Olive like Pezzer of ftoroplastovy D=14 mm to the Polittsera cylinder for blowing off of ear pipes, pneumomassage of eardrums, washings of a nose and bespunktsionny treatment of sinusitis

Olive like Pezzer ftoroplastovy for blowing off of ear (evstakhiyevy) pipes, pneumomassage of an eardrum, washings of a nose and bespunktsionny treatment of sinusitis.
The olive like Pezzer ftoroplastovy is applied for

• blowings off of ear (evstakhiyevy) pipes,
• pneumomassage of an eardrum and
• washings of a nose in otorhinolaryngology, and also for
• sine drainage,
• kavum - lavazha and
• sine injection, as to cheaper alternative of YaMiK to a method at treatment of sinusitis.

It is used complete with Polittser's cylinder, the CUCKOO device, otsasyvatel and other forcing and vacuumizing devices at treatment of otorinolaringologichesky diseases.
Material of olives - heat - resistant biologically inert ftoroplast, allowing to carry out disinfection and sterilization of olives by any way (sukhozharovy a case, the autoclave. Boiling, chemical and gas methods);
Olives like Pezzer ftoroplastovy have outer diameters D=18; 20; 22; 24 mm (for adults) and/or D=8; 10; 12; 14; 16 mm (for children).
Olives have a shaft with the outer diameter of 5 - 8 mm for accession of a tube with d vn. =5 - 8 mm.
Complete set by request.
Approximate ratios of outer diameter of the applied olives to growth of the patient at blowing off of Eustachian (ear) tubes and pneumomassage of an eardrum through a nose:

Olives with a diameter of 8 and 10 mm to a primenyayuttakzha for pneumomassage of an eardrum through external acoustical pass.
The product does not incorporate danger sources, ftoroplast is biologically inert, nontoxical and negoryuch.
Disinfection and sterilization - a cold way (in liquid antiseptics), autoclaving or in a sukhozharovy sterilizer (to the 200th a hail C).
Advantages of a ftoroplastovy olive before plastic - the thermal stability and a possibility of repeated use.
Advantage of a ftoroplastovy olive before metal - does not demand preliminary heating since has the room temperature and a low thermal capacity ("warm" and soft to the touch").
Advantages of a ftoroplastovy olive with a shaft before olives of klassichesy executions:
- a possibility of their use with a tube that allows to work remotely from the patient and to release a hand of the doctor (operator) since the patient holds an olive independently;
- reduction of probability of traumatizing mucous the patient's nose at the movements during manipulations.
- possibility of disinfection and sterilization in any way: from chemical to sukhozharovy.

Application techniques
I. The classical technique of a produvaniya: slukhovy pipe on Polittseru - Belogolovomu consists in the following:
1. The cavity of a nose is anemizirut by dispersion in it or installations of turund/vatnichok in it from 0,05% - 0,02% solution of a ksilometazolin for 5 - 7 minutes;
2. After an anemization (when puffiness of a mucous membrane decreases) the nose cavity is carefully cleared of slimes / allocations by a vysmarkivaniye, or an irrigation by the Spree method.
3. Establish an otoscope by one end in the patient's ear, and to others - in an ear to the person which is carrying out manipulation;
4. The tip of a cylinder of Polittser (an olive like Pezzer) is inserted into a nostril to the patient from the same party where the otoscope is established;
5. Ask the patient to begin to pronounce words lingeringly: "steamship" or "as - " or to "ku - k" - for obtaining such provision of a palatal curtain at which it blocks air current through Joana;
6. While the patient says above - mentioned sounds, the person which is carrying out manipulation vigorously squeezes Polittser's cylinder, creating thereby an elevated pressure of air in a nose cavity. A small amount of air under excessive pressure passes through an acoustical (evstakhiyevy) pipe in a cavity of a middle ear. Control of successful performance of procedure is exercised aurally - on the characteristic click or crackling heard through an otoscope (or a tube the otoskopichesky, inserted into an ear patient through an olive and connecting to the earphone at the doctor) at the time of hit of air in a drum cavity.
7. subitem 3 - 6 is repeated from the opposite side.
II. a) For washing of a cavity of a nose by means of Polittser's cylinder and Pezzer's olive after a nose anemization from 0,05% - 0,02% solution of a ksilometazolin of the patient stack on a couch sideways and insert into the nasal course which is from above an olive with the attached Polittser's cylinder (who is previously filled with the washing - out solution: physiological solution, Furacilin, other antiseptics or antibiotics). Ask the patient to begin to pronounce words lingeringly: "ku - ka", "steamship" or "as - " and slowly (! ) enter from a cylinder (or from other capacity) liquid for washing of a nose (warm physical. solution, Furacilin solution, etc. ). Solution comes out through the second nasal course which is below. For collecting flushing solution use a tray or other capacity.
Then procedure is repeated, having turned the patient on other side.
II. b) For more active washing of a nose and bosoms in addition to the item II and) the second (lower in situation on one side) nasal pass is in addition obturirut the second olive through which active removal of the washing - out liquid by means of depression creation is carried out by mechanical devices (an electrosuction, a water - jet suction, Polittser's cylinder, the syringe or other) also at lingering pronouncing patients of words: "ku - ka", "steamship" or "as - ".
Then procedure is repeated, having turned the patient on other side.

