NASOPHARYNGEAL DEVICE FOR OBSTRUCTIVE SLEEP APNEA SYNDROME
20170049981 ยท 2017-02-23
Inventors
Cpc classification
A61M16/0488
HUMAN NECESSITIES
International classification
Abstract
The system and method for reducing or eliminating obstructive sleep apnea in patients with the use of a nasopharyngeal device. The nasopharyngeal device has an obturator including reversibly expandable projections located at a distal end and a guide portion on a proximal end. The reversibly expandable projections are adapted to maintain patency of the nasopharyngeal airway by advancing anteriorly the soft palate. The nasopharyngeal device also has a tube that has a proximal end, a distal end, and a passage through which at least a portion of the obturator may be inserted.
Claims
1. A nasopharyngeal device for reducing obstructive sleep apnea, comprising: an obturator comprising a plurality of reversibly expandable projections located at a distal end and a guide portion on a proximal end, wherein the reversibly expandable projections are adapted to maintain patency of the nasopharyngeal airway by advancing anteriorly the soft palate; and a tube comprising a proximal end, a distal end, and a passage through which at least a portion of the obturator may be inserted.
2. The nasopharyngeal device of claim 1, wherein the tube further comprises a tapered member.
3. The nasopharyngeal device of claim 2, wherein the tapered member comprises one or more openings adapted to permit air to pass through during breathing.
4. The nasopharyngeal device of claim 2, wherein the tapered member is disposed at or near the proximal end of the tube.
5. The nasopharyngeal device of claim 1, wherein the tube comprises an adjustable clip member disposed at or near the proximal end of the tube and adapted to secure the tube to a nostril.
6. The nasopharyngeal device of claim 1, wherein the plurality of reversibly expandable projections are flexible.
7. The nasopharyngeal device of claim 1, wherein the plurality of reversibly expandable projections are attached to the obturator in a cantilevered manner.
8. The nasopharyngeal device of claim 1, wherein the plurality of reversibly expandable projections are adapted to permit air to pass during breathing.
9. The nasopharyngeal device of claim 1, wherein the guide portion is adapted to facilitate insertion of the obturator in the tube and manipulation of a position of the reversibly expandable projections relative to the soft palate.
10. The nasopharyngeal device of claim 1, wherein the guide portion is adapted to be secured to the tube.
11. A method of reducing obstructive sleep apnea with a nasopharyngeal device having a catheter and an obturator that is reversibly expandable at a distal end, the method comprising: inserting the nasopharyngeal device into the nasopharyngeal airway; and advancing the obturator through the catheter thereby expanding the distal end and opening the airway.
12. The method of reducing obstructive sleep apnea of claim 11, further comprising causing movement of the soft palate by expanding the distal end of the obturator.
13. The method of reducing obstructive sleep apnea of claim 11, further comprising securing the nasopharyngeal device to the nostril.
14. The method of reducing obstructive sleep apnea of claim 11, further comprising adjusting the catheter such that a tapered portion rests at the nostril.
15. The method of reducing obstructive sleep apnea of claim 11, further comprising adjusting the position of the nasopharyngeal device such that air is able to pass during breathing.
16. The method of reducing obstructive sleep apnea of claim 11, wherein the obturator comprises a plurality of reversibly expandable projections.
17. The method of reducing obstructive sleep apnea of claim 16, wherein the plurality of reversibly expandable projections are attached to the obturator in a cantilevered manner.
18. A nasopharyngeal device for reducing obstructive sleep apnea, comprising: a catheter comprising a proximal end, a distal end, and a passage; and an obturator comprising: means for projecting anteriorly the soft palate and thereby maintain patency of the nasopharyngeal airway; and means for advancing and retracting the obturator through the catheter.
19. The nasopharyngeal device of claim 18, further comprising means for securing the nasopharyngeal device to the nostril.
20. The nasopharyngeal device of claim 18, further comprising means for securing the obturator's position relative to the soft palate.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] The foregoing and other objects, features, and advantages of the invention will be apparent from the following description of particular embodiments of the invention, as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention.
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DETAILED DESCRIPTION OF THE INVENTION
[0044] Obstructive sleep apnea syndrome is characterized by obstruction to an individual's ability to breathe while sleeping. The two areas of obstruction are the soft palate and the base of tongue. The nasopharyngeal airway is the most frequently obstructed area involved in patients with OSA.
