JP7224742B2 - lingual frenuloplasty tongue retractor - Google Patents

Description

The present invention provides a tongue lifter (a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, a tongue lifter, and a tongue lifter for use in tongue frenulum surgery performed when abnormalities are observed in the "tongue frenulum" of infants and young children. tractor).

The human tongue is connected to the floor of the lower jaw by a mucosal fold called the lingual frenulum. This "lingual frenulum" may congenitally extend from near the tip of the tongue to the gums. in this case,
The limited range of motion of the tongue interferes with activities such as feeding and articulating. The condition that causes such a hindrance is called "tongue-tie."

Babies with "tongue-tie" are unable to suckle adequately because they can only hold their mother's nipples up to the shallow part of their mouth. As a result, the nipple is removed during feeding, the amount that can be drunk at one time is reduced, the feeding time is prolonged, and the number of times of feeding is increased. This causes problems such as prolonged moodiness and lack of weight gain.

In infants with "tongue-tie", the tongue and lips cannot wrap around the nipple sufficiently, causing the nipple to feel chewed by the gums, causing pain to the mother. In addition, since the amount of milk the baby drinks at one time is reduced, the mammary glands are likely to become clogged, mastitis may occur, and the amount of milk secreted may decrease. Increasing the number of feedings can also cause insomnia and stress for mothers and families.

Symptoms of lingual frenulum are improved by a relatively simple operation in which an incision is made from the tip of the lingual frenulum to the base of the tongue. Breast-feeding can be resumed on the day of surgery, so even if the patient is an infant, the burden on the infant and its mother is not great. In addition, postoperative care such as stretching the tongue can prevent the problem of postoperative ``re-adhesion'' of the wound causing the wound to return to its preoperative state.

The frequency of occurrence of ``glossus truncation'', which restricts the range of motion of the tongue, is said to be 4 to 10% of newborns, although it varies depending on the examination method and how abnormal it is considered to be. In any case, the number of patients who need surgery is about 1 in 10 to 20 infants, which is not a small number.

However, at the Japan Pediatric Society, there were few cases of dyspnea caused by "tongue-tie", and there was no relationship between "tongue-tie" and feeding (movement). A documented ethics committee report was published in 2001. The impact of this report is so great that many pediatricians still believe that 'tongue twitch' requiring surgery is rare.

In pediatrics, 'tongue-tie' surgery is rarely performed, and most of the operations in oral surgery are on older children and adults under general anesthesia. For this reason, despite the large number of patients undergoing surgery, there are few doctors who perform surgery for 'tongue truncation' in infancy, and the patient's family is perplexed.

Partly due to the small number of operations, there is no dedicated instrument optimized for the operation of "tongue frenulum", and the surgeon uses a tongue depressor instead. That is, a tongue depressor used to press the tongue toward the mandible is used to lift the patient's tongue toward the mandible.

Patent Literature 1 discloses a "tongue retractor" that is devised so as not to damage or give discomfort to the oral cavity during examination of the throat or treatment in the oral cavity. Although the name is a tongue depressor, it is a tongue depressor whose purpose is to press the tongue against the floor of the oral cavity, as in Patent Document 2.

Patent Literature 2 discloses a tongue depressor capable of illuminating the oral cavity while holding down the patient's tongue and ensuring a sufficient amount of light when examining the oral cavity.

Japanese Patent Application Laid-Open No. 2009-22702 Japanese Utility Model Laid-Open No. 6-68719

In surgery for lingual frenulum, the lingual frenulum to be incised is in the midline on the back of the tongue, so when the surgeon lifts the tongue, the tongue retractor is biased to either the left or right direction of the tongue. It becomes an operation.

In addition, while the surgeon lifts the tongue with one hand, the incision tool (
The incision must be performed with scissors). It is difficult to perform the incision while lifting the part of the tongue that is biased to either the left or right direction.

An object of the present invention is to provide a tongue lifter (tongue retractor for tongue lifting, tongue retractor, tongue retractor) that facilitates surgery for tongue-tie.

(First invention)
A first invention of the present application comprises a tongue frenulum insertion groove (14) having a substantially oval plate shape and having one end in the longitudinal direction split into two,
The bifurcated tip (13) forming the tongue frenulum insertion groove (14) is associated with the tongue retractor (10, 10A) having a curved plane shape (see FIGS. 1 to 3).

(Glossary)
A tongue retractor (10, 10A) is a medical device for lifting the patient's tongue toward the upper jaw.
It can also be used as a postoperative care tool to prevent adhesions at the surgical site after surgery. Appropriate overall size varies from patient to patient. In the embodiments to be described later, two types are described, one for infants (FIGS. 1 and 2) and one for adults (FIG. 3).
Materials such as stainless steel and antibacterial thermoplastic resin are used.

