JPH066801Y2 - Nerve discriminator - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Object of the Invention] (Industrial field of application) The present invention aims to identify nerves by applying electrical stimulation to a nerve part of a patient and detecting the movement of muscles that move by the stimulation. The present invention relates to a nerve identification device.

(Prior Art) In neurosurgery, there is a disease in which a tumor occurs on the temporal region. In this disease, tumors press nerves and cause various disorders. For this, surgery is performed to remove the tumor. In this procedure, the tumor must be removed without removing the nerve. For this purpose, the nerve site may be detected, and the tumor may be excised by removing that part. Then, in order to identify the nerve, a method of stimulating a nerve part with an electric stimulator, detecting the movement of the muscle moved by the stimulus with an acceleration sensor or a vibration sensor, and displaying the detection signal on a display device. Has been adopted. By the way, during the above-mentioned operation, the site other than the operation site of the patient (on the parietal side of the ear) is covered with a sterilized covering cloth, and therefore, there is a situation in which no movement of the face can be seen during the operation. Therefore, although an attendant has also been used to inform the patient of the movement of the patient from under the cloth, it is inconvenient, and the method described above is adopted for this purpose.

(Problems to be solved by the invention) However, in the past, a device for applying electrical stimulation to a nerve part and a device for detecting and displaying movements of muscles were separately provided, and therefore those devices were separately provided. It is troublesome to handle and the installation location is difficult in the operating room, and reliable detection of skin movements (reactions) is not possible because these devices are not compatible with this surgery. There was a drawback that I could not.

The present invention has been made in view of the above circumstances, and an object thereof is to reliably detect whether or not a nerve is present, and is easy to handle.
Moreover, it is to provide a nerve identification device that can be installed in a small number of places.

[Means for Solving the Problem] (Means for Solving the Problems) The present invention provides a nerve identifying apparatus for identifying a nerve by applying electrical stimulation to a nerve part of a patient and detecting the movement of a muscle moving by the stimulation. A stimulator for directly applying electrical stimulation to the site, an electrical stimulus output device that outputs a pulse voltage for electrical stimulation to the stimulator, and a soft device that is attached to the patient's skin surface and follows the movement of the skin. Vibration detection provided with a member-made membrane and a pressure-sensing element which is arranged so as to be pressed by a protrusion of the membrane and detects a movement of a muscle that is moved by stimulation of the stimulator by detecting a change in the pressing force. And a vibration detection display device that amplifies and displays a detection signal from the vibration detector, and the electrical stimulation output device and the vibration detection display device are housed in a single housing. Having the features the time.

(Operation) According to the above means, the electrical stimulation output device and the vibration detection display device can be handled as one device, so that the installation place can be reduced. Further, since it is composed of a small-sized detector that surely detects the optimal stimulation condition and skin movement for the operation, the reliable operation can be performed.

(Embodiment) An embodiment of the present invention will be described below with reference to the drawings.

First, in FIG. 1 showing the overall configuration, reference numeral 1 denotes a main body case which is a housing, in which an electric stimulation output device 2 and a vibration detection display device 3 which will be described later are housed. Is connected to a stimulator 4 made of bipolar tweezers for electrically stimulating the nerve site A via a lead wire 5, and the vibration detection display device 3 is a small vibration detector for detecting muscle movement. 6 are connected via a lead wire 7.

The electrical stimulation output device 2 is, as shown in detail in FIG. 2, a pulse waveform oscillating circuit 8 for oscillating a pulse wave required for electrical stimulation, and a current amplifier circuit for amplifying the pulse wave to a required current amount. 9, a booster circuit 10 for raising the pulse wave to a required voltage, and an output voltage display circuit 11 for displaying the output voltage. The booster circuit 10 supplies a pulse to the stimulator 4 for electrical stimulation. It is designed to output voltage. Further, the vibration detection display device 3 includes a vibration detector 6
A signal amplification circuit 12 for amplifying the detection signal from
The sounder 13 displays the detection signal as a sound.

As shown in FIG. 3, the vibration detector 6 includes a case 14 having a bottomed short cylindrical shape with an open lower surface, and a pressure sensing element 15 formed on the inner bottom of the case 14 and made of, for example, a semiconductor pressure chip. And a thin membrane 16 attached to the case 14 so as to close the lower surface opening thereof. The membrane 16 is made of a soft material such as silicone rubber, and a protrusion 17 whose tip presses against the pressure sensing element 15 is provided at the center of the inner surface, and a protruding portion 16a protruding laterally from the case 14 is provided at the periphery. Has been. Thus, in the vibration detector 6 having such a configuration, when the pressing force of the protrusion 17 against the pressure sensing element 15 changes due to the deformation of the membrane 16, the change in the resistance of the pressure sensing element 15 causes the change. A change in voltage is output to the vibration detection display device 3 as a detection signal.

