WO2014184695A2 - Appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient - Google Patents

Appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient Download PDF

Info

Publication number
WO2014184695A2
WO2014184695A2 PCT/IB2014/061063 IB2014061063W WO2014184695A2 WO 2014184695 A2 WO2014184695 A2 WO 2014184695A2 IB 2014061063 W IB2014061063 W IB 2014061063W WO 2014184695 A2 WO2014184695 A2 WO 2014184695A2
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
control means
laryngeal
air
pulse
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2014/061063
Other languages
English (en)
Spanish (es)
Other versions
WO2014184695A3 (fr
Inventor
Luis Fernando GIRALDO CADAVID
Mauricio AGUDELO OTALORA
Mario ARBULU
Javier BURGUETE
Secundino FERNANDEZ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Universidad de la Sabana
Original Assignee
Universidad de la Sabana
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universidad de la Sabana filed Critical Universidad de la Sabana
Priority to JP2016513464A priority Critical patent/JP2016521589A/ja
Priority to US14/537,288 priority patent/US10736500B2/en
Publication of WO2014184695A2 publication Critical patent/WO2014184695A2/fr
Publication of WO2014184695A3 publication Critical patent/WO2014184695A3/fr
Priority to JP2016565252A priority patent/JP2017518787A/ja
Priority to PCT/IB2015/001323 priority patent/WO2015177640A2/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4005—Detecting, measuring or recording for evaluating the nervous system for evaluating the sensory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/1104—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb induced by stimuli or drugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/113—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb occurring during breathing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6886—Monitoring or controlling distance between sensor and tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes

Definitions

  • the present invention relates to an apparatus for measuring sensory thresholds in the pharyngeal laryngeal tract of a patient.
  • the apparatus of the invention relates to means for measuring distance and angle comprising an endoscope structure and control means comprising the regulation of a pulse of air or water under pressure to the laryngeal-pharyngeal mucosa.
  • the control means comprises a connection to a pulse generator, which is constituted by a controller and an electrovalve that regulates the opening of the passage of air or water.
  • the purpose and purpose of this is the precision of the measurement and inclination of the endoscope to provide a train of pulses of air or pressurized water for the endoscopic exploration of sensory thresholds of the pharyngeal - laryngeal reflexes related to swallowing or breathing.
  • the pharynx is a structure that communicates the digestive and respiratory tracts with the entrance doors to them: the oral and nasal cavities.
  • the correct functioning of it and the neighboring structures which include the larynx, base of the tongue, soft palate and upper part of the esophagus, depends on the food bolus being transported correctly from the mouth to the esophagus, without entering to the airway; and that the air enters and leaves without difficulty of the lungs, without passing to the digestive tract.
  • the proper functioning of the pharyngeal and laryngeal reflexes is a crucial element for swallowing and breathing to work synchronously and without interference between them, thus guaranteeing the processes of gas exchange and nutrition, essential for human life.
  • the adductor laryngeal reflex, the swallowing reflex and the cough reflex are the main reflexes involved in the regulation of this process.
  • the adductor laryngeal reflex which consists of adduction of the vocal cords, is triggered by mechanical and chemical stimuli on the pharyngeal-laryngeal mucosa, and protects against the entry of food and foreign material into the lower respiratory tract.
  • the swallowing reflex is triggered by mechanical and chemical stimuli in the mucosa of the base of the tongue and pharynx, and generates synchronous contraction or relaxation of different muscle groups of the tongue, soft palate, pharynx, larynx and esophagus superior so that the food passes quickly from the mouth to the esophagus, without entering the airway.
  • the cough reflex serves as protection against possible failures in the aforementioned reflex mechanisms, which have allowed the entry of food into the airway.
  • This reflex is triggered by mechanical or chemical stimuli on the laryngeal or tracheal mucosa and allows the expulsion of material that has entered the airway.
  • swallowing studies are prepared by specialists in pulmonology, otolaryngology, neurology and physiatry.
  • the standardized exploration of this reflex requires, in addition to the instrument that improves the accuracy of the distance, angle and place of impact of the air pulse, an instrument that allows the air pulse to be adjusted at pressures ranging between 0 and 10 mm Hg and with a pulse duration between 50 and 100 ms.
  • the swallowing reflex is usually explored in the video-fluoroscopic evaluation of swallowing, where the time between the point of the bolus crosses the base of the tongue and the velo-pharyngeal closure, elevation of the hyoid is measured.
  • the tube located adjacent to the endoscope insertion tube; where the tube collapses before inserting the insertion tube into the patient's body. After the insertion tube is inside the patient's body, the tube expands to create a channel. In particular, it reveals that through the shaped channel other means can be passed through the channel to carry out a medical procedure.
  • the apparatus disclosed in document US5970978, of AVIV et al. Discloses an apparatus and method for objectively measuring sensory thresholds in the upper aero digestive tract of a patient.
  • An air pulse with controlled pressure and time is delivered to the inlet of a Y-shaped tube; an output branch of the Y-shaped tube delivers the air pulse to the patient and the output branch delivers the air pulse to a pressure transducer, for measuring and displaying the pressure.
  • these devices comprise adequate means of entering or sending an air pulse but do not measure the angle or distances to establish the parameters of swallowing disorder or to establish respiratory ease or difficulty.
  • an object of the present invention is to avoid the disadvantages of the prior art. More particularly, an object of the present invention is a configuration of control means of a pulse of air or water under pressure to the laryngeal-pharyngeal mucosa; and, means for measuring the distance and the angle of incidence that a laser generation system includes, with which the correct position for applying the pulse of air or water, once located the right place where the pulses will be applied.
  • Another object of the present invention is to provide a connection to a pulse generator, which is constituted by a controller and an electrovalve that regulates the opening of the passage of air or water.
  • a very important object is that from the device of the invention the measurement and inclination of the endoscope can be specified to provide a train of pulses of air or pressurized water for the endoscopic exploration of sensory thresholds of the related pharyngeal - laryngeal reflexes. with swallowing or breathing
  • a feature of the present invention resides in an arrangement comprising means for applying and regulating a pulse of air or water under pressure to the laryngeal-pharyngeal mucosa; and, means for measuring the distance and the angle of incidence that a laser generation system includes, with which the correct position for applying the air or water pulse is determined, once the correct place in which the pulses
  • the apparatus of the invention relates to means for measuring distance and angle comprising an endoscope structure and means of control comprising the regulation of a pulse of air or water under pressure to the laryngeal - pharyngeal mucosa.
  • the control means comprises a connection to a pulse generator, which is constituted by a controller and an electrovalve that regulates the opening of the passage of air or water.
  • a pulse generator which is constituted by a controller and an electrovalve that regulates the opening of the passage of air or water.
  • the purpose and purpose of this is the precision of the measurement and inclination of the endoscope to provide a train of pulses of air or pressurized water for the endoscopic exploration of sensory thresholds of the pharyngeal - laryngeal reflexes related to swallowing or breathing.
  • FIG. 1 Shows a schematic view of the apparatus for measuring the present invention.
  • FIG. 2. Illustrates the projection site for the measurement of sensory thresholds in the pharyngeal laryngeal tract of a patient.
  • FIG. 3 Schematically illustrates the projection inside the larynx, for the measurement of sensory thresholds in the pharyngeal laryngeal tract of a patient.
  • FIG. 4. Illustrates how visually the different positions of the laser point in the pharynx and the scale formed from the control means are observed.
  • the present invention relates to an apparatus for measuring sensory thresholds in the pharyngeal laryngeal tract of a patient. Particularly, based on Figure 1, the apparatus of the invention relates to means for measuring distance and angle comprising an endoscope structure 1 and control means 2 for the regulation and measurement of a pulse of air or water under pressure. to the laryngeal - pharyngeal mucosa.
  • the endoscope 1 includes a handle 3 with a lower body and an upper body that form an inner chamber 4 that projects to a circular nozzle 5 that ends at a free end.
  • a connection neck 6 is projected perpendicularly to the projection axis of the nozzle 5,
  • the connection neck 6 is arranged to receive a flexible duct, the interior of which comprises fluid inlet connection tubes. as an air duct 7 and a water duct 8; a fiber optic connection 9; and, a light supply connection 10, such as a light emitting diode (LED).
  • a light supply connection 10 such as a light emitting diode (LED).
  • each of these ducts is projected and terminated at the free end of the nozzle 5.
  • Said connections are projected towards the remote control means 2 as illustrated in Figure 1.
  • Said control means 2 comprise a laser emitter 1 1 connected to the endoscope 1 by means of the fiber optic connection 9.
  • the fluid connections such as the air duct 7 and the water duct 8 that come from of the endoscope 1, they are interconnected with the water and air supplies 12 and 13, respectively, of the control means 2, by means of pulse generation 14 that control the pulse of air or water under pressure directed towards the laryngeal-pharyngeal mucosa .
  • Said pulse generating means 14 may comprise high pressure valves that regulate the fluid pressure.
  • said pulse generating means 14 may comprise systems for regulating pulse width and application time, such as a controller and an electrovalve that regulates the opening of the fluid passage.
  • connection of light supply means 10 can be connected to conventional electrical networks or supplementary battery means.
  • the endoscope 1 comprises other ducts such as viewing means that can comprise a lens 16 located in the nozzle 5 and connected to a remote camera located in the control means 2 by a second optical fiber.
  • Said 1 may also comprise biopsy means and regulating valves or additional control devices.
  • the endoscope structure 1 and the control means 2 are controlled through computerized means 15, by software or software, electronic and similar.
  • the endoscope 1 is inserted through the patient's mouth and must be projected towards the pharynx 17 of the patient.
  • the pharynx 17 of the patient with the projection zone is illustrated in Figure 2.
  • the nozzle 5 is arranged towards the pharynx 17.
  • the light means 10 are projected to internally visualize the pharyngeal area 17 by means of the display means 16 that is projected on the computed means 15.
  • the fluid pulse is prepared to verify the response time, since the pulse is made and when the pharynx and larynx close the pulmonary duct and allow passage food
  • the angles ⁇ and ⁇ can be established, by tyrannulation and therefore the effective distance L between the nozzle and the pharynx where it should be emitted the pulse.
  • the known distance h has values of 2.8 mm, 3.2 mm, 3.6 mm, 4 mm and may vary from 0.4 mm according to the endoscope 1 to form the visual scale as illustrated in Figure 4.
  • the angles ⁇ and ⁇ of Figure 3 vary and therefore vaha L, until the angle is located and therefore the most accurate measure L to emit the pulse. Measure L must be chosen by the medical specialist.
  • moving the nozzle 5 away or closer to the pharynx 17 must be a step only based on the knowledge and experience of the physician, but substantially facilitates its location thanks to the laser 1 1 and the computed means 15, object of the present invention.
  • the measurement of the distance and the angle of incidence between the exit hole of the endoscope 1 and the mucosa is made by the laser generation system generated by the emitter 1 1 and driven by the optical fiber 9 towards the nozzle 5, with which when introducing the endoscope 1 through the patient's mouth towards his pharynx, where the correct position to apply the air or water pulse is determined, so that once the correct place is located, the necessary pulses will be applied by means of the pulse generator 14.
  • This regulation is done by modifying the potential difference applied to the solenoid valve in a range of 0 to 6.5 mV.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Physiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Neurology (AREA)
  • Neurosurgery (AREA)
  • Endoscopes (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)

