Device for facilitating laryngoscopies with dental protection and fulcrum for leveraging

Abstract

The present invention relates to a device made of silicone or another polymer material that preferably covers the teeth from tooth number 7 to tooth number 16 on the left part of the patient's upper dentition. The protector includes a metal reinforcement or wire on the lower part on which the blade of a laryngoscope can rest and a lever action can be applied to lift the base of the tongue and thus safely expose the patient's glottis without affecting the dentition. The length of the wire is covered by the silicone or polymer material, and each end of the protector has a clamp-shaped reinforcing plate that prevents the protector from moving while the laryngoscopy is being performed. The wire and the reinforcing plates serve to distribute the load exerted during the laryngoscopy procedure, keep the blade away from the dentition and allow safe leveraging. The wire also serves to change the shape of the protector and adapt it to the dental morphology of each patient. This protector does not require sterilisation, only disinfection, and it can be reused.

Description

[0001] DEVICE TO FACILITATE LARYNGOSCOPIES WITH DENTAL PROTECTION AND THAT'S IT

[0002] SUPPORT FOR LEVERAGE

[0003] TECHNICAL FIELD

[0004] The present invention relates to the field of laryngoscopy and intubation procedures, particularly to devices for facilitating laryngoscopy procedures. It provides a dental protector made of silicone or another polymeric material that preferably covers teeth 7 through 16 on the left side of the patient's upper dentition. This protector includes a metal reinforcement or wire at its lower end, upon which the blade of a laryngoscope can rest. This reinforcement allows for leverage to elevate the base of the tongue, thereby safely exposing the patient's glottis without damaging the teeth. The wire is entirely covered with silicone or the polymeric material. At each end of the protector, there is a clamp-shaped reinforcing plate that prevents displacement of the protector during the laryngoscopy.The wire and reinforcing plates serve to dissipate the force exerted during the laryngoscopy procedure, keeping the mouthpiece away from the teeth and allowing for safe leverage. The wire also allows the shield to be reshaped to fit each patient's dental anatomy. This shield does not require sterilization, only disinfection, and can be reused.

[0005] BACKGROUND OF THE INVENTION

[0006] Laryngoscopy is a procedure in which the patient is first given medication that induces a state of unconsciousness, during which they feel no pain or discomfort, and a state of apnea (the inability to breathe due to neuromuscular blockade). This aims to achieve complete relaxation of all the body's muscles, including the diaphragm, which is responsible for breathing. Once the medication has taken effect, a device called a laryngoscope is inserted through the right side of the oral cavity (Figure 1). The laryngoscope consists of a handle and a blade. The handle should always be held in the left hand. The blade is attached to the handle and is inserted into the oral cavity through the right side, attempting to displace the tongue to the left.The valve's purpose is to facilitate visualization of the glottis, since the orotracheal tube, which is responsible for the passage of oxygen to the lungs, passes through it.

[0007] Historically, it is absolutely contraindicated to use the laryngoscope handle as a lever, since the blade would rest against the upper teeth, causing significant and sometimes irreparable aesthetic damage. It is not uncommon to encounter difficulty in visualizing the glottis, which often represents an emergency, as the patient, due to the effects of the medications administered for the procedure, is unable to breathe spontaneously. In emergency situations where the patient needs to be intubated, the urgency and delay in exposing the glottis is critical. The longer the glottis remains unvisualized, the greater the risk of cardiac arrest and death, or irreversible brain damage due to lack of oxygen.

[0008] Thus, the prior art includes several disclosures related to dental protection devices, such as document US20070197876A1, which describes a device useful for preventing dental damage that occurs with common laryngoscopes and other airway intubation systems. The device comprises an upper mouth guard for the maxillary teeth attached to blocks or wedges to hold the jaw open. Optionally, a light, such as an LED, can be incorporated into one of the blocks to facilitate the intubation procedure. The invention is placed in the subject's mouth, and intubation can then be performed safely using a laryngoscope.Once intubation is complete and the laryngoscope has been removed, the dental shield of this invention can be retained in the patient's jaw as a bite retractor, removed, or replaced with another type of bite retractor. However, the invention defined herein has the disadvantage that it does not include a dental shield for leverage to visualize the glottis, nor does it include a metal wire reinforcement to prevent damage to the patient's teeth by dissipating pressure from the blade on the wire and shield, nor does it include compressive metal plates at each end to prevent displacement during laryngoscopy. Furthermore, the device does not obstruct the laryngoscopy view, as it only occupies the left side of the teeth and oral cavity.Furthermore, it does not feature a universally applicable device that can be molded to each patient's anatomy, as the wire structure allows it to conform to the shape of each dentition. Additionally, the blocks or wedges included with the US20070197876A1 device are unnecessary, since the goal is to perform a laryngoscopy and intubation procedure quickly and safely without affecting the dentition. Finally, the patients on whom this device is used are those who have been sedated with neuromuscular blocking agents and therefore will not be able to bite or protest with the endotracheal tube.

[0009] On the other hand, there is also document US5033480A, which provides an adjustable dental guard over a patient's upper incisors. It consists of an arched plastic tray approximately 1.5 inches long with a U-shaped cross-section. A conformal hydrogel elastomeric adhesive plug is located inside the U-shaped tray, adhering itself to the channel of the U-shaped tray, so that when pressed into place over the patient's incisors, the teeth remain embedded in the plug and the dental guard remains adhered in position over the incisors, leaving the posterior teeth (molars, including premolars) on each side uncovered.The use of this dental protector shields the incisors from the leverage forces exerted by the laryngoscope blade during intubation and provides the intubator with a clear view to easily guide an endotracheal tube through the pharynx, vocal cords, and into the trachea. However, the invention defined herein has the disadvantage of not including a superior dental protector made of rubber or plastic, which incorporates a structural reinforcement of high-strength metal or rigid polymer material located at the front, allowing leverage with the laryngoscope blade, where the device can cover all or part of the patient's dental arch.

[0010] In the prior art, there is also document US20220134036A1, which describes systems, designs, and methods for a bite retractor and for the use of a bite retractor or surgical mouthguard. The bite retractor can accommodate various tubes used during intubation. The bite retractor also provides a passage that allows the patient to be intubated or to breathe while using the bite retractor. Furthermore, the bite retractor can mitigate the migration of the tubes used during intubation. However, the bite retractor is NOT a device that enables laryngoscopy. It is a device that prevents the patient from biting the endotracheal tube; that is, the patient has already undergone laryngoscopy and endotracheal intubation. Therefore, this document can be considered the general prior art for the present invention.Additionally, the prior art includes document WO2019211258A, which describes a dental shield for the upper jaw during the use of a laryngopharyngeal retraction system in a patient. For this purpose, a pressure-relieving and cushioning material is positioned in various ways between the pressure-exerting upper jaw support of the laryngopharyngeal retraction system and the area of ​​the upper jaw receiving the pressure, specifically the incisors. This is achieved, firstly, with a repositionable cover on the upper jaw support of the laryngopharyngeal retraction system, and secondly, with the use of a customized dental shield for the upper jaw based on a molded plastic mass or a thermoformed film, which functions as a contact or support surface for the upper jaw support.In this way, damage to the incisors or the surrounding area of ​​the upper jaw, including gum irritation, can be largely prevented. However, the invention defined in this prior art has the disadvantage of not including a rubber or plastic upper dental protector with a structural reinforcement in high-strength metal or rigid polymer, located at the front. This reinforcement allows the laryngoscope blade to be used as a lever, enabling the device to fully or partially cover the arch of the patient's teeth. Document WO2019211258A discloses a different device from the present invention, as it is a laryngopharyngoscope with different dimensions and uses. Therefore, it is clear that the device disclosed in WO2019211258A differs from the present invention in size, shape, and structure.

[0011] On the other hand, the prior art includes document US20160263466A1, which describes a dental device designed to protect the user's dentures from impact injuries sustained during sports or other activities that could cause chipping, fracture, dislodgement, or avulsion of teeth. The device is adjustable and includes at least one compartment containing an energy-absorbing fluid. This fluid can be a nanosuspension of small particles in viscous fluids that thicken under shear when the dental device is struck by an object. The device dampens and diffuses horizontal and axial forces, directing them away from the dentures and thus reducing the risk of dental injury. This document can be considered the general prior art for the present invention.

