GB2421087A

GB2421087A - Airway inspection device

Info

Publication number: GB2421087A
Application number: GB0427042A
Authority: GB
Inventors: Simon Barry; Duncan Bradley; Paul Borkowski
Original assignee: ROYAL FREE HAMPSTEAD NHS TRUST
Current assignee: ROYAL FREE HAMPSTEAD NHS TRUST
Priority date: 2004-12-09
Filing date: 2004-12-09
Publication date: 2006-06-14
Also published as: GB0427042D0; WO2006061619A2; WO2006061619A3

Abstract

An airway inspection device 2 comprising an elongate housing having a mirror 18 at a distal end and a handle 12at a near end. The angular orientation of the mirror is adjustable via an actuator 46 situated in the handle. The actuator is connected to the mirror via a movable connector 24. The actuator may be manually operatable and the mirror could be mounted on a movable mount 36 using a biased hinge 20, preferably a web of resilient material. There may also be a light near the mirror and a tongue depression portion 80 which may be S shaped. Also claimed is an airway inspection device with a light.

Description

AIRWAY INSPECTION DEVICE

The present invention relates to an airway inspection device, in particular for oral use on a patient. The device may be used as an oral catheter guide.

It is sometimes necessary for medical practitioners to inspect the airway of a patient. This is necessary, for example, for the diagnosis of various lung diseases, for example tuberculosis. It is known to provide a fibre optical bronchoscope which is inserted into the airway of a patient, via the nose or mouth, and is employed to shine light down into the airway of the patient. The medical practitioner can then employ a conventional speculum mirror, held at the back of the patient's throat, for looking downwardly into the airway so illuminated by the light from the bronchoscope. The medical practitioner can manually manipulate the mirror to view parts of the airway and in particular so as to be able to see past the vocal cords of the patient, which may be located in different positions. It is also known to use the fibre optic bronchoscope and speculum mirror to assist the medical practitioner inserting a speculuni catheter downwardly into the airway and lung of the patient.

Such a known combination of a fibre optic bronchoscope and speculum mirror suffers from the problem that two-handed operation is required by the medical practitioner, which can be difficult and inconvenient. There is a need for a catheter guide which permits more reliable and easier operation by a medical practitioner to inspect the airway of a patient.

With a known fibre optic bronchoscope, it can be difficult for the medical practitioner to guide the catheter accurately down the airway and into the lung. There is a need for a catheter guide for assisting insertion of a catheter into the airway and lung of a patient.

The known fibre optic bronchoscope needs to be inserted through the throat of the patient into the airway. This can be uncomfortable for the patient because of the desire for the patient to swallow when the bronchoscope is inserted at the back of the throat. There is a need to provide a device for assisting insertion of catheters into the airway of a patient and for inspecting the airway of a patient which is more comfortable for the patient.

The present invention aims to provide an airway inspection device, in particular that is suitable for use as a catheter guide, at least partially meeting these needs.

Accordingly, the present invention provides an airway inspection device comprising an elongate housing having a distal end and a near end, a handle at the near end for manual holding of the airway inspection device by a user, a mirror disposed at the distal end, an actuator in the handle for actuating movement of the mirror, and a movable connector disposed between the actuator and the mirror, whereby the angular orientation of the mirror relative to the housing can be varied by operating the actuator.

Preferably, the actuator is manually operable, and more preferably is a manually rotatable element.

Preferably, the mirror is mounted on a movable mount which includes a biased hinge connected to the distal end. More preferably, the biased hinge comprises a web of resilient material.

Preferably, the movable connector comprises a reciprocable rod mounted between the mirror and the actuator.

The airway inspection device may further comprise a light emitting device further comprising a light emitting device for emitting light from the distal end of the device.

More preferably, the light emitting device is remote from the mirror, and the airway inspection device further comprises a light guide in the housing for transmission of light from the light emitting device to the distal end of the device, and a light port at the distal end for emitting light in a direction substantially orthogonal to the housing so as to be directed, in use, down the throat of a patient. The light emitting device may be comprised in a light emitting unit which is detachably fitted to the housing.

Preferably, the distal end of the housing is provided on an undersurface with a smooth configuration shaped to depress the tongue of a patient. The undersurface may be smoothly curved downwardly and substantially Sshaped.