(Action)
During surgery, the therapist (surgeon or surgical assistant) holds the tongue retractor (10,
10A), insert the lingual frenulum insertion groove (14) into the lingual frenulum at the center of the back of the patient's tongue,
Lift the patient's tongue. Since the planar shape of the bifurcated tip (13) is curved, it does not easily damage the patient's tongue.
No skill is required to lift the left and right sides of the tongue in a balanced manner. It then allows the therapist to cut the tongue frenulum straight along the patient's tongue.

After surgery, the patient's relatives and others use this tongue retractor (10, 10A) to stretch the patient's tongue several times a day in order to prevent adhesions at the surgical site. also available.

More preferably, the bifurcated tip (13) is provided with a scale (16) indicating the depth of the groove of the tongue frenulum insertion groove (14).
It is reasonable to provide the scale (16) on the convex surface (on the left side of the page in the side view of FIG. 1) which is not in contact with the patient's tongue.

(Variation 1)
More preferably, the bifurcated tip (13) is provided with a scale (16) indicating the depth of the groove of the tongue frenulum insertion groove (14).
The scale (16) has a convex surface (contact surface 1 in FIG. 1(a)) that does not contact the patient's tongue
5, ie the left side of the paper).
The scale (16) is useful in allowing the length to be cut to be measured and in pre-operative consultations to determine the need for surgery.

(Variation 2)
an operation portion (12) which is a portion extending from the lingual frenulum insertion groove portion (14) to the end portion on the opposite side;
Two bending portions (12A, 1
3A) and
When the bent portions (12A, 13A) form a contact surface (15) contacting the patient's tongue and a clearance (15) in the thickness direction dimension of the operation portion (12),
More preferred (see FIG. 1(a)).
This is because, when used for incision, a clearance (17) is ensured between the incision tool and the operation part (12), which facilitates the incision operation.

(Variation 3)
The tongue retractor (10, 10A) may be made of a transparent material (eg, ABS resin, PET).
When the tongue is pressed, the pressed portion can be visually observed, which facilitates examination and surgery.

According to the first invention, there is provided a tongue depressor (tongue lifter, tongue depressor hook) that widens the surgical field between the back side of the tongue and the floor of the oral cavity and facilitates the operation of tongue shortening. was made.

1 is a front view and a side view showing a tongue retractor (tongue lifter) for infants according to a first embodiment; FIG. It is the front view and side view which show the tongue retractor (tongue lifter) for infants based on 2nd embodiment. FIG. 10A is a front view and a side view showing an adult tongue retractor (tongue lifter) according to a third embodiment;

(Fig. 1)
FIG. 1 shows a tongue depressor (tongue lifter) 10 for infants.
As shown in FIG. 1(b), the overall shape is in the form of a substantially oval plate, and one end in the longitudinal direction is provided with a frenulum insertion groove portion 14 that is split into two. The tongue frenulum insertion groove 14 has a substantially oval shape.

The bifurcated tip (13) forming the tongue frenulum insertion groove 14 has a curved plane shape. This is because it is a part that contacts the patient's tongue and the back of the tongue, so that the contacted part will not be damaged.

It has an operation part 12 formed so that the dimension in the width direction becomes narrower from the tongue frenulum insertion groove part 13 toward the opposite end part. This operating portion 12 is a portion that is held between the thumb and forefinger of the therapist (surgeon or surgical assistant) when holding the tongue retractor 10 in one hand during surgery.

From the operation portion 12 toward the side opposite to the bifurcated distal end portion 13, the width dimension increases again and then becomes thin again. The narrowed portion is used as a grip portion 11 . This grasping part 11 is a part that comes into contact with the back of the hand of the person being treated (surgeon or surgical assistant).

As shown in the side view of FIG. 1(a), two bending portions 12A and 13A are provided between the operating portion 12 and the bifurcated tip portion 13. As shown in FIG. The bent portion 12A is a bent portion on the side closer to the operation portion 12, and the bent portion 13A is a bent portion on the side closer to the bifurcated tip portion 13. As shown in FIG.

The contact surface 15 of the tongue retractor 10 is the surface on the side where the curved portion 13A is concave and the curved portion 12A is convex.
, and comes into contact with the back surface of the patient's tongue.

A therapist (surgeon or surgical assistant) brings the contact surface 15 of the tongue retractor 10 having two bent portions 12A and 13A into contact with the back side of the patient's tongue and raises the tongue. When an incision is made with an incision tool (scissors), the operation part 12 and the grip part 11 of the tongue retractor 10 are separated from the incision tool by the clearance formed by the two bent parts 12A and 13A. . Therefore, it is easy for a surgeon to perform an incision operation.