Next, the operation of the above configuration will be described. The vibration detector 6 is attached to the face, for example, in the vicinity of the outer corner of the eye with a bandage (not shown) so that the membrane 16 is pressed against the skin. And
The electrical stimulation output device 2 sets a pulse frequency and a pulse width necessary for electrical stimulation and a pulse voltage of an output voltage and outputs the pulse voltage to the stimulator 4, and the stimulator 4 is applied to a nerve site A that controls muscles in the vicinity of the corners of the eyes. Give electrical stimulation. Then, the muscle contracts and extends based on this stimulus. Along with this movement, the membrane 16 of the vibration detector 6 is deformed so as to be curved, so that the pressing force of the protrusion 17 against the pressure sensing element 15 changes, and this change is detected by the vibration detector 6 as a detection signal. 3 and the detection signal is amplified by the signal amplification circuit 12 and only when this signal is present, the acoustic device 13 sounds and displays a sound of a specific frequency. By listening to the sound, the operator can determine whether or not the muscle has moved.

According to the above-described embodiment, the electric stimulus output device 2 that outputs the pulse voltage to the stimulator 4 and the vibration detection display device 3 that amplifies and displays the detection signal from the vibration detector 6 are included in one body case 1. Since they are housed in the device, they can be handled as a single device, are easy to handle, and are compact as a whole, so there is no need to worry about the installation location even in a small operating room. Further, since the vibration detector 6 for detecting the movement of muscles is small and lightweight, it can be securely fixed to the skin with a bandage or the like, and the membrane 16 easily fits on the skin.
Since the movement of the muscle is detected by the pressure sensing element 15 based on the deformation of the body, it is difficult for noise such as body movement to enter, and only the movement of the muscle can be surely detected. It can be surely identified, and thus reliable surgery can be performed. In addition, since it is difficult for electrical noise and the like generated by the stimulator 4 to enter the vibration detector 6, there is an advantage that the circuit configuration of the signal amplification circuit 12 of the vibration detection display device 3 can be simplified. . In addition, in the above-described embodiment, the fact that the muscle has moved is displayed by the sound device 13 by sound, so the surgeon does not need to check the presence or absence of muscle movement at a glance, and other operations You can check while doing.

In addition, in the above-mentioned embodiment, it is used to identify nerves in brain surgery, but other than this, it can also be used to identify nerves that control muscles such as limbs.

[Effects of the Invention] As is clear from the above description, the present invention provides a nerve discriminating apparatus that discriminates a nerve by applying electrical stimulation to a nerve part of a patient and detecting a movement of a muscle moving by the stimulation.
A stimulator for directly applying electrical stimulation to a nerve site, an electrical stimulus output device that outputs a pulse voltage for electrical stimulation to this stimulator, and attached to the patient's skin surface to follow the movement of the skin Vibration comprising a membrane made of a soft member and a pressure sensing element arranged to be pressed by a protrusion of the membrane and detecting a change in the pressing force to detect the movement of a muscle moving by stimulation of the stimulator. A detector and a vibration detection display device for amplifying and displaying a detection signal from the vibration detector are provided, and the electrical stimulation output device and the vibration detection display device are housed in a single housing. Therefore, it is easy to handle and can be installed in a small number of places.In addition, the vibration detector is not easily affected by body movements or electrical noise from stimulators, and it can reliably detect only muscle movements. Such as a circuit configuration of the detection and display device can also be easily, excellent effects.

[Brief description of drawings]

The drawings show one embodiment of the present invention. FIG. 1 is an overall configuration diagram in use, FIG. 2 is a block diagram, and FIG. 3 is an enlarged vertical sectional view of a vibration detector. In the drawings, 1 is a main body case, 2 is an electric stimulation output device, 3 is a vibration detection display device, 4 is a stimulator, 6 is a vibration detector, 13 is an acoustic device, 14 is a case, and 15 is pressure sensing. An element, 16 is a membrane, and 17 is a protrusion.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (56) References JP-A-62-155832 (JP, A) JP-A-60-194933 (JP, A) JP-A-58-183141 (JP, A) Actual development Sho-59- 140744 (JP, U) Actual development Sho 58-30406 (JP, U)

Claims (2)

[Scope of utility model registration request] 1. A method for identifying a nerve by applying electrical stimulation to a nerve part of a patient and detecting the movement of a muscle moving by the stimulation, and a stimulator for directly applying electrical stimulation to the nerve part. An electrical stimulation output device that outputs a pulse voltage for electrical stimulation to a stimulator, a membrane made of a soft member that is attached to the surface of the skin of a patient and follows the movement of the skin, and is pressed by the protrusions of this membrane. And a vibration detector equipped with a pressure sensing element that detects the movement of the muscle that moves by the stimulation of the stimulator by detecting the change in the pressing force, and the detection signal from this vibration detector is amplified. A nerve discriminating apparatus comprising: a vibration detection display device for displaying, wherein the electrical stimulation output device and the vibration detection display device are housed in a single housing. 2. The nerve identifying apparatus according to claim 1, wherein the vibration detecting and displaying device includes an acoustic device for displaying a detection signal by sound.