US3707150A - Laryngeal keel - Google Patents
Laryngeal keel Download PDFInfo
- Publication number
- US3707150A US3707150A US87094A US3707150DA US3707150A US 3707150 A US3707150 A US 3707150A US 87094 A US87094 A US 87094A US 3707150D A US3707150D A US 3707150DA US 3707150 A US3707150 A US 3707150A
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- US
- United States
- Prior art keywords
- keel
- anterior
- laryngeal
- thyroid
- umbrella
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/20—Epiglottis; Larynxes; Tracheae combined with larynxes or for use therewith
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
Definitions
- a laryngeal keel is disclosed that is effective in preventing the recurrence of anterior glottic stenosis after surgical correction thereof.
- the keel is molded from silicone rubber and includes a flexible extralaryngeal portion and a flexible keel portion dimensioned to extend through the anterior commisure and sufficiently thin to ensure that said commisure is sharp and that the thyroid laminae can be closely approximated.
- the extralaryngeal portion is dimensioned to umbrella the area of the anterior commisure to prevent the escape of laryngeal secretions by way of the thyrotomy and to be sutured securely to the thyroid laminae.
- the flexibility of the umbrella portion minimizes asynchronous motion between the keel and the vocal cords.
- the present invention relates to laryngeal keels for use in preventing the recurrence of anterior glottic stenosis after surgical correction thereof.
- anterior glottic stenosis has been unsuccessful in a significant number of cases even with the procedure which utilizes an approach to the stenosis by way of an anterior thyrotomy and a tantalum keel inserted, after correction of the stenosis, between the vocal cords and provided with oppositely'disposed extralaryngeal tabs apertured to permit their being sutured to the thyroid laminae.
- the keels were removed after a 6 to 8 week period.
- the stenosis recurred and anterior cordal granulation was found to be present so that this procedure, though until now regarded as the most effective, left much to be desired.
- the objective of the present invention is to provide larnygeal keels that will prevent such objectionable post-operative results in substantially all cases, an objective attained with a laryngeal keel of an inert plastic material and comprising an extralaryngeal anchoring portion and an intralaryngeal keel portion, both then are flexible, the keel portion being dimensioned to extend through the anterior commissure from end-to-end thereof and the anchoring portion being dimensioned to umbrella the thyrotomy in the area of said commissure.
- the keel portion is desirably as thin as possible thus to permit the thyroid laminae to be closely approximated and the umbrella portion is sufficiently thin to conform to the contours of the thyroid laminae and to holdthe sutures by which the keel is secured and the thyrotomy tightly closed and with the flexibility of the keel preventing asynchronous motion between the laryngeal portion of the keel and the vocal cords.
- FIG. 1 is a view showing a laryngeal keel sutured to the thyroid laminae
- FIG. 2 is a section, on an increased scale, taken approximately along the indicated Iines 2-2 of FIG. 1;
- FIG. 3 is a section, on a further increase in scale, taken approximately along the indicated lines 3-3 of FIG. 1;
- FIG. 4 is a view of the keel as seen from the anterior end thereof, the keel being shown substantially full size;
- FIG. 5 is a side view thereof.
- FIG. 6 is an end view of the keel.
- a laryngeal keel in accordance with the invention is generally indicated at 10 and includes, see FIGS. 4, 5, and 6, an extra-laryngeal or umbrella portion 11 and an intralaryngeal keel portion 12 extending at right angles thereto and terminating short of the ends of the umbrella portion 11 as will be apparent from FIG. 5.
- the margins of the umbrella portion taper as at 13 and the keel portion 12 has a tapered edge 14.
- the keel 10 is formed from a plastic that is inert with respect to body secretions and both portions are thin and flexible.
- silicone rubber is used in the production of the keels l0 and has proved to be satisfactory in actual use in a substantial number of cases.
- the keel portion 12 is in the neighborhood of 0.014 inches in thickness except for its edge 14 while the central, thickest part of the umbrella portion 11 is in the neighborhood of 0.050 inches.
