US 3884241 A
For treating severe epistaxis a substantially hemispherical-shaped pack of foam rubber is disposed posteriorly of the soft palate and maintained in place by a pair of sutures secured to the pack and tied together at their other ends anterior the nasal septum.
Description (OCR text may contain errors)
United States Patent [1 1 Walker [451 May 2a, 1975 POSTERIOR PACK AND METHOD FOR TREATING SEVERE EPISTAXIS  Inventor: Adrienne A. Walker, 6412 Nicklas Ave., Oklahoma City, Okla. 73132  Filed: June 24, 1974  Appl. No.: 482,723
 US. Cl. 128/325  Int. Cl ..A61b 17/12  Field of Search 128/270, 296, 325, 303.1
 References Cited UNITED STATES PATENTS 1,732,697 10/1929 Ryan 128/270 2,141,026 12/1938 Valle 128/270 X FOREIGN PATENTS OR APPLICATIONS 1,289,464 2/1962 France Primary Examiner-Lawrence W. Trapp Attorney, Agent, or Firm-Robert K. Rhea  ABSTRACT For treating severe epistaxis a substantially hemispherical-shaped pack of foam rubber is disposed posteriorly of the soft palate and maintained in place by a pair of sutures secured to the pack and tied together at their other ends anterior the nasal septum.
4 Claims, 4 Drawing Figures POSTERIOR PACK AND METHOD FOR TREATING SEVERE EPISTAXIS BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an article and method for treatment of severe epistaxis.
If a nasal bleeding point is located posterior and cannot be directly visualized, a posterior pack is required.
2. Description of the Prior Art Articles for treating epistaxis as disclosed by prior patents have generally comprised inflatable tubes or spongelike members which are inserted into the nasal cavity to bear against the bleeding point or area. The usual practice is to pack the nasal cavity with gauze, however, this method of treating epistaxis has the disadvantage, particularly when the bleeding point or area is posterior, of the packing material prolapsing into the pharynx.
This invention provides a posterior pack and method for its placement posteriorly of the soft palate for occluding the choanae so that the nasal cavity can be packed tightly without prolapse of the packing into the pharynx.
SUMMARY OF THE INVENTION A section of latex foam rubber is cut to define a sub stantially hemispherical-shape with a section of fabric forming a base bonded across the diametric surface of the hemispherical shape. A pair of elongated silk sutures are passed coaxially through the base in close spaced juxtaposed relation and tied together at the surface of the base and hemispherical shape, respectively. The pack is then disposed posteriorly of the soft palate with the base surface facing downwardly and is held in place by one end portion of the pair of sutures extended through the nares and tied together anterior the nasal septum.
The principal object of this invention is to provide a posterior pack and method for the treatment of severe epistaxis which eliminates the deficiencies and disadvantages of conventional posterior packing.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of the pack;
FIG. 2 is a vertical cross sectional view taken substantially along the line 22 of FIG. 1;
FIG. 3 is a view in vertical cross section through a fragment of a human head illustrating the pack in operative position; and,
FIG. 4 is a frontal view, to a different scale, pictorially illustrating the sutures when tied together over a gauze pad anterior the nasal septum.
DESCRIPTION OF THE PREFERRED EMBODIMENT Like characters of reference designate like parts in those figures of the drawings in which they occur.
In the drawings:
The reference numeral 10 indicates the pack which is substantially hemispherical in shape defining an armate surface 12 and a planar diametric surface 14. The pack 10 is preferably formed by cutting a section of latex foam rubber to define the hemispherical-shape. A section of fabric, for example adhesive tape, overlies and is bonded to the diametric surface 14 to form a base 16 for the pack. Diametrically the pack is sized in accordance with the patient to be treated. I have found that sizes ranging from 1% inches to 1% inches in diameter are satisfactory. The axial length L of the pack is preferably one-half to two-thirds its diameter D. A pair of sutures, preferably of silk to avoid decomposition and size 0 to 3, are longitudinally extended coaxially through the base 16 and hemispheric shape 12 in closely spaced juxtaposed relation and knotted together adjacent the respective surface to prevent movement of the pack relative to the sutures and to form a pair of longer end portions 18 and 20 extending beyond the surface 12 and a pair of shorter end portions 22 and 24 extending beyond the base 16. A preferred length of the longer end portions 18 and 20 is approximately 14 inches while the shorter end portions 22 and 24 are approximately 8 inches for the purposes presently apparent.
The method of placement of the pack is as follows:
The mucous membranes of the nose, nasopharynx and pharynx are anesthetized with topical tetracaine or alternatively the patient is usually given sedation to aleviate discomfort. A small rubber catheter is inserted through the nose into the pharynx. The catheter is grasped with bayonet forceps and brought out through the mouth. The longer end portions 18 and of the sutures are tied to the end of the catheter projecting through the mouth. The pack 10 is then pulled into place by removing the catheter from the nose while simultaneously guiding the pack 10 posterior to the soft palate with the index finger. During this operation care must be exercised to avoid laceration of the soft palate with the suture. The pack is positioned to occlude the choanae and its selected size is such that it does not interfere with the patients respiration or swallowing.
The nasal cavity is then sufficiently filled with packing to produce firm pressure throughout the posterior nasal cavity to avoid leaving space for blood clots to form. A relatively small gauze pad 26 is then placed anterior the nasal septum and the suture end portions 18 and 20 tied together over the pad 26 to maintain the position of the pack 10. The shorter ends 22 and 24 of the sutures are cut off approximately two centimeters below the soft palate to serve as a means for removal of the pack 10.
Obviously the invention is susceptible to changes or alterations without defeating its practicability, therefore, I do not wish to be confined to the preferred embodiment shown in the drawings and described herein.
1. A posterior pack for treatment of severe epistaxis, comprising:
a resilient body adapted to occlude the choanae of ametrically through said body and said base.
4. The posterior pack according to claim 3 in which said body is formed from foam rubber and said pair of sutures comprise silk strands.
l =i l =0: