Choanal Tubes With Metallic Inserts Prevent Restenosis
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Solution Overview
Problem
Current treatments for choanal atresia, such as stents made from polyvinyl chloride or rubber, often lead to restenosis and require repeated anesthetics, posing risks of material collapse and toxic reactions, and existing methods for preventing stenosis are time-consuming and unsatisfactory.
Innovation Solution
An apparatus comprising two choanal tubes made from medical-grade plastics with embedded stainless steel inserts and a plastic strip, positioned to lie side-by-side in the nasal passageways with a bridge and apertures for secretion discharge, designed to prevent stenosis by maintaining patency and reducing pressure on nasal structures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If stents are made from polyvinyl chloride or rubber materials, then the stents can be manufactured and inserted, but the stents collapse under re-epithelialization pressure and cause restenosis
Solution Approach 1:
The stent is constructed as a composite device combining a flexible outer tube made of biocompatible material with an internal metallic support structure. This composite design provides both the flexibility needed for insertion and the structural strength to resist collapse pressures during re-epithelialization, directly resolving the contradiction between material softness and structural integrity.
Solution Approach 2:
The metallic insert is positioned locally within the stent structure where maximum mechanical support is needed to resist collapse pressures. This localized reinforcement provides strength exactly where required without compromising the overall flexibility and biocompatibility of the stent material, addressing the strength-patency contradiction.
2Reliability
If repeated serial dilatation or bougienage procedures are performed, then stenosis prevention is attempted, but multiple anesthetics are required causing unnecessary hazards to newborn infants
Solution Approach 1:
The stent is inserted once immediately after surgical opening of the choanae and maintains patency continuously during the critical re-epithelialization period. This preliminary and sustained action prevents stenosis formation from occurring in the first place, eliminating the need for subsequent repeated dilatation procedures and associated anesthetic exposures.
Solution Approach 2:
The stent provides continuous mechanical support and patency maintenance over the entire healing period, ensuring uninterrupted prevention of stenosis. This continuous action replaces the need for multiple discrete intervention procedures, thereby eliminating repeated anesthetic hazards while maintaining reliable stenosis prevention.
3Ease of manufacture
If stents are made from rubber material, then the stents can be inserted, but localized toxic tissue reactions are induced
Solution Approach 1:
The stent material is changed from rubber to a biocompatible material with improved biocompatibility parameters. This material substitution maintains the manufacturability and flexibility of the stent while eliminating the toxic tissue reaction hazard, resolving the contradiction between ease of manufacture and biocompatibility.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The apparatus effectively prevents stenosis by maintaining the patency of choanal openings, reducing the risk of restenosis, and minimizing the need for repeated anesthetics, while being comfortable and safe for patients, including infants and adults.
Implementation Method 1
each has a lengthwise extending flexible metallic insert embedded internally within its wall. Each metallic insert may comprise a spiral of metallic material embedded within the respective choanal tube
Data Source
AI summary
A choanal atresia apparatus for use in prevention of stenosis following choanal atresia repair in patients. Two tubular choanal tubes each have an interior surface and an exterior surface, an anterior end and a posterior end, and a central axis. A plurality of axially spaced apertures in each of the two choanal tubes are for discharging nasal secretion. A strip has opposed ends coupled to the posterior ends of the two choanal tubes respectively. The strip couples the two choanal tubes in a laterally spaced relationship. The choanal tubes and the strip are fabricated of a medical grade plastic.