[0012] In the prior art, document NC2019 / 0008794 provides a device based on the Guedel airway. In addition to maintaining airway patency, as the airway does, its innovative design also allows it to function as a dental protector, a protector of the soft tissues of the mouth (such as lips and gums), and a facilitator for tracheal intubation. This innovation can be manufactured using recyclable materials, such as sugarcane bagasse or avocado seeds. Therefore, this document can be considered the general prior art for the present invention.

[0013] Finally, patent US20150068538A1 describes an oral airway and intubation assist device that protects a patient's teeth and includes a wedge adapted to redirect force from the patient's incisors to the patient's upper jaw, a block adapted to keep the patient's mouth open, and an airway guide adapted to prevent tongue obstruction and maintain a clear passage for air. Additionally, the device may include a tube retainer adapted to secure the intubation tube against movement.However, the invention defined in this prior has the disadvantage that it does not show a superior dental protector made of rubber or plastic, which includes a structural reinforcement in metallic material or rigid polymer with high resistance, located at the front, which allows a lever to be made with the valve of the laryngoscope, where the device can totally or partially cover the arch formed by the patient's teeth.

[0014] Based on the above, it is clear that the current state of the art requires the design of a device that allows for leverage during laryngoscopy procedures without causing damage or injury to the patient's teeth, thus facilitating and reducing the patient's breath-hold time and the use of muscle strength. This mechanism or device should be adaptable to different patients, allow for fixation using hook geometries, and dissipate the load across a metallic structure.

[0015] BRIEF DESCRIPTION OF THE FIGURES

[0016] The present invention is more clearly understood from the following figures, which show the components and results associated with the present development, as well as the novel features with respect to the state of the art, where the figures are not intended to limit the scope of the invention, which is solely defined by the attached claims, where:

[0017] Figure 1 corresponds to a view of the laryngoscopy process where the location of the device (1) of the present invention is evident.

[0018] Figure 2 corresponds to a view of the upper dental arch with references that allow for a clearer understanding of the present invention.

[0019] Figure 3 shows a bottom view of the device (1) of the present invention. Figure 4 shows a top view of the device (1) of the present invention.

[0020] Figure 5 shows a view of dental protectors known in the prior art. DETAILED DESCRIPTION OF THE INVENTION

[0021] The present invention consists of a device comprising a main body (1) in the form of an arch, which is formed by an inner part (2) and an outer part (3), wherein said inner part (2) includes a portion for receiving the teeth (16), wherein, between said inner part (2) and said outer part (3) a metal reinforcement (13) in the form of an arch is housed, and between 1 and 4, preferably 2 compression plates (11 and 12) are housed, wherein said compression plates (11 and 12) are located at the ends of the main body (1) perpendicular to the metal reinforcement (13) in order to protect the teeth while distributing the load made by the lever in the laryngoscopy procedure.

[0022] In one embodiment, the present invention includes 2 additional compression plates (not shown in the figures) between said compression plates (11 and 12) along the main body (1).

[0023] Where the tooth-receiving portion (16) is channel-shaped and includes a fitting portion for the patient's frenulum. Where the metal reinforcement (13) is a malleable material that can be bent to change shape and is coated with the material of the main body (1). Where the main body (1) is made of polymeric materials, such as rubber, silicone, or acrylic. Where the metal material of the reinforcement (13) is aluminum, stainless steel, surgical steel, or titanium. Where the material of the compression plates (11 and 12) is a polymer, such as nylon, PEEK, or PEKK, or a metal, such as aluminum, stainless steel, surgical steel, or titanium.

[0024] Wherein, said compression plates (11 and 12) are U-shaped clamps that allow the protector to be held on the patient's teeth, by applying pressure to the outer wall (14) and the inner wall (15) of said protector, preventing unwanted slippage.

[0025] Where, the device is located in the upper left dental arch of the patients.

[0026] In a preferred embodiment, the device of the present invention covers teeth number 5 to number 14, or number 6 to number 15, or number 7 to number 16 of the left side of the patient's upper dentition.

