Apparatus for treating nasal organs

April 28, 1942. r. _{M W}ri_GHt etal 2,280,992

APPARATUS FOR TREATING NASAL ORGANS Filed Jan. 8, 1940 3 Sheets-Sheet 1

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April 28, 1942. r, m. wright et al 2,280,992

APPARATUS FOR TREATING NASAL ORGANS Filed Jan, 8, 1940 3 Sheets-Sheet 2

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April 28, 1942. r. _M wright etal 2,280,992

APPARATUS FOR TREATING NASAL ORGANS Filed Jan. 8, 1940 3 Sheets-Sheet 3

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Patented Apr. 28, 1942

2,280,992

UNITED STATES PATENT OFFICE

2,280,992 APPARATUS FOR TREATING NASAL ORGANS Russell M. Wright and Carl Voorhies, Detroit, Mich.

Application January 8, 1940, Serial No. 312,810

Claims. (Cl. 128—297)

This invention relates to medical equipment in general for treating nasal organs and more particularly concerns an apparatus providing means for effecting complete treatment of the sinuses. 5

Heretofore in the treatment of sinus. sufferers the_: physician in cleaning out, flushing and treating the mucous membranes lining the sinuses, has had, insofar as this applicant knows, access to only the simplest form of power operated low- 10 pressure spray gun for introducing a medicated solution into the nasal openings leading to the sinuses. If the membranes of the sinuses were too inflamed to effect normal drainage of the sinus chambers it was usually necessary to open 15 a drainage passage therefrom by packing the upper end of the nasal openings with medicated swabs containing styptics effective to shrink the membranes lining the openings to the sinuses. Thereafter under normal circumstances the si- 20 nuses would slowly permit drainage of the secreted pus, fluid and other foreign matter trapped in the affected sinuses, which are normally hollow air chambers, and which: under a clogged condition cause much pain to the sufferer. The 25 aforementioned method of treatment is somewhat long drawn out for a conventional “office call” as the patient must usually remain in the physician’s office during the interval the nose remains packed and while the medicine for 30 shrinking the inflamed membranes is taking effect. Thereafter the packing is removed and an antiseptic or germicidal solution is sprayed or introduced into the sinuses, and then a healing and soothing oil or balm is used to cover the 95 tender surfaces before the patient leaves. This procedure is disagreeable to handle, very susceptible of. spreading the ailment, and causes the patient much suffering. Therefore a system of treatment which would obviate the above objec- 40 tionable factors, be relatively more sanitary, economical to administer, cause less suffering to the patient in the treatment, and be readily portable for use in any office or home would find ready acceptance. Accordingly, to this end, the 45 apparatus of the present invention contemplates the provision of means for selectively administering a nasal tube charged with a heat-tempered medicated solution under regulated pressure, or producing a regulated vacuum in the nasal cham- 50 bers to introduce a medicated solution in one nostril and draw out the mucus, pus and other foreign matter in a circuit through the sinuses and out the other nasal chamber.

Among the objects of this invention is the 55 provision of an apparatus providing means for treating certain ailments of the human body which are relatively inaccessible without surgery and deep seated and that are reactive to a system of treatment which comprises the introduction of a medicament to the affected part and the withdraw of the combined used medicament and infected matter in solution into a trap joined in circuit with a vacuum producing means and thereafter selectively reversing said system circuit to provide means for the introduction of a heat-tempered medicated solution in a low-pressure spray form to envelope the affected parts with a protective coating of a healing and soothing balm; the provision in an apparatus as above described of control means for selectively reversing the system circuit from a pressure producing system to a vacuum producing means, and separate control means for independently regulating the amount of vacuum and/or pressure produced; the provision of means in an apparatus as above described comprising yieldable valve means for limiting to a predetermined amount the extent of vacuum or pressure produced, including dial gauges for viewing the degree of positive or negative pressure in the system; the provision in an apparatus as above described of means comprising a sanitary filter trap in the vacuum branch of the system circuit for the removal of bacteria and lighter foreign particles hot retained by the trap but carried in suspension in the vacuum line back into the apparatus and their separation from the apparatus before deposition in the valve parts or conduits thereof, including removable filter means for periodically readily cleansing and renewing the filter trap; another object of this invention is the provision of means in an apparatus as above described comprising an air heater and sterilizer, having a fixed maximum operating temperature, in series with the pressure branch of said system and affording a heat tempering and purifying member for the introduction of pure treated air and/or medicated spray to the affected part.

. Other objects of the invention include the provision of apparatus having its component parts so constructed and arranged that it may be compactly mounted substantially in its entirety as a unit upon a removable panel board forming a section of a housing cabinet; the provision in an apparatus as described of a unit pump and driving means therefor loosely disposed in said cabinet connected through flexible conduits to said system circuit; the provision in an apparatus as above described of muffler means on the air in2 2,280.092 take side of said vacuum and/or pressure branch of the system circuit for quiet operation of the apparatus when inducting or discharging a fluid medium into or from the atmosphere, namely, air.

Further and other objects and advantages of the invention reside in the novel combination and arrangement of parts and will become apparent as disclosed in the attached drawings, which form a part of this specification, and are limited in scope only by the extent of the appended claims.

Like numerals have been used to designate similar parts throughout the several views, and in which:

Fig. 1 is an elevational view of a panel board for mounting the attached instruments and controls shown upon a reduced scale; and

Fig. 2 is a rear elevational view of the back of the panel shown in Fig. 1, and is drawn on a much larger scale; and

Fig. 3 is an end elevational view of the apparatus, shown in Fig. 2, taken substantially on the line 3—3 thereof, and includes a sprayer attached to the pressure side of the system.

Fig. 4 is a similar end elevational view taken from the opposite side of the view shown in Fig. 3, substantially on the line 4—4 of Fig. 2, and includes an associated combination of medicament vial and. mucous trap vial means in the vacuum branch of the apparatus.

Fig. 5 is a sectional plan view through the regulatable vacuum valve taken substantially on the line 5—5 of Fig. 4; and

Fig. 6 is a sectional elevational view of the spring-tensioned regulatable pressure valve of Fig. 3.

It will be noted that substantially the entire components of the apparatus of the present invention are nicely and compactly arranged upon the rear face of a panel board, with the exception of the energizing means comprising a vacuum-pressure pump, and as such may be mounted as a unit in a cabinet for office use, or may be housed in a portable case for traveling, only a source of electric power being necessary to plug into for energizing the driving means of the pump. Likewise, since the initial diagnosis of most nasal disorders includes a careful examination and illumination of the sinuses, a pencil-like light having a strong concentrated beam is used, and because these ear or nose lights operate at a reduced voltage below that of the standard power supply, a convenient outlet or socket is incorporated in the panel layout for the operator’s ready use as will be hereinafter described.

Now having reference to the drawings, and particularly to Figs. 1 and 2, the assembly and other component parts of the apparatus are shown. A mounting board or panel, generally designated 10, of rectangular outline and preferably composed of Bakelite, plastic, wood, or other dielectric material, has a plurality of holes 11 in the corners thereof for mounting the panel in a cabinet or portable case and a series of stamped or cored openings in the central portion of the panel body for the reception of the dial gauges, valve controls and other component parts of the apparatus. As previously mentioned, the system circuit comprises a vacuum branch and a pressure branch, and since the common means to the two branches of the circuit is an energizing means which includes a powered pressure-vacuum pump, the system description will begin there and extend progressively through each branch of the circuit to the respective outlets therefor.

A pump unit 12, which energizes the circuits, is a compact combination vacuum-pressure pump 5 and electric motor driving means coupled thereto and all housed within a small cylindrical shell. That is to say, the pump is of the conventional vane type which has a pressure side and a suction side from which extend flexible conduits 14 10 and 16, respectively. This pump unit, which has its own rubber tipped feet to stand on and requires no mounting means, may be located at any convenient location in the cabinet behind the panel board 10 and controlled from the face 15 of the panel by a snap-on switch 11 secured therethrough which is connected in series with - the motor current wire and a source of electric power, not shown. A jeweled bezel 18 with an electric light in line therewith is also mounted 20 through the panel 10 adjacent the switch 17 and being connected across the switch provides a visual tell-tale means for determining when current is flowing through the switch and the pump motor is on.

