The instant application is a continuation of International Application No. PCT/DEO3/01146 filed on Apr. 1, 2003 and published as International Publication WO 03/082089 on Oct. 9, 2003, the disclosure of which is hereby expressly incorporated by reference hereto in its entirety. The instant application also claims priority under 35 U.S.C. §119 of German Application No. 102 15 212.8 filed on Apr. 2, 2002.
1. Field of the Invention
The invention relates to the fields of medicine and device construction and relates to a method and an arrangement for optically measuring swelling of the nose, which can be used to, e.g., measure nasal obstruction after allergen provocation.
2. Discussion of Background Information
From a medical point of view, there is a need for an objectification of the measurement of swelling, and of the course of swelling, e.g., in allergic reactions that are triggered by, e.g., the nasal provocation test.
Nowadays, the diagnosis of allergic rhinitis is made by calculating a symptom score (itchy nose, secretion, remote symptoms, such as watery eyes) and by measuring the nasal obstruction after allergen provocation with the aid of rhinomanometry (Clement et al.: Rhinomanometry—a review, ORL J. Otorhinolaryngol. Relat. Spec. 46, 173-91, 1984). The disadvantage of rhinomanometry is that the measurement cannot be carried out during the allergen application. With severe nasal obstruction, patients experience the rhinomanometry as a very unpleasant experience. Faulty measurements also occur frequently with uncooperative patients.
Another possibility for determining the swelling of the nose and, in particular, of the nasal mucous membrane is acoustic rhinometry (Fisher: Acoustic rhinometry, Clin. Otolaryngol. 22, 307-17, 1997). These measurements have a relatively large spread in their results. Moreover, sufficient precision is achieved only for the front sections of the nose. Additionally, no medication or allergen provocation can take place during the measurement. A continuous measurement is not possible with this method, either.
Furthermore, it is not possible with either method to say whether a nasal swelling is due to a change in the microcirculation or the formation of an edema.
The invention relates a method and an arrangement for optically measuring swelling of the nose. As a result, a largely objective measurement of the swelling of the nose is rendered possible, in particular, while provocation tests are being conducted.
The arrangement according to the invention for optically measuring swelling of the nose includes a basic device with light-producing components and light-detecting components. The device also includes associated emitter and receiver electronic systems and controllers. Furthermore, at least one optical connection is utilized between the basic device and an optical emitter element, whereby the transmission of the light produced by the light-producing components provided by optical elements in the optical connection to the emitter element. Furthermore, at least one optical connection is present between an optical receiver element and the light-detecting components. Emitter and receiver elements, which are arranged on an application element, are located outside the basic device. The application element thus provides for an arrangement wherein the emitter and receiver elements makes it possible for the light emitted by the emitter element to pass through the swellable tissue of at least one side of the nose to the receiver element. Furthermore the application element can be placed in a form-lockiing manner at least on the upper part of the nose.
With the arrangement according to the invention, the swelling of the nasal tissue can be optically recorded. With the device, the nasal tissue is irradiated from outside by a light source that is emitted from an emitter element. The scattered light passing through the tissue is then recorded by a detector, which can have the form of a receiver element. The emitter and receiver can be arranged on either the same side of the nose or on the opposite sides of the nose. When passing through the nasal tissue, the light passes through a number of tissue layers, such as skin, musculature, mucous membrane, bone, cartilage, and the airways. A part of the tissue which is penetrated is characterized by swellability, in particular, the nasal mucous membrane located above the bone of the nasal concha. In the course of the swelling, an increase of the blood volume occurs in this part of the tissue due to the influx of blood into the cavernous bodies. The inflowing blood is primarily of an arterial nature and thus normally 95% saturated with oxygen. Furthermore, in the event of the formation of an edema, possibly associated with the swelling, an increase in the tissue fluid volume occurs. It is therefore advantageous to conduct the irradiation spectrometrically in order to be able to quantitatively record, separately, the volume proportions of the oxygenated and deoxygenated hemoglobin and of the tissue fluid. This can take place either by using a white-light source and a spectrometer detector (e.g., diode line spectrometer) or by using several light sources with discrete radiation spectra (e.g., LEDs and laser diodes).
Since the above-noted substances involved in the swelling have different optical absorption spectra, a separate absolute or relative determination of the volume proportions is possible with corresponding mathematical methods. Such an arrangement has hitherto not been described.