Preferably, the distal end of the housing includes a light transmission cavity therethrough located under the minor.

The present invention further provides an airway inspection device comprising an elongate housing having a distal end and a near end, a handle at the near end for manual holding of the airway inspection device by a user, a minor disposed at the distal end and a light emitting device for emitting light from the distal end of the device.

An embodiment of the present invention will now be described, by way of example only, with reference to the accompanying drawings, in which: Figure 1 is a side view olan airway inspection device in accordance with an embodiment of the present invention; Figure 2 is a top view of the airway inspection device of Figure 1; Figure 3 is a bottom view of the airway inspection device of Figure 1; Figure 4 is a perspective view from above and one side, and shown partly in phantom, of the airway inspection device of Figure 1; and Figure 5 is a schematic side illustration showing the use of the airway inspection device of Figure 1 to inspect an airway of a patient.

Referring to Figures 1 to 3, there is shown an airway inspection device, designated generally as 2, in accordance with an embodiment of the present invention. The airway inspection device 2 comprises an external housing 4 comprising a pair of opposed side pieces 6,8 assembled together along a central junction 10. The housing 4 comprises a handle 12 located towards a near end 14 of the airway inspection device 2. The handle 12 has an external shape and configuration to permit it securely and comfortably to fit within the palm of the hand of a medical practitioner. At the distal end 16 of the airway inspection device 2 is located a movable mirror 18. The mirror 18 is mounted, via a hinge 20, to a distal end 22 of an elongate portion 24 of the housing 4, with a near end 26 of the elongate portion 24 adjacent the handle 12. The mirror 18 has a front reflecting surface 28, facing towards the elongate portion 24 of the housing 4. The mirror surface 28 is planar and inclined with respect to a longitudinal axis, which extends between the near end 14 and distal end 16 of the airway inspection device 2. The minor 18 is affixed on its rear face 30 to a rear support 32. The hinge 20 connects the support member 32 at a lower edge 34 thereof to the distal end 22 of the elongate portion 24 of the housing 4. The hinge is a live hinge comprising a web of resilient plastics material, for example polypropylene. The live hinge 20 has sufficient resilience so that when deflected from a rest position, the assembly of the mirror 18 on the mirror support 32 is biased by the live hinge 20 back towards the rest position. However, other hinge constructions could alternatively be employed, such as using a hinge element with two wings relatively movable by rotation about a fixed axis.

An elongate reciprocable rod 40, preferably of metal such as stainless steel, is rotatably mounted at one end 42 thereof to the mirror support 32. The rod 40 extends generally longitudinally along the airway inspection device 2 and, as shown in Figure 4, is rotatably connected at a second end 44 thereof to a rotatable actuator 46 mounted within the handle 12. The rotatable actuator 46 is in the form of a thumb wheel and comprises a part- ai-mular body 50 mounted on a radially directed support 52 and the support 52 is rotatably mounted to a fixed support member 54 so as to be pivotable about an axis 56. The external surface 58 of the part-annular body 50 is contoured, for example being provided with grooves 60, and a portion of the surface 58 extends upwardly through a hole 62 in the handle 12 so as to stand proud of the upper surface 64 of the handle 12.

An opening 48 is provided in the upper surface of the elongate portion 24 of the housing 4 through which opening 48 the rod 40 extends so as to be disposed along a majority of its length within the housing 4 in a concealed fashion, so that only the distal portion of the rod 40 is exposed. The opening 48 is sufficiently large so as to permit reciprocal movement of the rod 40 by the operation of the thumb wheel 46.

Rotation in a back and forth motion of the thumb wheel 46 by manual operation by a medical practitioner manually holding the handle 12 causes the rod 40 to be reciprocated in a corresponding back and forth motion which in turn causes the angular orientation of the mirror 18 to be varied. This provides very convenient control of the mirror orientation by the medical practitioner by manual operation of the thumb wheel 46.

In an alternative construction, the actuator may comprise other than a reciprocable metal rod. For example, a plastic actuator could be provided in an all plastic assembly which would facilitate cleaning and assembly of the device.