The classical technique of washing of a nose with use of the device the CUCKOO (it is recommended for small children of 3 - 5 years) is based on the principle of introduction and jet washing of cavities and bosoms of a nose with use of "the law of communicating vessels"
1. The nose cavity is previously anemizirut by dispersion in it or installations of turund/vatnichok in it from 0,05% - 0,02% solution of a ksilometazolin (or xycain combinations with noradrenaline) for reduction of puffiness for 5 - 7 minutes;
2. After an anemization (when puffiness of a mucous membrane decreases) the nose cavity is carefully cleared of slimes / allocations by a vysmarkivaniye, or an irrigation by the Spree method.
3. For performance of procedure of the patient stack on a couch sideways and insert into the nasal course which is from above Pezzer's olive with the attached Esmarkh's mug (or Polittser's cylinder) which is previously filled with the washing - out solution. The patient lingeringly pronounces words: "ku - ka", "steamship" or "as - " and having turned the crane of a mug of Esmarkh (or squeezing Polittser's Cylinder) slowly give liquid for washing of a nose (warm physical. solution, solution of Furacilin or other anti - septic tanks or antibiotics. ). Solution passes on nasal pass, okolonosovy bosoms, one half, taking away exudate, slime and pus from there and comes to light through the second nasal course which is below. For collecting flushing solution use a tray. or other capacity (at more adult patients this procedure can be carried out directly over a sink).
Then procedure is repeated, having turned the patient on other side.
III. A washing technique with the device the CUCKOO combined with method of "movement of liquids on Proyettsa" (it is recommended to children 5 years and the adult are more senior).
1. At the same time, after a preliminary anemization, the patient stack sideways on a couch. In one (top) nasal pass through an olive the washing - out liquid moves (physical. solution, furacyllean or solution of other anti - septic tanks or antibiotics), and from other nasal pass obtyurirovanny other olive, is carried out active removal of this liquid by means of depression creation by mechanical devices (an electrosuction, a water - jet suction, a cylinder of a polittser, the syringe or other).
2. At the same time ask the patient to pronounce words lingeringly: "ku - ka", "steamship" or "as - " (when pronouncing these words the soft palate rises up and pressurizes, closes a nasopharynx and a cavity of a nose, interfering with hit of liquid in a throat and in Eustachian tubes).
3. After active washing through one nasal pass, the patient overturn on other side and procedure repeat.
The technique of use of the Cuckoo device is shown for treatment of a frontit, an etmoidit and a sfenoidit, an exacerbation of chronic antritis and prolonged sharp rhinitis, especially catarrhal. It is less shown this technique at treatment of antritis because of large volume of a gaymorovy bosom (is less effective) and as a result, difficulties of creation of necessary pressure / depression for evacuation of pus and slime from a gaymorovy bosom outside (at antritis the application technique a sine drainage, a kavum - lavazh and a sine injection by means of olives or application of YaMiK a sine catheter is more effective). Application Yamik - metoda about a sine catheter is complicated in the presence of the bent partition of a nose, polyps of a cavity of a nose and bosoms of a nose, and also large adenoidny vegetations at the patient. These difficulties techniques a sine drainage, a kavum - lavazh and a sine injection by means of olives are deprived.

