the endotracheal tube stabilizer 20 , of the invention includes the faceplate , flange , or collar 21 , which is preferably of soft , flexible , resilient plastic 22 so that it will easily conform to the configuration of the face 23 of a patient 24 . faceplate 21 includes at least one pair of integral ears 25 and 26 each of substantial length and terminating in tips 27 and 28 , each having holes such as 29 for strands 31 of ribbon , tape or the like for tying around the head 32 of the patient 24 to position the faceplate over the mouth 33 of the patient . the faceplate 20 is of predetermined width at least equal to the width of the mouth 33 of a patient 24 and is of predetermined height at least sufficient to abut and cover the mouth 33 , upper front teeth 34 and lower front teeth 35 . faceplate 21 is provided centrally with a wide slot 36 which is substantially coextensive in width with the width of the mouth 33 of a patient and which includes upper edge 37 and lower edge 38 which are equally spaced apart and in substantial parallelism except for two pairs 39 and 41 of oppositely disposed integral flexible , resilient prongs such as 42 , 43 , 44 and 45 . the pairs 39 and 41 of prongs divide the slot 36 into a left side aperture 46 , a central aperture 47 and a right side aperture 48 , each with straight , or flat , upper and lower walls , or edges , as at 49 and 51 which are in parallelism . the tubular mouthpiece 52 of the invention includes a tubular portion 53 , forming a &# 34 ; bite block &# 34 ;, which portion enters the mouth 33 of the patient 24 for receiving the bite of the upper front teeth 34 and the lower front teeth 35 and includes a tubular guide portion 54 extending away from the mouth 33 and flared at 55 for receiving and guiding an endotracheal tube 56 . the mouthpiece 52 includes an axial bore 57 of uniform diameter which extends generally normal to faceplate 21 and which slidably receives the tube 56 . flange means 58 is provided for retaining the mouthpiece 52 in slot 36 while permitting selective sidewise movement therein . means 58 includes a front flange 59 of circular flat configuration spaced from a rear flange 61 of generally square configuration , flange 61 being concave curved in plan to conform to the curve of the teeth of the patient . the central portion 62 of rear flange 61 is spaced from the front flange 59 a distance substantially equal to the thickness of the material 22 of the faceplate so as to prevent forward or rearward tilting of the mouthpiece relative to the faceplate while enabling side wise sliding movement of the mouthpiece in the slot 36 . the upper surface 63 and the lower surface 64 of the portion of mouthpiece 52 between the flanges 59 and 61 are each flat and parallel to each other so that the mouthpiece will slide side wise in slot 36 but will not turn on its axis . the upper surface 65 and the lower surface 66 of the bite block tubular portion 53 are also flat and parallel to each other to conform to the flat configuration of the upper and lower front teeth 34 and 35 . in operation the mouthpiece 52 is affixed in the slot 36 of faceplate 21 by flexing the material of the faceplate , in the area of the slot , aound the front flange 59 until the faceplate is received in the gap 67 between flange 59 and flange 61 . with the bite block portion 53 of the mouthpiece inserted in the patient &# 39 ; s mouth , the ears of the faceplate are then bent to conform to the shape of the patient &# 39 ; s face and the faceplate tied around the patient &# 39 ; s head by the strands 31 . the mouthpiece may start in the central aperture 47 and the endotracheal tube 56 slid into the bore 57 and down into the trachea . a cuff not shown but well known may then be inflated by the conduit 68 extending along a shallow groove 69 in the wall of the axial bore 57 in a well known manner . the endotracheal tube 56 is usually taped to the guide portion 54 of the mouthpiece to slide with the mouthpiece into side aperture 48 or 49 when the attendant or physician feels that the patient &# 39 ; s mouth and teeth need relief . the other unused apertures permit insertion of other tubes into the mouth for any desired purpose . as shown in fig9 - 15 a tubular mouthpiece 71 of preferred construction corresponds to tubular mouthpiece 52 in having a tubular portion 72 forming the &# 34 ; bite block &# 34 ;, a tubular guide portion 73 and an axial bore 74 of predetermined , uniform diameter which slidably receives a tube 56 of slightly less predetermined uniform diameter . the tube 56 is of resilient compressible material such as rubber or plastic so that it may be compressed to oval cross section as shown in fig1 . mouthpiece 71 includes the integral flange means 75 , corresponding to flange means 58 , for retaining the mouthpiece 71 in slot 36 while permitting selective side wise movement therein . however , holes 76 , 77 , 78 and 79 are provided in each corner of the flange means 75 , each having a curved entrance slot such as 81 leading thereinto to enable tapes 31 to be directly attached if desired , without the use of a faceplate 21 . the outwardly projecting , fixation flange 82 of flange means 75 , corresponding to rear flange 61 is similarly curved to take the shape of the face and teeth of the patient 24 . the tubular portion 72 of mouthpiece 71 , includes a elongated , annular , protruberance 83 , extending therearound and which co - operates with fixation flange 82 in assisting the patient 24 to retain the bite block between his teeth without tendency to slip , slide or dislodge . the fixation flange 82 of flange means 75 is provided with a recess 84 and 85 , each on an opposite side thereof . the entire mouthpiece 71 is provided with a full length , tapered , slot 86 flaring from an outer opening 87 , in flange 82 , considerably greater than the outside diameter of the compressible tube 56 to the inner opening 88 , at the bore 74 , which is substantially smaller than the outside diameter of tube 56 . it will be seen that the mouthpiece 71 may be used without a face plate by slipping tapes 31 into slots 81 and thence into tape holes , 76 , 77 , 78 and 79 ( fig1 ) and tying the tapes around the head of the patient . the patients teeth are clamped on the bite block portion 72 and the tube 56 may be quickly locked in bore 74 by sliding it laterally through tapered slot 87 , compressing it at opening 88 and allowing normal expansion to retain the tube from side wise movement . ( fig1 ). while the tube 56 is shown of smaller diameter than the bore 74 in fig1 , to enable longitudinal movement inwardly and outwardly of the mouthpiece when desired , it may prove desirable in some cases to have the tube make a close friction fit in the bore so that it will not slide in and out easily but can be inserted and withdrawn laterally through slot 87 with ease and rapidity . thus when the tube 56 will not slide easily out of bore 74 , and mouthpiece 71 is mounted in a faceplate 21 , as shown in fig9 the mouthpiece may be moved side wise past prongs 39 or 41 to left side aperture 46 or to right side aperture 48 or the tube may be compressed to pass opening 88 and slide freely in opening 87 of slot 86 for longitudinal shift or removal .
an endotracheal tube stabilizer avoids the pain of repeatedly stripping tape from the face of a patient , which affixes an endotracheal tube in position , and avoids damage caused by continuous pressure on one spot of a patient &# 39 ; s mouth and teeth on a bit block by providing a straight mouthpiece with an outwardly projecting , integral fixation flange held in position by strands around the head which are received in holes in the fixation flange . the entire mouthpiece including the fixation flange is longitudinally slit with an opening substantially smaller than the outside circumference of the tube , so that the tube may be compressed for sidewise insertion .