The extending portion 24 of the housing 4 is generally S-shaped towards the distal end 16 thereof. Thus the extending portion 24 comprises a near substantially straight part 70, connected to the handle 12, and an adjacent downwardly curved part 72 which in turn cotmects with an adjacent bottom curved part 74 which is smoothly upwardly curved at an upwardly directed part 76 terminating in the distal end 22. The downwardly curved part 72 has a smoothly shaped lower surface 80 which is curved and is shaped and configured so as comfortably to engage the upper surface of the back of the tongue of a patient when the elongate portion 24, carrying the mirror 18, of the airway inspection device 2 is inserted into the mouth of a patient.

The elongate portion 24 is also provided in the bottom curved part 74 with a cavity 78 extending therethrough. The cavity 78 is located beneath the mirror 18 and permits light from the airway of the patient to be transmitted up through the cavity 78 onto the mirror surface 28 which is then reflected back along a line of sight to be seen by a medical practitioner.

As shown in Figure 5, when the airway inspection device 2 is inserted into the throat of a patient, it is possible for the medical practitioner to look along a line of sight, marked as L in Figure 5, towards the front reflecting surface 28 of the mirror 18 and view in the mirror 18 a reflected image, received along a corresponding image line marked as I, from within the airway, marked as A. The line of sight passes through the cavity 78. If the medical practitioner changes the angular orientation of the mirror 18 by operation of the thumb wheel 46, this permits the medical practitioner to be able to view other images of the airway A of the patient. For example, this readily permits the medical practitioner to be able to see beyond the vocal cords of the patient.

As shown in Figure 5, the curved lower surface 80 of the downwardly curved part 72 can be held by a medical practitioner against an upper surface of the back of the tongue T so as to hold the tongue T forwardly and downwardly during the inspection of the airway A. This provides a comfortable mechanism for holding the tongue T of the patient during the inspection of the airway A which reduces the likelihood of the patient feeling discomfort or even choking.

The airway inspection device 2 of the illustrated embodiment further includes a light emitting unit 84 removably mounted within the housing 4. The light emitting unit 84 includes an outer lower face 86 which is flush with a lower surface 88 of the handle 12. A manually operable snap fit catch 88 is provided to permit the light emitting unit 84 selectably to be fitted to or removed from the housing 4. The light emitting unit 84 includes a casing 90 within which is mounted a light emitting device such as a light emitting diode 92 together with a control circuit therefor, including a source of electrical power or a connector for connecting the control circuit to such a source of electrical power. If desired, the casing may also include a rechargeable battery for storing electrical power for driving the light emitting diode 92.

A hollow tubular light guide 94 is fitted at a near end 96 thereof over the light emitting diode 92. The light guide 94 extends along the elongate portion 24 of the housing 4 to terminate at a distal end thereof in a downwardly directed light port 98. Light is reflected down the light guide 94 by internal reflection. The light port 98 is located at a bend of the light guide and, for example, is a roughened surface of the light guide to cause light emission therefrom. The light port 98 is oriented so as to direct light down the throat of the patient, in a direction substantially orthogonal to the housing. By providing the light port with a length extending about an arc around the bend of the light guide 94, illuminating light is emitted over a large angular extent, as shown by lines R in Figure 5, providing a good field of illumination of the throat of the patient. In this way, light from the light emitting diode 92 can be transmitted along the light guide 94 and then downwardly into the airway A of the patient to enable the medical practitioner to view the airway A so illuminated. Alternatively, the light port may be located and oriented so as to direct light onto the front reflecting surface 28 of the mirror 18.

The external surface of the light guide 94 is smooth and substantially corresponds to or matches the external surface of the elongate portion 24 of the housing 4 to which the light guide 94 is affixed. The light guide 94 extends along one side edge 100 of the cavity 78 so that the cavity 78 is bounded on three sides by the elongate portion 24 of the housing 4 and on one side by the light guide 94. This provides a closed cavity 78 which permits the viewing of the airway A at a variety of angular orientations of the mirror 18 yet without reducing the strength of the distal end 16 of the airway inspection device 2 so that in operation the airway inspection device 2 can securely hold down the tongue T of a patient.

The light emitting unit 84, including the light emitting diode 92, may be detached from the remainder of the airway inspection device 2. Then the remainder of the airway inspection device 2 can readily be sterilised, for example in an autoclave or in a sterilising solution.

This permits the device to be reusable. However, the device may alternatively be manufactured with the intention that it is disposable. Since the distal end of the rod 40 is exposed, this readily permits the rod 40 to be sterilised in this maimer.