One advantage of the arrangement according to the invention is that it is characterized by a non-invasive application and/or measurement from the outside and requires simple handling.
The invention also provides for an arrangement for optically measuring swelling of a nose, wherein the arrangement comprises a device which includes at least one light-producing component, at least one light-detecting component, an emitter electronics system, a receiver electronics system, and a controller. At least one optical emitter device is connected to the device via at least one first optical connection. At least one optical receiver device is connected to the device via at least one second optical connection. The at least one optical emitter device and the at least one optical receiver device are arranged on an application device.
The at least one first optical connection may transmit light produced by the at least one light-producing component. The at least one light-producing component may produce light which is transmitted by the at least one first optical connection to the at least one optical emitter device. The at least one second optical connection may transmit light received by the at least one light-detecting component. The at least one light-detecting component may detect light which is transmitted by the at least one second optical connection to the at least one optical receiver device. The at least one light-producing component may comprise a plurality of light-producing components. The at least one optical emitter device and the at least one optical receiver device may be arranged external to the device. The application device may be structured and arranged to fit onto a nose of a person. The at least one optical emitter and receiver devices may be structured and arranged to allow the light emitted by the at least one optical emitter device to pass through swellable tissue of at least one side of the nose and to the at least one optical receiver device. The application device may be capable of being fixed in a form-locking manner to at least an upper part of a nose of a person.
The at least one light-producing component may comprise at least one light source. The at least one light source may comprise a plurality of light sources emitting light of different wavelengths. The at least one light-producing component may comprise at least one of an LED, a laser, and a halogen lamp. The at least one light-producing component may produce a constant optical output. The emitter electronics system may be structured and arranged to allow the at least one light-producing component to produce a constant optical output. The emitter electronics system may be structured and arranged to modulate an intensity of the at least one light-producing component. The emitter electronics system may be structured and arranged to provide for high-frequency modulation of the at least one light-producing component. The emitter electronics system may provide for light impulses which are less than or equal to a nanosecond.
The at least one light-detecting component may comprise at least one of at least one photodetector and at least one spectrometer detector. The at least one light-detecting component may comprise at least one of at least one photo semiconductor detector and at least one photomultiplier. The application device may comprise a clamp-shaped body. The clamp-shaped body may be rigid. The clamp-shaped body may be slightly flexible. The application device may comprises two separate elements. The application device may be capable of being adhesively attached to a nose of a person. The application device may be capable of being secured to a person via an expansible/length-adjustable strap running around a back of a head of the person. The application device may be capable of being secured to a spectacle frame.
The arrangement may further comprise a strap adjustably connected to the application device. The arrangement may further comprise at least one optical screening element capable of being arranged around a measuring field. The at least one optical screening element may comprise one of a light-impervious cap and an optical filter. The at least one optical emitter device may comprise at least two optical emitter elements and the at least one optical receiver device may comprise at least two optical receiver elements.
The at least one optical emitter device may comprise at least two optical emitter elements arranged on one side of the application device and the at least one optical receiver device may comprise at least two optical receiver elements arranged on another side of the application device.
The at least one optical emitter device comprises at least two optical emitter elements adapted to be arranged on one side of a nose of a person and wherein the at least one optical receiver device comprises at least two optical receiver elements adapted to be arranged on another side of the nose of the person.
The invention also provides for a method of optically measuring swelling of a nose using the arrangement described above, wherein the method comprises emitting light with the at least one light-producing component, transmitting the light, via the at least one first optical connection, from the at least one light-producing component to the at least one optical emitter device, allowing the light to penetrate through at least one side of the nose, capturing the light emerging from the nose with the at least one optical receiving device, and transmitting the light, via the at least one second optical connection, from the at least one optical receiver device to the at least one light-receiving component.
The method may further comprise recording incoming values that represent a time course of a spectral extinction of optical radiation produced by the at least one light-producing component at selected emission wavelengths before and during a natural swelling of swellable nasal tissue. The method may further comprise calculating diagnostically utilizable parameters from the incoming values.
The method may further comprise recording incoming values that represent a time course of a spectral extinction of optical radiation produced by the at least one light-producing component at selected emission wavelengths before and during a provoked swelling of swellable nasal tissue. The method may further comprise calculating diagnostically utilizable parameters from the incoming values.