[0027] The reason the protector only covers the teeth on the left side is that the tongue must always be moved to the left so that the endotracheal tube always enters from the right side. A series of definitions are provided below to clarify the present invention; any concepts or words not included in these definitions should be understood in their broadest sense.

[0028] Orotracheal intubation: Once the laryngoscopy visualizes the glottis, an orotracheal tube is inserted through the right side of the oral cavity and the tip is taken to the glottis, crossing the vocal cords to the trachea. It is confirmed that the tube is not located only in one lung (monobronchial), and ventilation with oxygen is initiated through the orotracheal tube.

[0029] Hypoxia: Low levels of oxygen in the blood.

[0030] Muscle relaxant: A medication that blocks muscle contraction, including that of the diaphragm, the muscle responsible for breathing. Laryngoscope: A device used to perform laryngoscopy.

[0031] Laryngoscope blade: A device that attaches to the handle of the laryngoscope. It is the device inserted into the oral cavity to locate the patient's glottis in order to insert the endotracheal tube.

[0032] Glottis: It is the organ located in the larynx, in which the vocal cords are found, through which the orotracheal tube passes.

[0033] Apnea: Absence of breathing.

[0034] The main advantages of the present invention are: • Facilitating the procedure by being able to create a lever, reducing the need for muscular force.

[0035] • Facilitate laryngoscopy in large, obese patients, patients with short necks, patients with limited cervical spine extension, and other situations.

[0036] • The device of the present invention is compatible with all valves used for laryngoscopy.

[0037] • The device of the present invention does not require its own light since the laryngoscope valve is responsible for visualizing the deep part of the oral cavity and the glottis.

[0038] • The device of the present invention has the main objective of being able to be used as a lever to visualize the glottis, while still protecting the patient's teeth.

[0039] • The device can be easily manufactured and acquired, since, due to its manufacturing characteristics, the costs and production are affordable at any level of medical care, whether it is a first level of care or a fourth level.

[0040] • It is a device that should be as routine in emergency medical clinical practice as the stethoscope, with the advantage over the stethoscope that it saves lives in emergencies. Although the foregoing description defines the preferred embodiments of the present invention, the invention is not limited to these; on the contrary, it is also intended to include within the scope of this application all variations or modifications that are obvious to those skilled in the art and that do not affect or change the spirit of the invention.

Claims

CLAIMS 1. Device characterized in that it comprises a main body (1) in the form of an arch which is formed by an inner part (2) and an outer part (3), wherein said inner part (2) includes a portion to receive the teeth (16), wherein between said inner part (2) and said outer part (3) a metal reinforcement (13) in the form of an arch is housed, and between 1 and 4, compression plates (11 and 12) are housed, the purpose of which is to prevent the displacement of the device during the application of necessary forces made during laryngoscopy.

2. The device of claim 1 characterized in that said compression plates (11 and 12) are located at the ends of the main body (1) perpendicular to the metal reinforcement (13).

3. The device, according to the preceding claims, characterized in that 2 additional compression plates are located between said compression plates (11 and 12) along the main body (1).

4. The device, according to the preceding claims, characterized in that the portion for receiving the teeth (16) has a channel shape.

5. The device, according to the preceding claims, characterized in that the metallic reinforcement (13) is a malleable material and is coated with the material of the main body (1), wherein the metallic material of the reinforcement (13) is aluminum, stainless steel, surgical steel, or titanium 6. The device, according to the preceding claims, characterized in that the material of the compression plates (11 and 12) is a polymer, such as nylon, PEEK, PEKK, or a metal, such as aluminum, stainless steel, surgical steel, or titanium.

7. The device, according to the preceding claims, characterized in that the main body (1) is made of polymeric materials, such as rubber, silicone or acrylic.

8. The device, according to the preceding claims, characterized in that said compression plates (11 and 12) are U-shaped clamps that hold the protector on the outer wall (14) and on the inner wall (15), fixing the protector and preventing unwanted slippage.

9. The device, according to the preceding claims, characterized in that it is located in the upper dental arch of the patients.

0. The device, according to the preceding claims, characterized in that it covers the teeth from number 5 to number 14, or from number 6 to number 15, or from number 7 to number 16 of the left side of the patient's upper dentition.

Images