[0045] One aspect of the present invention is a nasopharyngeal device to assist patients who suffer from OSA. The design is intended to be a non-intrusive nasal device that enables the patient to maintain patency of the nasopharyngeal airway by stenting open the palate, which, in the patient with OSA, closes upon laying down to sleep. By stenting open the nasopharyngeal airway with an embodiment of the present invention, the patient maintains his or her ability to breathe in a recumbent position.
[0046] Currently, the gold standard of treatment for OSA is continuous positive airway pressure (CPAP). However, the obtrusive, claustrophobic nature of the various facial interfaces causes many patients to refuse to use CPAP units over the long term. Also, patients with OSA can undergo a uvulopalatopharyngoplasty (UPPP) surgical procedure, which is surgically effective in opening up the nasopharyngeal space, but this method requires patients to experience all of the risks associated with a surgical procedure. In contrast, the device of the present invention is non-invasive and will help a large number of patients to reduce or eliminate OSA without any of the risks associated with surgical procedures.
[0047] Referring to
[0048] U.S. Patent Publication No. 2013/0152940 describes a nasopharyngeal trumpet as one possible treatment of OSA. U.S. Patent Publication No. 2006/0283464 describes a nasal trumpet or nasopharyngeal airway as a tube that is designed to be inserted into the nasal passageway to secure an open airway. When a patient becomes unconscious, the muscles in the jaw commonly relax and can allow the tongue to slide back and obstruct the airway. The purpose of the flared end (a.k.a., the trumpet) is to prevent the device from becoming lost inside the patient's nose.
[0049] There are several drawbacks to the trumpet design in treating OSA. To begin, the trumpet design obstructs the airway by blocking the nostril with the trumpet, as seen in
[0050] Another drawback of the nasal trumpet is the tube 14 extends past the soft palate. Referring to
[0051] Referring to
[0052] Referring to
[0053] As shown in
[0054] It should be noted that, as shown in
[0055] Still referring to
[0056] According to one embodiment, the tube 110 may be formed from a variety of suitable materials known to those skilled in the art, for example, but not limited to, polyvinyl chloride. Likewise, the balloon-cuff 160 may be formed from a variety of suitable materials such as, for example, but not limited to, polyvinyl chloride or polyurethane.
[0057] The proximal end of the nasopharyngeal device of the present invention is designed with multiple perforations that enable the user to breathe, not only through the lumen of the tube, but also around the tube. See, for example,
[0058] Referring to
[0059] In certain embodiments, the maximum outer diameter of the tube is fitted to suit the individual patient. In certain embodiments, the outer diameter of the tube is about 2 mm. In certain embodiments, the outer diameter of the tube is about 3 mm. In certain embodiments, the outer diameter of the tube is about 4 mm, although it can be larger.
[0060] Referring to
[0061] Referring to
[0062] In certain embodiments, the length of the tube is fitted to suit the individual patient. The outer diameter and length of the tube will vary with the patient's nasal anatomy and the size of their head and length of their soft palate. Measurements will be made in order to ensure that the balloon-cuff of the nasopharyngeal device is able to advance the palate appropriately in order to open up the retro palatal space. In certain embodiments, the balloon-cuff is comprised of soft polymers.
[0063] Referring to
[0064] Referring to
[0065] In certain embodiments of the present invention, the device is a modified, shortened, nasopharyngeal airway tube. In certain embodiments, the device has an elongated inflatable balloon-cuff near its distal end, which rests behind the soft palate and posterior nasopharyngeal wall. Upon inflation, the soft palate is moved forward, enabling the patient to breathe freely. In certain embodiments, the proximal end of the device is located at the nasal vestibule (nostril) and is tapered, flexible and has an attached soft plastic clamp, which keeps it secured to the nose during sleep.
[0066] In certain embodiments, the diameter and length of the tube will vary depending upon the anatomical dimensions of the patient.
[0067] Another embodiment of a nasopharyngeal device consistent with the present invention will now be described with reference to
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[0069] In one embodiment the tapered portion 315 may be adjustable to assist with positioning of the nasopharyngeal device 300, including for example, slidable along the length of the tube 310, and rotatable.
[0070] The tube 310 may be formed from a variety of suitable materials known to those skilled in the art, for example, but not limited to rubber, plastic, polyvinyl chloride, or a composite material.
[0071] In one embodiment the tube 310 may include a clip 313 disposed on the tapered end as shown in
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[0073] The obturator 320 may be formed from a variety of suitable materials known to those skilled in the art, for example, but not limited to metal, rubber, plastic, polyvinyl chloride, or a composite material.