IV. A technique a sine drainage, a kavum - lavazh and a sine injection by means of Pezzer's olives, as cheaper alternative of YaMiK to a method at treatment of sinusitis.
Pezzer's olives can be applied to reproduction of effects of the YaMIK - method without sine catheter of YaMiK and without electrosuction. This technique quite effective though demands certain expenses of time, desire of the doctor and well trained patient.
• Unlike a puncture (puncture) of a bosom, a technique a sine drainage, a kavum - lavazh and a sine injection by means of Pezzer's olives as well as the YaMiK - method are low - traumatic, noninvasive methods of treatment of a rinosinusit. At a puncture there is always a danger of a trauma a punktsionny needle of the neighboring areas – orbits, soft tissues of a cheek, etc.
• Techniques a sine drainage of a kavum - lavazh and a sine injection by means of Pezzer's olives as well as the YaMIK - method allow to avoid such complications as a trauma, infection and suppuration of the next bodies. In out - patient conditions the puncture only maxillary is usually made (gaymorovy bosoms). It is known that during a sharp rinosinusit practically all bosoms in a varying degree are surprised (maxillary, frontal, trellised, wedge - shaped).
• Techniques a sine drainage, a kavum - lavazh and a sine injection by means of Pezzer's olives as well as the YaMIK - method, unlike a puncture, allow to make evacuation of pus from all bosoms and, respectively, to inject medicine in all bosoms.
These techniques excludes an injury of a mucous membrane and bone structure of a cavity of a nose, are painless procedures, allow to evacuate at the same time separated from several bosoms and to make delivery of medicinal solutions directly in okolonosovy bosoms. It defines pathogenetic effect of a method, and also reduces time of sanitation of okolonosovy bosoms and accelerates recovery process. Techniques it is easily transferred by patients, we will apply at children from 5 - year age and at pregnant women.
• At application of techniques a sine drainage, a kavum - lavazh and a sine injection by means of Pezzer's olives, in difference from the YaMIK - method, anesthesia is not necessary.
• The partition curvature is also not a hindrance.
• Besides, the patient himself can control a pain threshold during creation of depression in a nose cavity.
• Techniques a sine drainage, a kavum - lavazh and a sine injection by means of Pezzer's olives cost cheaper, than the YaMiK - method since it is possible to apply reusable olives of Pezzer.

