Mandibular Subluxation Device Ratchet Mechanism
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Solution Overview
Problem
Surgical access to zone 3 of the neck is restricted by the triangular bony confines of the vertical mandibular ramus and mastoid process, making it challenging to expose critical anatomic structures like the internal carotid artery and major cranial nerves, especially in cases of short neck, morbid obesity, high carotid bifurcation, or extended carotid dissection above C2.
Innovation Solution
A mandibular subluxation device (MSD) comprising a first and second mandibular subluxation component with tooth guides and a ratchet mechanism that allows relative longitudinal movement from a neutral to an extended position, facilitating distraction of the mandible and maintaining the extended position for improved access.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Area of stationary object
If mandibular subluxation is performed to access zone 3 of the neck, then exposure to critical anatomic structures is improved, but risk of mandibular dislocation increases
Solution Approach 1:
The device enables dynamic adjustment of mandibular position through a ratchet mechanism that allows controlled movement from neutral to extended positions. The surgeon can progressively distract the mandible to achieve optimal exposure while maintaining the ability to adjust the degree of subluxation, thereby balancing exposure needs with joint stability.
Solution Approach 2:
The MSD acts as an intermediary device between the mandible and the surgical field. It provides a controlled mechanical interface that allows gradual mandibular distraction while maintaining stability through the ratchet mechanism, preventing uncontrolled dislocation while achieving necessary exposure.
2Area of stationary object
If the mandible is distracted to extended position for better exposure, then access to anatomical structures is improved, but surgical procedure complexity increases
Solution Approach 1:
The MSD is divided into separate components (upper component with upper tooth guide, lower component with lower tooth guide, and ratchet mechanism) that can be independently positioned and adjusted. This segmentation allows the surgeon to systematically assemble and adjust each component to achieve the desired mandibular distraction while maintaining procedural control.
Solution Approach 2:
The device components are pre-configured with tooth guides and ratchet mechanisms that establish the distraction path and limits before the surgical procedure begins. This preliminary setup simplifies the intraoperative process by providing predetermined adjustment parameters and reducing the need for complex intraoperative decision-making.
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 MSD provides enhanced exposure to critical anatomical structures by allowing anterior displacement of the mandible, enabling safer and more effective medical procedures while minimizing the risk of dislocation.
Implementation Method 1
A ratchet mechanism acts between the first and second mandibular subluxation components. The ratchet assembly allows for movement of the second mandibular subluxation component from the neutral position to an extended position and inhibits movement of the second mandibular subluxation component from an extended position toward the neutral position.
Data Source
AI summary
A mandibular subluxation device (MSD) is provided. The device includes an upper MSD component and a lower MSD component. The upper MSD component includes and upper tooth guide connected to an upper plate having a pair of depending legs. The upper MSD component further includes an upper force receiving plate. The MSD also includes a lower MSD component. The lower MSD component includes a lower tooth guide connected to a lower plate. The lower MSD component further includes a lower force receiving plate. The upper and lower MSD components are connected in a way that allows relative longitudinal movement between the two components between a neutral position and a plurality of extended positions. A ratchet mechanism inhibits movement of the lower plate from any extended position toward the neutral position. The ratchet mechanism may be manually disengaged to allow the lower MSD component to return to the neutral position.