Abstract

La présente invention concerne un appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient. Plus particulièrement, l'appareil de l'invention se met en relation avec des moyens de mesure de la distance et de l'angle que comprend une structure d'endoscope et de moyens de commande que comprend la régulation d'une impulsion d'air ou d'eau sous pression à la muqueuse laryngo-pharyngée. Les moyens de commande, comprennent une connexion à un générateur d'impulsions, lequel est constitué d'un régulateur et d'une électrovalve qui régule l'ouverture du passage d'air ou d'eau. La présente invention a pour objet et comme finalité la précision de la mesure et l'inclinaison de l'endoscope pour administrer un train d'impulsions d'air et d'eau sous pression pour l'exploration endoscopique des seuils de sensibilité des réflexes laryngés en rapport avec la déglutition et la respiration.
PCT/IB2014/061063 2013-05-17 2014-04-28 Appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient Ceased WO2014184695A2 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP2016513464A JP2016521589A (ja) 2013-05-17 2014-04-28 患者の咽頭・喉頭管における知覚閾値を測定する装置
US14/537,288 US10736500B2 (en) 2014-04-28 2014-11-10 System and method for measuring sensory response of tissue
JP2016565252A JP2017518787A (ja) 2014-04-28 2015-04-28 組織の感覚応答を測定するためのシステム及び方法
PCT/IB2015/001323 WO2015177640A2 (fr) 2014-04-28 2015-04-28 Système et procédé de mesure de réponse sensorielle de tissu