1. The first task solved with the help a sine catheter – creation of negative pressure in a nose cavity at certain position of the head, (drainage) for each bosom.
In alternative option at application of olives of Pezzer osushchestvlyaetya a drainage of okolonosovy bosoms of a nose the patient on special to a technique which is called "sine drainage".
Preliminary procedures:
By a technique a sine drainage that the drainage of bosoms was effective, it is necessary previously, for 10 minutes (after injection of vasoconstrictive drops like naftizin, galazolin, sanorin, oksimetazolin, tizin, Dlyanos, otrivin, tizin ksit bio, xyflax, ksimelin, grippostad Rino, rinorus, or greasing by a probe with the wadded navivka impregnated 0,1% with adrenaline solution. ) to give to the affected bosom optimum situation. During procedure position of the head is kept.
Just before procedure it is good to pour in a nose in several drops of solution of cleaner antiseptics (for example a miramistina, etoniya, hlorgeksildin).
Miramistin is domestic antiseptics of new generation, possesses a broad spectrum of activity used in treatment virus, fungal and bakterialnykhinfektion;
Etony - bischetvertichny ammoniyevy connection which causes the bakteriostatichesky and bactericidal effects caused by violation at streptococci, stafilokokk and other microorganisms of processes of synthesis in a cellular wall. Shows also easy anesthetizing and wound healing action.
Hlorgeksidin is an antiseptics, checked by time, highly effective concerning many vegetative forms of grampolozhitelny and gramotritsatelny microorganisms, and also gerpesvirus and barmy fungi).
Reception of a raising of a soft palate
Necessary condition of carrying out procedure is development of reception of a raising of a soft palate at which it hermetically fences off a cavity of a nose and a nasopharynx from underlying departments or creation of discharge in a nose cavity during the forced breath through a mouth.
Reception of a raising of a soft palate consists in attempt of an exhalation through the closed mouth or a long exhalation through a mouth and pneumoresistance (for example, exhaled through a tube with an internal diameter of 3 - 4 5 - 6 cm long). At the same time air pressure in a rotoglotka and underlying airways increases, and the patient feels pressure upon a soft palate which is reliable how the valve, closes an exit from a nasopharynx. Lingering pronunciation patient of words: "ku - ka", "steamship" or "as - " is actually the same reception of "a raising of a soft palate", but less controllable.
In most cases it is enough to make at the beginning of procedure the forced breath through a mouth and at this time quickly to create negative pressure in a nose cavity. At a breath through a mouth the soft palate deviates kzad a little, under the influence of negative pressure in a cavity of a nose sticks and closes an exit from a nasopharynx. The sealing issue from a nasopharynx is so resolved.
In the elementary option the device for procedure a sine drainage is banal and represents the 20 ml syringe connected silicone (or rubber) a tube with Pezzer's olive.
It is all about the correct implementation of a technique!
Procedure technique sine drainage:
The doctor recommends to the patient of position of the head, optimum for drainage of the affected bosoms.
The olive from the device is hermetically entered into a threshold of a nasal cavity and is kept by the 2nd on the right, and at the left the 1st finger of the left hand. At the same time the opposite wing of a nose nestles on a partition (depending on the party) according to a free 1 or 2 finger of the same hand. The 4 and 5 fingers of the left hand cover and fix the top part of the syringe.
The patient takes the forced breath through a mouth or the above described reception allowing to lift a soft palate is carried out and, right after it, the right hand delay the piston of the syringe of a tag 5,10 or even 20 ml. In a cavity of both half of a nose notable depression is created. The size of depression is regulated by a syringe piston stroke. Depression has to be notable, but not cause unpleasant feelings and pain, not to cause after removal of an olive of feeling of a congestion of a nose.
At a large number of separated bigger depression is used, in process of its reduction it is enough to delay the piston on a tag of 5 ml. Gradually the patient himself finds the necessary depression. It is recommended to begin procedure with procrastination of the piston of the syringe to a tag of 10 ml. After creation of negative pressure in a nose cavity the patient continues to breathe through a mouth and if reception of a raising of a soft palate was executed, then can begin to breathe through a mouth (that can and be not done taking into account a short - term cycle).
Within 5 - 20 seconds discharge in a nasal cavity then the patient releases at first an opposite wing of a nose from that remains into which the olive is entered. At this moment there is an evacuation of the exudate emitted from bosoms in a nose cavity in the syringe. Then deletes an olive from other half of a threshold of a cavity of a nose. Through a small period, procedure for this bosom repeat several times, without changing position of the head. Upon termination of procedure of an olive are stored in disinfecting solution.
According to Boyle - Mariotta's law it is simple to calculate how approximately pressure in a nasal cavity at a fast piston stroke of the syringe to a tag of 10 ml will change. Let's take the volume of a nasal cavity and nasopharynx for 35 ml, then at procrastination of the piston to a mark of 10 ml this volume will increase up to 45 ml. At the same time pressure in a nasal cavity will make:
r2= p1 * V1/V2=101 325 Pa * 0,35 * 10 - 3/0,45 * 10 - 3 = 78 808 Pas.
Thus, there will be a pressure decrease in a nasal cavity approximately on 0,2 atmospheres. Certainly, in practice this figure usually happens slightly less and depends on features of a soft palate, correctness of performance by the patient of reception of a raising of a soft palate and volume of the okolonosovy bosoms which are well reported with a cavity of a nose. In process of intake of air from bosoms pressure in a cavity of a nose increases.
The depression caused by a fast piston stroke of the syringe to a mark of 20 ml usually causes unpleasant feelings.
Before teaching the patient, it is recommended to test procedure to the doctor! And nothing should be inflated in a nasopharynx! And position of the head the patient can give any necessary!
2. The second problem of the last modifications sinus - katetera - cleaning of a cavity of a nose before introduction of medicines to avoid an exudate reflux in not affected bosoms.
In the device STORK this problem is solved with the help of procedure kavum - lavazh when the aerosol, and through other half of a nose under the same pressure, but with an opposite sign comes to one half of a nose under a certain pressure, it is evacuated through Pezzer's olive. At the same time reception of a raising of a soft palate is executed. With use of make - shifts it is hard - hitting, though it is possible. Therefore the nasal shower, for example introduction of solution by means of the device the CUCKOO with an olive (capacity from which the washing - out liquid arrives spontaneously), Polittser's Cylinder or DOLFIN is recommended instead of this procedure. It is necessary to consider at introduction of the washing - out solution that at the introduction of liquid under pressure exceeding depression in another the half - aries of a nose there is a risk of hit of exudate in not affected bosoms! Therefore in the absence of control of pressure liquid supply spontaneously through the CUCKOO is more preferable.
3. The third problem of YaMiK of a method – delivery of medicines in bosoms.
Similar hardware procedure call "sine injection".
Technology of procedure sine injection make - shifts:
The patient carries out procedure a drainage sine; from conditionally healthy party, with that difference that the nurse enters a silicone tube (a subclavial catheter or the olive) connected to the syringe (or Polittser's Cylinder with an olive) filled with solution of medicine or with an olive of an aerosol can into a threshold of the struck (other) half of a nose (for example, with the preparation Bioparox), hermetically pressing them fingers.
When using solutions of medicines the head deviates horizontally on the struck party (an exception at damage of the main bosoms – the head is located horizontally, the person up, it is thrown a little back kzad).
After achievement of depression in a nasal cavity (by a technique a sine drainage) the patient gives in advance stipulated readiness sign to the nurse, and it drives medicine in a nose cavity (1 - 5 ml) or makes one injection from an aerosol can.
When using aerosols position of the head of essential value has no. Medicine comes to bosoms where negative pressure was created previously.
When using solutions characteristic sounds of penetration of liquid into bosoms are heard. Then (in several seconds), the patient exhales, and devices for a sine drainage and a sine injection are removed.
When the doctor hears characteristic sounds of passing of liquid to bosoms, it will be confirmation, as the third task is solved.

The technique several nagruzochn for the patient, but costs cheaper with make - shifts and standard olives of Pezzer, and there is a risk that the patient, having mastered a technique, can cease to go for treatment, but the same risk is also at application YaMiK catheter sine.