The at least one light-producing component may comprise different light-producing components producing different emission wavelengths, and the method may comprise switching, with the emitter electronics system, the different light-producing components, whereby the different light-producing components are switched on brightly one after another.
The method may further comprise measuring, before optically measuring swelling of the nose, a dark value with non-activated light-producing components to correct for ambient influences.
The method may further comprise detecting, while optically measuring swelling of the nose, an intensity measurement of the at least one light-producing component.
The method may further comprise simultaneously detecting, while optically measuring swelling of the nose, an intensity measurement of the at least one light-producing component, whereby the detecting detect an optical output power. The light may comprise light emitted from a single white-light source, whereby the light is used to differentiate different tissue components
The at least one light-producing component may comprise a single white-light source. The at least one optical receiving device may comprise a spectrometer detector. The at least one light-producing component may comprise a plurality of light-producing components, and the method may further comprise producing, with the light-producing components, light with different carrier frequencies and modulating an intensity of the light emitted by the light-producing components. The method may further comprise separately detecting, via frequency demultiplexing, light signals. The modulating may be sinusoidal.
The at least one light-producing component may comprise a plurality of light-producing components, and the method may further comprise emitting, with the light-producing components, high-frequency modulated light and demodulating light signals in order to determine a phase shift and an amplitude damping.
The at least one light-producing component may comprise a plurality of light-producing components, and the method may further comprise emitting, with the light-producing components, very short light pulses of less than or equal to one nanosecond and determining a temporal photon arrival distribution of received light signals.
The at least one light-producing component may comprise a plurality of light-producing components, and the method may further comprise emitting, with the light-producing components, very short light pulses of less than or equal to one nanosecond and determining, via an optical receiver element, a temporal photon arrival distribution of received light signals, where by measuring occurs in a time-resolved manner.
The optically measuring of the swelling of the nose may comprise one of optically measuring a swelling of each nostril separately and optically measuring a swelling of each side of the nose separately.
The at least one light-producing component may comprise a plurality of light-producing components, and the method may further comprise emitting, with the light-producing components, light of different wavelengths and transmitting the light of different wavelengths from the light-producing components to at least one optical emitter device.
The at least one optical emitter device may comprise a plurality of optical emitter devices, and the method may further comprise arranging the optical emitter devices on each side of the nose and transmitting the light from the at least one light-producing component to the optical emitter devices.
The invention also provides for a system for optically measuring swelling of a nose, wherein the system comprises an arrangement including at least one light-producing component, at least one light-detecting component, an emitter electronics device, a receiver electronics device, and a controller. At least one optical emitter device can be arranged on a portion of the nose. At least one optical receiver device can be arranged on another portion of the nose. The at least one optical emitter device is structured and arranged to emit light into the nose, and the at least one optical receiver device is structured and arranged to capture the light emitted by the at least one optical emitter device.
The invention also provides for a method of optically measuring swelling of a nose using the system described above, wherein the method comprises emitting light with the at least one light-producing component, transmitting the light from the at least one light-producing component to the at least one optical emitter device, allowing the light to penetrate through at least one side of the nose, capturing the light emerging from the nose with the at least one optical receiving device, and transmitting the light from the at least one optical receiver device to the at least one light-receiving component.
The invention also provides for a system for optically measuring swelling of a nose, wherein the system comprises an arrangement including at least one light-producing component, at least one light-detecting component, an emitter electronics device, a receiver electronics device, and a controller. At least one optical emitter device can be arranged on a portion of the nose. At least one optical receiver device can be arranged on another portion of the nose. A first connection device is used for transmitting light from the at least one light-producing component to the at least one optical emitter device. A second connection device is used for transmitting light from the at least one optical receiving device to the at least one light-receiving component. The at least one optical emitter device is structured and arranged to emit light into the nose and The at least one optical receiver device is structured and arranged to capture the light emitted by the at least one optical emitter device.
The invention also provides for a method of optically measuring swelling of a nose using the system described above, wherein the method comprises emitting light with the at least one light-producing component, transmitting the light from the at least one light-producing component to the at least one optical emitter device, allowing the light to penetrate through at least one side of the nose, capturing the light emerging from the nose with the at least one optical receiving device, and transmitting the light from the at least one optical receiver device to the at least one light-receiving component.