The conduit 14, leading from the pressure side of the pump 12, extends to a short pipe line 23 which is threadedly secured by any suitable nipple means to one port of a two way, spring seated, valve cock 22, which is also mounted on the rear Ί of the panel 10 and operated from the front face thereof by a handle 23. A second port of the valve cock 22 also has a pipe line 25 threadedly secured thereto through a similar nipple means. The remaining port of the valve cock *’’⁵ 22 has a relatively smaller pipe line 2S similarly threaded thereto and its free end is rolled up into a hollow cylindrical formation to provide a muffler 21 in which are a series of atmospheric openings 28 in adjacent convolutions thereof, for a pur⁴⁰ pose to be hereinafter described in the operation of the system. Since the two-way valve cock 22 may be adjusted by the handle 23 to only a pressure or vacuum setting, not including the “off” position, i. e., to provide communication between *⁵ pressure line 20 and pipe line 25, or between the muffler 21, pipe line 25 therefrom and pressure line 20, respectively, it will be hereinafter referred to as the control means for convenience of refergg ence purposes in differentiating between this con^υ trol and separate adjustable valve means which regulate the degree of pressure or vacuum in the branches of the System circuit.

The pipe line 25 is in fluid tight communication with one port of a cross or four-way fitting 30 which is threaded into the end of an adjustable valve 32 which is secured to the rear face of the panel 10 by any suitable fastening means. A rotatable knob 34 on the front of -0 the panel board has an operating shaft extend^u ing therefrom for effecting regulation of the valve 32. Another relatively smaller pipe line 35 is threaded by a conventional nipple means on one end thereof into a second port of the fit_eg ting 30 and extends to and in communication with a pressure gauge 35 mounted by any suitable fastening means 37 and projecting through an opening in the panel board for viewing from the front face of the panel the extent of pressure in the system circuit. From the remaining port of the fitting 30 a pipe line 38 is in communication with a heater and sterilizer 40, preferably in the form of a cartridge or bomb, with a base 41 supported by a bracket 42, con75 nected through threaded fastening means 43

2,280,992 to the rear face of the panel 10. The heater and sterilizer 40 may consist of a heating element comprising a wire having a predetermined resistance, and hence a fixed operating temperature, in the hollow interior of the shell which 5 is enveloped on its outer periphery by an insulating material to prevent radiation and heat losses therefrom. The heater is; connected in series with a switch 45 located adjacent thereto and mounted through the panel 10 for control 10 from the; front face thereof. Above the switch 45 is a jeweled bezel 46 having a light in line therewith and connected across the switch for visualizing when current is flowing through the switch and the heater 40 is functioning. A fur- 15 ther pipe line 48 is in communication with the outlet from the heater and extends to a flexible conduit 50 forming an outlet: from the apparatus for connection to any desired equipment or instruments for use on the patient, one 20 embodiment of which will be hereinafter described. :, The location of the heater or sterilizer 40 in: this_; order in the pressure branch of the circuit, after the control 22, the adjustable valve 32 and just before transmission to the patient, ₂₅is preferred not only as concerns conservation of heat losses from the tempered fluid but more particularly because the operating temperature of the heater was found to introduce problems of heat expansion of the metal and operation of 30 the aforementioned valve parts and the fluid tightness of other component soldered joints and seals, which is entirely obviated by the illustrated circuit; however this is not intended as a limiting location because obviously a choice selec- 35 tion of various available metal alloys or fibers for the valves and controls would reveal materialsnot readily affected by heat.

Now having reference to Fig. 6, there is shown a sectional plan view of the adjustable valve 32, 40 for regulating the degree of compression in the pressure branch of the system circuit, and which is provided with means for limiting the maximum pressure obtainable to a predetermined value. The rotatable knob 34, in Fig. 1 or Fig. ₄₅3, has an axial shaft extending through the panel IS into one end of a rectangular hollow sleeve, 52 disposed on the interior bore of the valve body 32. The opposite end of the sleeve 52 is fitted over a complementary shaped stud 53 jq integral, with a screw member 54, which is threaded into the body of the valve and adapted to be moved forward or back by the knob 34. Upon the opposite axial end of the screw member 54 one end of a spring 55 is secured, _δ5which has the other end attached to a piston 56 movable in a cylinder bore 57 of reduced diameter. An opening 58, which is preferably in the i form of a slot, as best shown in Fig. 3, exhausts to _: the atmosphere from a point_: in the ₆q cylinder bore 57. The spring 55 is adapted to transmit rotary movement of the knob 34 to effect forward movement and retraction of the piston 57 to control the degree of pressure in the circuit;: and it will be obvious that, by a ¢5 proper selection of the spring pressure desired, any force on the opposite side of the piston greater than the force required to collapse the spring will move the piston axially inward in its: cylinder until the exhaust slot 58 is uncov- 70 ered to relieve the excess pressure in the system, after which it will again automatically close the opening. By so limiting the maximum pressure obtainable in the system any possibility of accidentally applying an injurious amount to 75 the patient by an inexperienced operator is avoided.