- FIGS. l-3 Before further describing the keel 10, reference is made to FIGS. l-3.
- the anterior commissure of the vocal cords 15 is generally indicated at 16 and is, see FIG. 2, located posteriorly of the thyroid cartilage l7.
- Glottic stenosis is a transverse web in this area and to enable it to be repaired, a horizontal incision 18 is made where it enables the thyroid membrane, the thyroid cartilage, and the cricothyroid membrane to be exposed.
- a vertical midline thyrotomy 20 is effected enabling access to the area of the stenosis to be made.
- the intralaryngeal portion 12 of the keel is inserted.
- the thyroid laminae 21, see FIG. 3, above and below the umbrella portion of the keel 10 are then approximated with the suture indicated at 22.
- the keel 10 is then secured by suturing it to the thyroid laminae as by two figure-of-eight sutures 23, each passing through the umbrella portion 11 and through the keel portion 12 adjacent its junction therewith.
- the height of the keel portion 12, i.e., its vertical extent when sutured in place, must be at least equal to the corresponding extent of the anterior commissure 16 and that the dimensions of the extralaryngeal portions 11 must be such as to cover or umbrella the thyrotomy 20 in the area of the anterior commissure.
- the length of the keel portion 1 1 must be such as to extend through the incised tissue in the anterior commissure 16, for example 16 mm for use in the case of a male larynx and 12 mm for the larynx of a female or child. It may, of course, be trimmed as needed.
- the thinness of the umbrella portion 11 enables it to conform to contours of the thyroid laminae to which it is sutured
- the thinness of the keel portion 12 not only permits the thyroid laminae marginally thereof to be closely approximated and a sharp anterior commissure to be established but also provides such flexibility that asynchronous motion between it and the vocal cords is effectively minimized.
- a keel in accordance with the invention permits regrowth of vocal cord epithelium enabling it to be removed within a 2 or 3 week interval without complicating granulomas in the region of the vocal cords. At the same time, it allows a more complete closure of the anterior commissure to minimize laryngeal secretions into the extralaryngeal spaces by way of the thyrotomy.
- the umbrella portion 12 conforms to the contour of the thyroid laminae due to its flexibility when secured thereto, the keel is securely fixed. This factor, together with the flexibility of the keel portion contributes to prevent asynchronous motion between the keel portion and the vocal cords.
- a laryngeal keel for use in preventing the recurrence of anterior glottic stenosis following surgical correction thereof, said keel being of a flexible inert plastic material comprising an extralaryngeal anchoring portion to be sutured to the thyroid laminae laterally of the anterior commissure, and an intralaryngeal keel portion emerging from the central part of the anchoring portion and dimensioned, when inserted in the thyrotomy, to extend through the anterior commissure and of a length to extend from end-to-end thereof, said anchoring portion extending beyond the ends of the keel portion and being of a width throughout its length to over lie and completely cover the margins of the thyrotomy at the anterior commissure from end-to-end thereof and to provide an area adequate for keel-retaining suturing, said anchoring portion being sufficiently thin and flexible throughout-to enable it to be sutured to the thyroid laminae and then to conform to the external contour thereof, said
Abstract
Description
Claims (5)
- 2. The keel of claim 1 in which the plastic material is silicone rubber.
- 3. The keel of claim 1 in which the thickness of the keel portion is in the order of 0.014 inches.
- 4. The keel of claim 1 in which the maximum thickness of the umbrella portion is in the order of 0.050 inches.
- 5. The keel of claim 1 in which the maximum thickness of the keel portion is in the neighborhood of 0.014 inches and the maximum thickness of the umbrella portion is in the neighborhood of 0.050 inches.