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CO13-121843 2013-05-17
CO13121843 2013-05-17

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US14/537,288 Continuation-In-Part US10736500B2 (en) 2014-04-28 2014-11-10 System and method for measuring sensory response of tissue
US14/537,288 Continuation US10736500B2 (en) 2014-04-28 2014-11-10 System and method for measuring sensory response of tissue

Publications (2)

Publication Number Publication Date
WO2014184695A2 true WO2014184695A2 (fr) 2014-11-20
WO2014184695A3 WO2014184695A3 (fr) 2015-03-05

Family

ID=51898931

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2014/061063 Ceased WO2014184695A2 (fr) 2013-05-17 2014-04-28 Appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient

Country Status (2)

Country Link
JP (1) JP2016521589A (fr)
WO (1) WO2014184695A2 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015177640A3 (fr) * 2014-04-28 2016-06-23 ARBULÚ SAAVEDRA, Mario Système et procédé de mesure de réponse sensorielle de tissu

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IL93587A (en) * 1990-03-01 2001-01-11 Shirit Yarkony Analysis of swallowing defects
US6036655A (en) * 1993-04-16 2000-03-14 The Trustees Of Columbia University In The City Of New York Apparatus and method to objectively measure sensory discrimination thresholds in the upper aero digestive tract
FR2824723B1 (fr) * 2001-05-15 2003-08-15 Univ Joseph Fourier Embout destine a un dispositif d'evaluation de la sensibilite du pharynx, dispositif le comportant et procede d'utilisation
CN202168826U (zh) * 2011-04-18 2012-03-21 佛山市第一人民医院 一种吞咽功能检测仪

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015177640A3 (fr) * 2014-04-28 2016-06-23 ARBULÚ SAAVEDRA, Mario Système et procédé de mesure de réponse sensorielle de tissu
JP2017518787A (ja) * 2014-04-28 2017-07-13 アルブル サアベドラ、マリオ 組織の感覚応答を測定するためのシステム及び方法

Also Published As

Publication number Publication date
JP2016521589A (ja) 2016-07-25
WO2014184695A3 (fr) 2015-03-05

Similar Documents

Publication Publication Date Title
US5676635A (en) Instrument for insertion of an endotracheal tube
JP4932768B2 (ja) 気管挿管訓練装置
US6705320B1 (en) Methods for performing tracheal intubation on an animal and endotracheal tubes therefore
ES2592384T3 (es) Aparato de tubo endotraqueal
US20180169365A1 (en) Intubating Neonatal Laryngeal Mask Airway
US10736500B2 (en) System and method for measuring sensory response of tissue
ES2427044T3 (es) Conector broncoscópico
CN105451629A (zh) 视频喉镜和视频喉镜插入部
ES2901970T3 (es) Dispositivo de conversión para laringoscopia
US10874295B2 (en) Medical imaging system and device
US20180221649A1 (en) Catheter
WO2014184695A2 (fr) Appareil de mesure des seuils de sensibilité dans le tractus laryngo-pharyngé d'un patient
CN207412483U (zh) 一种用于纤维支气管镜插管的引导器
BR112020014176A2 (pt) Dispositivos e métodos para introduzir um tubo endotraqueal
CN206603997U (zh) 一种光纤引导插入及可定位气管插管
WO2016041331A1 (fr) Canule trachéale
ES3004861T3 (en) Curved bougie guide
EP3335068B1 (fr) Cathéter avec détection optique
CN103785089B (zh) 经鼻气管插管检查镜
CN209450964U (zh) 可测酸碱度的胃肠管
CN203724584U (zh) 经鼻气管插管检查镜
CN215227437U (zh) 一种耳鼻喉科观察镜
Jones et al. Photometries: a new method of measuring the cross‐sectional area of the subglottis
ES2524654B1 (es) Pala video-laringoscópica con conexión a smartphones
Syed et al. LARYNGOSCOPY FOR VISUALIZATION AND MONITORING OF ENDOTRACHEAL ACTIVITY WITH IMPROVED PARAMETERS.

Legal Events

Date Code Title Description
ENP Entry into the national phase in:

Ref document number: 2016513464

Country of ref document: JP

Kind code of ref document: A

122 Ep: pct application non-entry in european phase

Ref document number: 14798645

Country of ref document: EP

Kind code of ref document: A2