The description of the vacuum branch of the system circuit is much the same as the initial component parts of the pressure branch of the circuit. Now having reference to Figs. 1, 2 and 4, there is shown a flexible conduit 16, leading from the suction side of the pump 12, that extends to the free end of a short pipe line GO which is threadely secured by a nipple on the opposite end thereof to one port of a two-way valve cock 62, similar to valve cock 22, and also secured to the rear of panel 10 and operable from the front face thereof by a handle 63. One port 64 of the two remaining ports of the cock 62 is open to the atmosphere, and the remaining port has a pipe line 66 extending therefrom to another four-way or cross fitting 67. The valve cock 62 which selectively communicates the vacuum branch of the circuit with the energizing means is similar in operation to member 22 and will hereinafter be referred to. as vacuum control 62, for convenience of reference purposes in distinguishing from its associated adjustable valve which regulates the degree of vacuum in the circuit in accordance with the setting of control 62.

The four-way fitting 67 is threaded in the end of an adjustable valve 69, also mounted on the rear of the panel 10 similarly to valve 32, and which has a rotatable knob 70 on the front face of the panel for effecting adjustment movement of the valve. A relatively smaller pipe, line 72 is threaded by a nipple means into a second port of the fitting 62 and provides the feed line for a vacuum gauge 73 mounted through the panel 10, which is secured thereto by fastening means 74, for viewing the dial indicating the degree of vacuum in the circuit from the front of the panel, all as similar to the pressure gauge 36 previously described. A by-pass pipe 75, which has one end sealed into a third port of the fitting 67, is shunted around the metering means of the valve 69 into the interior of the valve body, and functions in a manner as will be described in connection with operation of the valve 69. From a fourth port of the fitting 67 a pipe-line 76 extends into the interior of a filter trap 78.

The filter trap 78 may comprise an inverted glass bowl 79 threaded into a cover member 80 which is supported by the pipe line 76 extending thereinto a substantial distance. Another pipe line 82 is sealed to the cover member 80 and is in communication with the interior of the filter trap. The free end of pipe line 82 is encased by a flexible conduit 84 which is the outlet, or more correctly, since this is a vacuum line, the inlet to the apparatus for connection to any selected surgical apparatus or instruments for use on the patient, one embodiment of which will be hereinafter described. . The filter trap 78 is designed so as to be covered on the interior, especially adjacent the opening of pipe-line 82 thereinto, with a piece of absorbent tissue, such as filter paper or cleansing tissue, whereby any foreign matter or infectious germs evacuated from the patient which is carried by a liquid trap adjacent the administering instrument and entrained in the vacuum line, may be caught by the filter trap and prevented from reaching the interconnected controls and valves of the apparatus forming the system circuit.

In Fig. 5 is shown a sectional plan view of the adjustable valve 69 which regulates the extent of vacuum in the vacuum branch of the circuit, and.