- 6. The keel of claim 1 in which the umbrella portion is flat and its margins taper substantially to a knife edge.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US8709470A | 1970-11-05 | 1970-11-05 |
Publications (1)
Publication Number | Publication Date |
---|---|
US3707150A true US3707150A (en) | 1972-12-26 |
Family
ID=22203078
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US87094A Expired - Lifetime US3707150A (en) | 1970-11-05 | 1970-11-05 | Laryngeal keel |
Country Status (1)
Country | Link |
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US (1) | US3707150A (en) |
Cited By (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3818894A (en) * | 1971-01-22 | 1974-06-25 | Ceskoslovenska Akademie Ved | Laryngeal implant |
EP0453186A1 (en) * | 1990-04-20 | 1991-10-23 | SMITH & NEPHEW RICHARDS, INC. | Phonosurgery devices |
WO1992019162A2 (en) * | 1991-04-24 | 1992-11-12 | Seid Arnold S | Surgical implantation device and related method of use |
EP0535833A1 (en) * | 1991-09-20 | 1993-04-07 | Xomed-Treace, Inc. | Vocal cord medialization prothesis |
US6113641A (en) * | 1997-08-27 | 2000-09-05 | Ethicon, Inc. | Prosthesis for the obturation of a hernial canal |
US6180848B1 (en) | 1997-08-27 | 2001-01-30 | Ethicon, Inc. | Prosthesis obturating device for the obturation of a hernial canal |
US6241768B1 (en) | 1997-08-27 | 2001-06-05 | Ethicon, Inc. | Prosthetic device for the repair of a hernia |
US20070198059A1 (en) * | 2006-01-31 | 2007-08-23 | Patel Umesh H | Fistula grafts and related methods and systems for treating fistulae |
US20070288041A1 (en) * | 1999-10-20 | 2007-12-13 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US20080188931A1 (en) * | 2006-11-01 | 2008-08-07 | Seoul National University Hospital | Cricoid wedge implant |
US9149262B2 (en) * | 2006-06-21 | 2015-10-06 | Cook Biotech Incorporated | Fistula grafts and related methods and systems useful for treating gastrointestinal fistulae |
CN108697432A (en) * | 2015-08-10 | 2018-10-23 | 耐贝医药株式会社 | Pararthria therapeutic kit and pararthria treatment group |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2243529A (en) * | 1940-05-09 | 1941-05-27 | Grossman Abraham | Colostomy appliance |
US3505988A (en) * | 1967-04-11 | 1970-04-14 | Norman Deane | Prosthesis for chronic access to the peritoneum |
-
1970
- 1970-11-05 US US87094A patent/US3707150A/en not_active Expired - Lifetime
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2243529A (en) * | 1940-05-09 | 1941-05-27 | Grossman Abraham | Colostomy appliance |
US3505988A (en) * | 1967-04-11 | 1970-04-14 | Norman Deane | Prosthesis for chronic access to the peritoneum |
Non-Patent Citations (2)
Title |
---|
Dedo et al. Annals of Otology, Vol. 77, 1968, pp. 435 441. * |
McNaught Laryngoscope 60: Mar. 1950, pp. 264 272. * |
Cited By (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3818894A (en) * | 1971-01-22 | 1974-06-25 | Ceskoslovenska Akademie Ved | Laryngeal implant |
EP0453186A1 (en) * | 1990-04-20 | 1991-10-23 | SMITH & NEPHEW RICHARDS, INC. | Phonosurgery devices |
AU650646B2 (en) * | 1990-04-20 | 1994-06-30 | Ent, L.L.C | Phonosurgery devices |
US5549673A (en) * | 1990-04-20 | 1996-08-27 | Smith & Nephew Richards Inc. | Phonosurgery implant instruments and a system and method of implantation |
WO1992019162A2 (en) * | 1991-04-24 | 1992-11-12 | Seid Arnold S | Surgical implantation device and related method of use |
WO1992019162A3 (en) * | 1991-04-24 | 1992-12-10 | Arnold S Seid | Surgical implantation device and related method of use |