The bifurcated distal end portion 13 is provided with a scale 16 indicating the groove depth of the tongue frenulum insertion groove portion 14 on the surface opposite to the contact surface 15 . The scale 16 is used as a guideline for determining the cutting length, and for judging the necessity of surgery in a medical examination before surgery.

The tongue depressor 10 for infants described above is formed by cutting out stainless steel and cutting or chamfering it.

(Figure 2)
The embodiment shown in FIG. 2 differs from the embodiment shown in FIG. 1 in side shape.
That is, as shown in FIG. 2(a), the thickness direction is formed so as to form a generally loose "S" shape. More specifically, the shape is such that the vertex of a quadratic curve is formed near the boundary between the operation portion 12 and the grip portion 11 . Such shapes are empirically determined for ease of operation of the operating portion 12 and the grip portion 11 by a medical practitioner (surgeon or surgical assistant).

When stainless steel is used, it is possible for the therapist to appropriately change the degree of bending according to the preferences of the therapist and the condition of the patient. Alternatively, it may be provided in advance in a flat plate form (Fig. 3
(a)).

The material for forming the tongue retractor 10 is not limited to stainless steel. For example, it may be made of thermoplastic resin (for example, ABS resin).
When a thermoplastic resin is used, the thickness dimension becomes large because the strength is inferior to that of stainless steel. Therefore, it is disadvantageous when considering putting it in the mouth. However, tongue retractor 1
As a manufacturer of 0, processing is easier than stainless steel, so the tongue frenulum insertion groove 14,
It is possible to complicate the shapes of the bifurcated tip portion 13, the operation portion 12, the grip portion 11, and the like. The tongue retractor 10 that employs a thermoplastic resin is particularly suitable for oral care after surgery. Also, marking of the scale 16 is easy.
Also, marking of the scale 16 is easier than in the case of stainless steel.

When the tongue retractor 10 is made transparent by adopting ABS resin, PET (polyethylene terephthalate), special glass, or the like, the pressed part can be visually observed when pressing the tongue, which facilitates examination and surgery. There are also advantages such as

(Fig. 3)
FIG. 3 shows a tongue retraction hook (tongue retractor) 10A for adults.
The difference from the tongue retractor 10 for infants shown in FIGS. 1 and 2 is that the longitudinal dimension is large and the shape is flat as shown in the side view.
is.

Although not shown, the bifurcated distal end portion 13 may be provided with a scale 16 indicating the groove depth of the tongue frenulum insertion groove portion 14 . The scale 16 may be provided on both sides, but if it is provided only on one side for reasons such as manufacturing cost reduction, it should be on the side that does not come into contact with the patient's tongue.

The flat plate shape is provided by the manufacturer of the tongue retractor 10A on the premise that it will be folded and used by the operator.

The tongue retractors 10 and 10A shown in FIGS. 1 to 3 are primarily used by a therapist (surgeon or surgical assistant) during surgery for tongue shortening, but surgery is unnecessary. It can also be used in diagnosing
After surgery, the patient's relatives obtain and use the tongue retractors 10 and 10A to lift the patient's tongue several times a day (for about three weeks). This is to prevent adhesions from occurring at the surgical site.

INDUSTRIAL APPLICABILITY The present invention has applicability in the medical equipment manufacturing industry, the medical equipment rental industry, the medical information service industry, and the like.

10; Tongue retractor (for infants) 10A; Tongue retractor (for adults)
Reference numeral 11: Grip portion 12: Operation portion 12A: Bending portion 13: Bifurcated tip portion 13A; Bending portion 14; Tongue frenulum insertion groove portion 15; Contact surface 16;

Claims (3)

It has a substantially oval plate shape, and has a tongue frenulum insertion groove part that is split into two at one end in the longitudinal direction,
The bifurcated tip that forms the tongue frenulum insertion groove has a curved planar shape,
an operation portion which is a portion directed from the lingual frenulum insertion groove portion to the end portion on the opposite side;
Between the operation part and the bifurcated tip part, there are provided two bending parts that are concave on the bifurcated tip part side and convex on the operation part side in a side view, and the bifurcated tip part side is concave and the operation part side is convex. The surface on the side that becomes
A tongue retractor for lingual frenulum surgery, wherein the bent portion is formed such that a contact surface that contacts the back side of the patient's tongue and a clearance in a thickness direction dimension of the operating portion are formed. 2. The tongue retractor for lingual frenulum surgery according to claim 1, wherein said bifurcated distal end portion is provided with a scale indicating the groove depth of said lingual frenulum insertion groove portion. 3. The tongue depressor for lingual frenulum surgery according to claim 1 or 2, which is made of a transparent material.

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