3,980,00^ that is provided with means for limiting the maximum vacuum obtainable. This valve is very similar to pressure valve 32 before described but has an important distinction in the means arranged to limit the degree of vacuum produced. The rotatable knob 70 in Figs. 1 or 4, has an axial shaft projecting through the panel 10 and extending into one end of a rectangular hollow sleeve 86 freely disposed in the interior bore of the valve body 69. The opposite end of the hollow sleeve is slidingly fitted over a complementary shaped stud 87 integral with a screw member 88, threaded into the body of the valve and arranged to be projected forward and retracted by the knob 70. A spring member 89 is secured to the opposite axial end of the screw 88, and is arranged for connection with a piston 90 movable in a cylinder bore 91 of reduced diameter in the valve body. An opening 93 through the peripheral wall of the valve, between the piston 90 and the screw 88, communicates with the atmosphere. As in the description of the pressure valve 32, the spring 89 is adapted to transmit rotary movement of the knob 70 to effect forward movement and retraction of the piston to control the degree of vacuum in the circuit, and the spring is preselected to accommodate the desired break down point in the vacuum line. However it will be noted that, since a vacuum is being drawn through the fitting 67, on the end of the valve, as the extent of vacuum is increased by movement of the piston in the valve body until the vacuum overcomes the resisting force of spring 89 an opening such as 93 would have no vacuum relief function, in the manner that the slotted opening 58 of valve 32 provides a pressure relief as in Fig. 6. Accordingly, the by-pass tube 75 is shunted around the piston 90; now when the measure of vacuum in the circuit overcomes the selected spring tension the piston will be drawn forward and seated upon the end of the cylinder bore 91, as shown, to uncover the entrance to the by-pass tube and communicate the atmospheric opening 93 with the main line thus breaking the vacuum, and after the vacuum has fallen to a safe amount will automatically close and recharge the system. It may be noted here that under a badly congested condition of the sinus passages, for example, where impeded by a polyp, or jelly-like matter, which should be removed with a snare, the reading on the vacuum gauge would increase to a degree harmful to the patient due to the congestion, if no means were relied upon other than the operator to watch the dial gauge, but in view of the safety vacuum relief means incorporated in the valve structure such a possibility is obviated. Furthermore, with the present invention the operator by observing the reading on the dial gauge increase until the safety relief vacuum is reached may be advised of the presence of such blocking matter and have an opportunity to remove the same as mentioned above before completing the treatment.

The operation of the apparatus is as follows: the heater 40 is energized by the switch 45 and the tell-tale light 46 glows to indicate that current is flowing through the unit. After the heater reaches its operating temperature the pump 12 is energized by the switch 17 and the associated tell-tale light 18 indicates its functioning. The control handles 63 and 23 are both turned to indicate either a vacuum or pressure setting in accordance with the function selected. The valve 32 or 69 is adjusted by the regulator knob 34 or 70 to secure the desired reading on the gauges 36 or 73, respectively, in accordance with the setting of the control handles 23 and 63. Assuming that the apparatus has been set to function in a pressure producing manner, air r, will be inducted through the atmospheric opening 64, into the control 62, through the channels 60 and 16 to the suction side of the pump and compressed fluid will flow from the pump through the pipes 14, 20, into the control 22, the 10 pipe 25, and through the pressure adjusted valve 32 into the heater and sterilizer 40 from the pipe 38. From the heater 40 the pipe 48 conveys the tempered compressed fluid to flexible conduit 50 which forms the outlet from the apparatus. As 15 shown at the right hand side of Fig. 3, there is illustrated a simple form of sprayer which may be connected to the pressure line 50. This instrument comprises a test tube or vial 100, with an apertured sealing cover 102 closing the open 20 top thereof. A hollow tube 103 extends diametrically through the cover 102 and has a nozzle 104 on one end thereof for insertion in the nasal columns. Upon the other end of tube 103 is a thumb valve 106 for communicating the pres25 sure line 50 secured adjacent thereto with the nozzle. Intermediate the valve 106 and the nozzle 104, in the tube 103 is an aspirator tube 108 having its upper end bonded into the interior bore thereof substantially on the axis and facgQ ing in the direction of fluid flow. The lower end of the aspirator tube extends deep down into the test tube 100. Obviously when the system circuit is functioning in the manner above mentioned, and the thumb valve iOS is depressed, S3 the medicament or styptic carried in the vial or test tube will be drawn from the reservoir by the aspirating effect produced around the upper end of tube 108 and sprayed from the nozzle 104 in an atomized form to whatever part of the anat40 omy desired, in this case the nasal column.