The airway inspection device in accordance with the present invention provides a low cost disposable or reusable unit which can be employed easily by a medical practitioner to inspect the airway of a patient without discomforting the patient. If desired, the device may omit the light emitting device, the corresponding control unit and the light guide, although these are preferred to provide an integrated unit which is able to illuminate the airway and permit visual inspection of the airway in a single device. The mirror may also have a fixed orientation, without an actuator. This is a more simple and less expensive device.

Claims

CLAIMS: 1. An airway inspection device comprising an elongate housing

having a distal end and a near end, a handle at the near end for manual holding of the airway inspection device by a user, a mirror disposed at the distal end, an actuator in the handle for actuating movement of the mirror, and a movable connector disposed between the actuator and the mirror, whereby the angular orientation of the mirror relative to the housing can be varied by operating the actuator.
2. An airway inspection device according to claim 1, wherein the actuator is manually operable.
3. An airway inspection device according to claim 2, wherein the actuator is a manually rotatable element.
4. An airway inspection device according to any one of claims 1 to 3, wherein the mirror is mounted on a movable mount which includes, a biased hinge connected to the distal end.
5. An airway inspection device according to claim 4, wherein the biased hinge comprises a web of resilient material.
6. An airway inspection device according to any foregoing claim, wherein the movable connector comprises a reciprocable rod mounted between the mirror and the actuator.
7. An airway inspection device according to any foregoing claim, further comprising a light emitting device for emitting light from the distal end of the device.
8. An airway inspection device according to claim 7, wherein the light emitting device is remote from the mirror, and further comprising a light guide in the housing for transmission of light from the light emitting device to the distal end of the device, and a light port at the distal end for emitting light in a direction substantially orthogonal to the housing so as to be directed, in use, down the throat of a patient.
9. An airway inspection device according to claim 7 or claim 8, wherein the light emitting device is comprised in a light emitting unit which is detachably fitted to the housing.
10. An airway inspection device according to any foregoing claim, wherein the distal end of the housing is provided on an undersurface with a smooth configuration shaped to depress the tongue of a patient.
11. An airway inspection device according to claim 10, wherein the undersurface is smoothly curved downwardly and is substantially S-shaped.
12. An airway inspection device according to claim 10 or claim 11, wherein the distal end of the housing includes a light transmission cavity therethrough located under the minor.
13. An airway inspection device comprising an elongate housing having a distal end and a near end, a handle at the near end for manual holding of the airway inspection device by a user, a minor disposed at the distal end and a light emitting device for emitting light from the distal end of the device.
14. An airway inspection device according to claim 13, wherein the light emitting device is remote from the mirror, and further comprising a light guide in the housing for transmission of light from the light emitting device to the distal end of the device, and a light port at the distal end for emitting light in a direction substantially orthogonal to the housing so as to be directed, in use, down the throat of a patient.
15. An airway inspection device according to claim 13 or claim 14, wherein the light emitting device is comprised in a light emitting unit which is detachably fitted to the housing.
16. An airway inspection device according to any one of claims 13 to 15, further comprising an actuator in the handle for actuating movement of the mirror, and a movable connector disposed between the actuator and the mirror, whereby the angular orientation of the mirror relative to the housing can be varied by operating the actuator.
17. An airway inspection device according to claim 16 wherein the actuator is manually operable.
18. An airway inspection device according to claim 17, wherein the actuator is a manually rotatable element.
19. An airway inspection device according to any foregoing claim, wherein the mirror is mounted on a movable mount which includes a biased hinge connected to the distal end.
20. An airway inspection device according to claim 19, wherein the biased hinge comprises a web of resilient material.
21. An airway inspection device according to any one of claims 16 to 18, wherein the movable connector comprises a reciprocable rod mounted between the mirror and the actuator.
22. An airway inspection device according to any one of claims 13 to 21, wherein the distal end of the housing is provided on an undersurface with a smooth configuration shaped to depress the tongue of a patient.
23. An airway inspection device according to claim 22, wherein the undersurface is smoothly curved downwardly and is substantially S-shaped.
24. An airway inspection device according to claim 22 or claim 23, wherein the distal end of the housing includes a light transmission cavity therethrough located under the mirror.
25. An airway inspection device substantially as hereinbefore described with reference to the accompanying drawings.