[0074] The flexible projections 324 may be made of metal, plastic, polyvinyl chloride, or a composite material. Optionally, the flexible projections 324 may include a sheath that is made of rubber, plastic, polyvinyl chloride, or the like. Further, the number of flexible projections 324 and their respective girth and length is preferably sufficient to expand/fan-out as described above in the interior part of the nasopharynx and project the soft palate forward (anterior) and open the airway. In one embodiment, one or more of the flexible projections 324 have a different girth and/or a different length.
[0075] The semi-rigid solid-walled tube 310 is configured to receive the obturator 320 as illustrated in
[0076] In one embodiment the obturator 320 may include a clip or hook 325 to secure the obturator 320. The clip 35 may be optionally configured to fit into the groove 314 of the clip 313. The clip 325 helps prevent aspiration by preventing the obturator 320 from passing too far into the airway. Further, the clip 325 and groove 314 help to stabilize and orient the obturator 320 for optimal placement of the palatal expander 323.
[0077] The proximal end 321 and clip 325 may also serve as a handle or guide that is manipulatable by a user to advance the obturator 320 through the tube 310 and position the obturator 320 and the palatable expander 323 relative to a patient's airway anatomy, including the soft palate.
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[0081] The obturator 320, which is slidably inserted into the tube 310, may be advanced through the tube 310 such that the palatal expander 323 exits the distal end 311 of the tube 310 and expands to move the soft palate. A user may manipulate the clip 323 to advance the obturator 320 through the tube 310 and position it relative to the patient's airway anatomy. As the expansion occurs, the palatal expander 323 pushes or projects the palate forward, away from the back wall of the throat, thereby opening up the retropalatal space to facilitate improved air flow during breathing. The clip 325 may engage in the groove 314 of the clip 313, securing the placement and position of the obturator 320 and helping to prevent aspiration due to any part of the obturator 320 (or the tube 310 for) advancing too far into the oropharynx or the hypopharynx. The clip 325 is optionally configurable to engage the clip 313 after a predetermined length of the obturator 320 has been inserted.
[0082] The nasopharyngeal device 300 may be inserted into the patient's airway with the obturator 320 already inserted in the tube 310. Alternatively, the tube 310 may be inserted and then the obturator 320 inserted.
[0083] In one embodiment, the nasopharyngeal device 300 is inserted to project the soft palate forward when the patient is in a supine position, such that the patient is able to breathe substantially freely without experiencing apneas or hypopneas.
[0084] In certain embodiments, the length of the tube 310 and/or the obturator 320 is fitted to suit the anatomy of the individual patient. In this embodiment, the outer diameter and length of the tube and obturator are varied with the patient's nasal anatomy and the size of their head and length of their soft palate. Preferably, measurements are made in order to ensure that the palatal expander 323 is positioned to advance the palate appropriately in order to open up the retro palatal space. In certain embodiments, the balloon-cuff is comprised of soft polymers. In one embodiment the palatal expander 323 is attachable and detachable in order to fit an appropriately sized palatal expander 323 to the obturator 320.
[0085] In another embodiment of the nasopharyngeal device Transderm Xylocaine or another numbing agent is applied to and coats the outside of the nasal tube. This coating minimizes discomfort to the patient while introducing the tube into the nostril and reduces friction.
[0086] Those of ordinary skill in the art will appreciate that embodiments of the present invention may be used with other devices to assist with treating sleep apnea. For example, medical imaging devices and techniques, such as ultrasound and fluoroscopy may be used in conjunction with the nasopharyngeal device to assist with diagnosis and placement of the device.
[0087] While the principles of the invention have been described herein, it is to be understood by those skilled in the art that this description is made only by way of example and not as a limitation as to the scope of the invention. Other embodiments are contemplated within the scope of the present invention in addition to the exemplary embodiments shown and described herein. Modifications and substitutions by one of ordinary skill in the art are considered to be within the scope of the present invention.
[0088] These aspects of the invention are not meant to be exclusive and other features, aspects, and advantages of the present invention will readily be apparent to those of ordinary skill in the art when read in conjunction with the following descriptions, appendages, appended claims, and accompanied drawings. The foregoing and other objects, features, and advantages of the invention will be apparent from the following description of particular embodiments of the invention and as illustrated in the accompanied drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed on illustrating the principals of the invention.