Now if the styptic has been deposited in the nasal columns, the entrance to the sinuses, and accomplished its opening function, and it is desired to flush out or irrigate the sinus chambers, -;_y an apparatus such as shown in the upper left ^4-' hand side of Fig. 4 is used. This apparatus consists of two test tubes or vials HO and ill secured together by the bracket 112. The test tube 110 may be open to the atmosphere and partially filled with a germicidal or flushing so’’ lution, and have a discharge outlet at the bottom thereof to which is attached one end of a flexible tube 114, containing a petcock 115 intermediate its ends, and a nozzle 116 depends from its lower end for insertion into one nasal opening of the ’’’ patient. The other test tube 111 has an apertured cover member 117 tightly closing the open upper end thereof and from which extends a tube 118, having one end deep down in the test tube, and the other free end supporting a nozzle 119 for insertion into the other nasal opening of the patient. A T-shaped hollow pipe 120 has one arm of the T in communication with the interior of the test tube 111 and the opposite free _G5 end 121 of the arm open to the atmosphere. ^J The depending leg of the T is inserted in the suction line 84 of the vacuum producing system circuit. Now if the system is cycled so that the control handles 23 and 63 are set to a vacuum γθ reading and the regulator knob 70, of the vacuum valve 69, is adjusted to produce the desired degree of vacuum, as visualized by the gauge 73, a vacuum will be drawn through the atmospheric opening 121, the line 84, Alter trap 78, adjusted 75 valve 69, pipe line 66, control 62 and into the

3,280,992 g suction side. 16 of the pump 12. The exhaust of the pump will now be handled through the pressure side of the pump and on through and out of the pressure branch of the system as previously described. It will be noted here that in this &amp; vacuum producing cycle of the system the control 62 has the atmospheric opening 64 closed from communication therewith and hence draws through the opening 121, of the T shaped pipe 120, and line 84; while the control 22 is set so io that the port supporting the pipe line 26 is in communication with the muffler 27 for a quiet exhaust to the atmosphere.

It will be obvious that if the bracket 112, and the tubes 110 and ill supported thereby, are J5 grasped in the hand of the operator, the nasal nozzles 116 and 119 inserted in the nostrils of the patient, the petcock 115 opened, and the thumb of the operator placed over the opening 121, the vacuum line will be closed to the atmosphere and qq be drawn in a circuit through the medicament fed by gravity into one nostril through the sinuses and out the other nostril. Most of the mucus and pus or foreign matter evacuated from the patient will be deposited and trapped in the test tube 111 before being carried into the interconnected lines and valves of the system. Any smaller particles or germs which are light enough to be entrained in the vacuum line will be caught by the filter trap 78 next in series in so this branch of the circuit. It will be further noted that since the exhaust from the apparatus, when it is functioning in a vacuum producing manner, may be through the pressure branch of the system, any extraneous impurities can be 35 passed through the heater and sterilizer 49 and thus neutralized or killed, whereby they will not be transmitted further on the next cycle of the apparatus, to the same or another patient.

Other combinations in which the apparatus of 40 the system circuit may be arranged to produce variations of the straight vacuum or pressure producing functions may be illustrated. For example, when the apparatus is caused to operate in a full vacuum producing manner by setting ^5 the handle 23, of the control 22, so that the exhaust or pressure side of the pump is passed through the pipe line 25, instead of through the muffler 27 to the atmosphere, and through the sterilizer or heater 40 to the outlet conduit 50, in- 50 stead of dissipating this pressure to the atmosphere it may be put to useful work. Obviously now the pressure gauge 36 will record a pressure in the exhaust line and the metering valve 69 by its regulator knob 70 may be adjusted to suit; 55 thus the system will be producing full vacuum effect and minor pressure characteristics at the same time, or any ratio of the same, under separate and independently controllable metering means. Accordingly, the said exhaust pressure eo available in the conduit 50 may be conveyed to an apertured cover member 124 secured in the test tube 110, as shown in Fig. 4. Under this arrangement instead of the medicament solution normally contained in the test tube 110 being fed 65 by gravity, there will be a pressure behind the solution to positively force the matter through a badly blocked condition of the nasal passages or sinuses, if such be the case.

From the foregoing description it will be apparent that among other things a novel and useful apparatus and method have been provided for accomplishing the first mentioned objects of this invention; however, it is to be understood that since only one embodiment of this invention has been disclosed it is not intended to be limited to the specific construction herein disclosed but to cover all modifications fairly within the spirit of the broad invention and limited in scope only by the extent of the appended claims