US5254133A (en) * | 1991-04-24 | 1993-10-19 | Seid Arnold S | Surgical implantation device and related method of use |
EP0535833A1 (en) * | 1991-09-20 | 1993-04-07 | Xomed-Treace, Inc. | Vocal cord medialization prothesis |
US6241768B1 (en) | 1997-08-27 | 2001-06-05 | Ethicon, Inc. | Prosthetic device for the repair of a hernia |
US6180848B1 (en) | 1997-08-27 | 2001-01-30 | Ethicon, Inc. | Prosthesis obturating device for the obturation of a hernial canal |
US6113641A (en) * | 1997-08-27 | 2000-09-05 | Ethicon, Inc. | Prosthesis for the obturation of a hernial canal |
US20070288041A1 (en) * | 1999-10-20 | 2007-12-13 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US7776096B2 (en) * | 1999-10-20 | 2010-08-17 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US20070198059A1 (en) * | 2006-01-31 | 2007-08-23 | Patel Umesh H | Fistula grafts and related methods and systems for treating fistulae |
US9538996B2 (en) * | 2006-01-31 | 2017-01-10 | Cook Biotech Incorporated | Fistula grafts and related methods and systems for treating fistulae |
US11696749B2 (en) | 2006-01-31 | 2023-07-11 | Cook Biotech Incorporated | Fistula grafts and related methods and systems for treating fistulae |
US9149262B2 (en) * | 2006-06-21 | 2015-10-06 | Cook Biotech Incorporated | Fistula grafts and related methods and systems useful for treating gastrointestinal fistulae |
US10342523B2 (en) | 2006-06-21 | 2019-07-09 | Cook Biotech Incorporated | Fistula grafts and related methods and systems useful for treating gastrointestinal fistulae |
US20080188931A1 (en) * | 2006-11-01 | 2008-08-07 | Seoul National University Hospital | Cricoid wedge implant |
CN108697432A (en) * | 2015-08-10 | 2018-10-23 | 耐贝医药株式会社 | Pararthria therapeutic kit and pararthria treatment group |
CN108697432B (en) * | 2015-08-10 | 2021-04-16 | 耐贝医药株式会社 | Sound-producing disorder treatment device and sound-producing disorder treatment group |
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STCF | Information on status: patent grant |
Free format text: PATENTED FILE - (OLD CASE ADDED FOR FILE TRACKING PURPOSES) |
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AS | Assignment |
Owner name: ROCKLAND TRUST COMPANY,MASSACHUSETTS Free format text: SECURITY INTEREST;ASSIGNOR:E. BENSON HOOD LABORATORIES, INC. A MA CORP.;REEL/FRAME:004336/0619 Effective date: 19840816 Owner name: ROCKLAND TRUST COMPANY 288 UNION ST., ROCKLAND, MA Free format text: SECURITY INTEREST;ASSIGNOR:E. BENSON HOOD LABORATORIES, INC. A MA CORP.;REEL/FRAME:004336/0619 Effective date: 19840816 Owner name: BARBER ENTERPRISES INCORPORATION, Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:HOOD, EUGENE B.;REEL/FRAME:004338/0357 Effective date: 19840816 Owner name: E. BENSON HOOD LABORATORIES, INC. Free format text: CHANGE OF NAME;ASSIGNOR:BARBER ENTERPRISES, INCORPORATED;REEL/FRAME:004338/0705 Effective date: 19840816 |
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Owner name: BOSTON MEDICAL PRODUCTS, INC., ("BMP"), 100 CHARLE Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:MONTGOMERY, WILLIAM W.;REEL/FRAME:004580/0313 Effective date: 19860627 |
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Owner name: SOUTH SHORE BANK, A TRUST COMPANY OF MA.,MASSACHU Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:E. BENSON HOOD LABORATORIES, INC., A MA. CORP.;REEL/FRAME:004837/0758 Effective date: 19880120 Owner name: SOUTH SHORE BANK, 1400 HANCOCK STREET, QUINCY, MA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:E. BENSON HOOD LABORATORIES, INC., A MA. CORP.;REEL/FRAME:004837/0758 Effective date: 19880120 |