material is selected from natural and synthetic rubbers, plastics, and cloth matrices impregnated with such materials.
4. A method of treating severe epistaxis which comprises (1) inserting a flexible thin tape of rubberized material surrounded by a sleeve of gauze-like material through the nasal passages by means of a nasal catheter, said tape and sleeve, after insertion, having an end thereof extending from each nostril, said tape and surrounding sleeve forming a firm wall across the posterior chamber of the nasal passages, (2) packing the nostrils by feeding in gauze in increments, and (3) closing off the nostrils by means of the ends of said tape and surrounding sleeve extending therefrom.
5. The method of claim 4 wherein a pad of gauze-like material is placed in front of the nasal septum as a base prior to scaling off the nostrils by the ends of the tape and surrounding sleeve extending therefrom.
6. The method of claim 4 wherein the sleeve of gauzelike material is coated or impregnated with an antibiotic ointment or hemostatic medicament.
7. The method of claim 4 wherein the rubberized material is selected from natural and synthetic rubber, plastics, and cloth matrices impregnated with such materials.
8. The method of claim 4 wherein the ends of the tape and surrounding sleeve are held with forceps to create an anchor after insertion of the tape and sleeve and prior to packing to facilitate packing of the nasal passages and to create a firm wall across the posterior chamber of the nasal passages.
9. The method of claim 8 wherein the sleeve of gauzelike material is coated or impregnated with an antibiotic ointment or hemostatic medicament.
10. The method of claim 8 wherein the rubberized material is selected from natural and synthetic rubber, plastics, and cloth matrices impregnated with such materials.
References Cited UNITED STATES PATENTS 2,007,503 7/1935 Riordan 128-296 2,154,968 4/1939 Alkio 128348 2,524,195 10/1950 Hoover 128325 2,647,515 8/1953 Pollock et al. 128-325 2,847,997 8/1958 Tibone 128325 3,049,125 8/1962 Kriwkowitsch 128325 CHARLES F. ROSENBAUM, Primary Examiner.