The present invention is further described in the detailed description which follows, in reference to the noted plurality of drawings by way of non-limiting examples of exemplary embodiments of the present invention, in which like reference numerals represent similar parts throughout the several views of the drawings, and wherein:
a shows a front view of an application element;
b shows a top view of the application element of
a shows another embodiment of the application element with an active emitter element and an active receiver element;
b shows another embodiment of the application element with a passive emitter element and a passive receiver element;
a shows a diagrammatic representation of a cross section of the nose before swelling and illustrates the position of the optical elements and the irradiation channel;
b shows a diagrammatic representation of a cross section of the nose after swelling and illustrates the position of the optical elements and the irradiation channel; and
The arrangement according to the invention comprises an application element 1 and at least one basic device 12 which includes an emitter electronics system 15 and a receiver electronic system 16 which are necessary to carry out the measuring task. The application element 1 is in direct contact with the nasal tissue during the measurement.
a and 1b show one embodiment of the application element 1. The application element 1 has the form of a clamp-shaped base body. Both sides of the body can be placed on the sides of the nose in a form-locking manner (see
The application element 1 can also be embodied as a spectacles-like frame that sits on the root of the nose so that the optical emitter and receiver elements are pressed onto the nasal tissue by gravity;
In order to provide for precise and reproducible measurement, in addition to the spatially stable and motion-free fixing of the application element 1 to the nose, it is important to suppress and/or calibrate out extraneous light influences. It is therefore advantageous to utilize optical filters in the arrangement. Alternatively, the measuring site should be covered during the measurement by a light-impervious cap, which can be, e.g., a plastic cap. The cap can also be fixed to the headband 8 as well, and can be closed over the field of measurement during the examination as required.
The light-detection component 14 is connected to the input of the receiver electronics system 16. In this way, light enters from the optical connection 7 into the component 14.
A spectrometric measurement is advantageously used for the optical measurement of swelling and provides for the differentiation of the causes of swelling. Light sources with limited spectrum (LEDs, semiconductor lasers) and a photodetector that is adequately sensitive for the selected spectral range (semiconductor photodetector, photomultiplier) can be used for this measurement. Alternatively, a white-light source and a detector measuring in a spectrometrically resolving manner can be used. The object of the measurement is to detect light attenuation values (optical density of the tissue) at individual wavelengths of interest over time. This results from the equation:
where IS(λ,t) denotes the light intensity radiated at the emitter element and ID(λ,t) denotes the light intensity arriving at the receiver element at the wavelength λ and at the point of time t. In general the extinction E(λ,t) is a function of the light scattering and the light absorption in the tissue and thus provides a measured value for the geometric and optical change of the tissue. By performing the subtraction E(λ1,t)−E(λ2,t) at two wavelengths, a relative measurement of the change can be determined, which reflects the ratio of the volume change values of individual tissue constituents and which is largely free of geometric effects. Thus when using, e.g., a hemoglobin-sensitive wavelength of λ1=800 nm and an H2O-sensitive wavelength of λ2=970 nm, the ratio between the blood and tissue fluid increase can be shown. Furthermore, by using special optical measurement techniques, it is possible to separately determine the scatter and absorption properties of the tissue. To this end, photon time delay measurements are necessary with the aid of a high-frequency modulation technology (intensity modulation of the light source(s) and amplitude and phase measurement of the receiver signal) or a pulse laser technology (application of short laser pulses and time-resolved measurement of the receiver signal). These measuring methods and associated mathematical methods for determining optical parameters from such measurement data are state of the art (e.g., Sevick et al., Quantitation of time and frequency resolved optical spectra for the determination of tissue oxygenation, Anal. Biochem. 195, 330-51, 1991; and Patterson et al., Time resolved reflectance and transmittance for the non-invasive measurement of tissue optical properties, Appl. Opt., 28, 2331-36, 1989).
The course of a measurement will be explained here using the example of a provoked allergic reaction (provocation test).
After the person to be examined has been prepared, the application element 1 is fixed on the bridge of the nose near the root of the nose such that the optical emitter element 2 and receiver element 3 are opposite one another on the tissue and so that the optical radiation penetrates as much swellable tissue inside the nose as possible (See
Number | Date | Country | Kind |
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102 15 212.8 | Apr 2002 | DE | national |
Number | Date | Country | |
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Parent | PCT/DE03/01146 | Apr 2003 | US |
Child | 10954292 | Oct 2004 | US |