The present invention relates to the amelioration of obstructive sleep apnea syndrome and more particularly to a nasopharyngeal device used to reduce or eliminate obstructive sleep apnea episodes.
Obstructive sleep apnea syndrome is characterized by obstruction to an individual's ability to breathe while sleeping and the two areas of obstruction are the soft palate and the base of the tongue.
Obstructive sleep apnea syndrome (“OSA”) affects millions of Americans and currently, the gold standard of treatment is continuous positive airway pressure (“CPAP”). Unfortunately, although CPAP is almost uniformly effective in terms of facilitating a patient's ability to breathe while they sleep, the obtrusive, claustrophobic nature of the various facial interfaces translates into many patients refusing to use the units at night. Therefore, although CPAP therapy is effective, there is a very low long-term compliance seen in patients utilizing this modality of treatment. Consequently, health care professionals have sought alternative treatments for nocturnal airway obstruction such as surgery of the palate and tongue base and mandibular advancement devices. No treatment has been found to be uniformly effective in ameliorating OSA. Because of the dynamics of airway obstruction, predicting success with any one treatment plan has also proven to be difficult.
Accordingly, there is a need for a treatment for OSA that overcomes the deficiencies of the existing methods described above.
One aspect of the present invention is a nasopharyngeal device used to assist patients who suffer from OSA. An advantage of the design is that it is 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, would otherwise close upon laying down to sleep.
According to one aspect of the present invention a nasopharyngeal device for reducing obstructive sleep apnea is provided. The nasopharyngeal device also includes an obturator that has a plurality of 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 includes 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.
In one embodiment, the tube may further include a tapered member. The tapered member may have one or more openings adapted to permit air to pass through during breathing. In one embodiment, the tapered member is disposed at or near the proximal end of the tube.
In another embodiment, the tube may have an adjustable clip member disposed at or near the proximal end of the tube and adapted to secure the tube to a nostril.
In yet another embodiment, the plurality of reversibly expandable projections may be flexible. In one embodiment, the plurality of reversibly expandable projections may be attached to the obturator in a cantilevered manner. In one embodiment, the plurality of reversibly expandable projections may be adapted to permit air to pass during breathing.
In yet another embodiment, 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. In one embodiment, the guide portion may be adapted to be secured to the tube.
According to another aspect of the present invention, a method is provided for reducing obstructive sleep apnea with a nasopharyngeal device having a catheter and an obturator that is reversibly expandable at a distal end. The method includes: inserting the nasopharyngeal device into the nasopharyngeal airway; and advancing the obturator through the catheter thereby expanding the distal end and opening the airway.
In one embodiment, movement of the soft palate may be caused by expanding the distal end of the obturator.
In another embodiment, the nasopharyngeal device may be secured to the nostril.
In another embodiment, the catheter may be adjusted such that a tapered portion rests at the nostril.
In another embodiment, the position of the nasopharyngeal device may be adjusted such that air is able to pass during breathing.
In another embodiment, the obturator may include a plurality of reversibly expandable projections. In one embodiment, the plurality of reversibly expandable projections may be attached to the obturator in a cantilevered manner.
According to another aspect of the present invention, a nasopharyngeal device is provided for reducing obstructive sleep apnea. The nasopharyngeal device includes a catheter and an obturator. The catheter includes a proximal end, a distal end, and a passage. The obturator includes means for projecting anteriorly the soft palate and thereby maintaining patency of the nasopharyngeal airway, and means for advancing and retracting the obturator through the catheter.
In one embodiment, the nasopharyngeal device may also include means for securing the nasopharyngeal device to the nostril.
In another embodiment, the nasopharyngeal device may include means for securing the obturator's position relative to the soft palate.
These aspects of the invention are not meant to be exclusive and other features, aspects, and advantages of the present invention will be readily apparent to those of ordinary skill in the art when read in conjunction with the following description, appended claims, and accompanying 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, 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.
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.
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.
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.
Referring to
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.
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
Another drawback of the nasal trumpet is the tube 14 extends past the soft palate. Referring to
Referring to
Referring to
As shown in
It should be noted that, as shown in
Still referring to
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.
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,
Referring to
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.
Referring to
Referring to
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.
Referring to
Referring to
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.
In certain embodiments, the diameter and length of the tube will vary depending upon the anatomical dimensions of the patient.
Another embodiment of a nasopharyngeal device consistent with the present invention will now be described with reference to
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.
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.
In one embodiment the tube 310 may include a clip 313 disposed on the tapered end as shown in
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.
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.
The semi-rigid solid-walled tube 310 is configured to receive the obturator 320 as illustrated in
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The present application is a continuation-in-part of U.S. patent application Ser. No. 14/621,722 filed on Feb. 13, 2015, which claims the benefit of Provisional Patent Application Ser. No. 61/939,759 filed Feb. 14, 2014, the disclosures of both of which are hereby incorporated by this reference, in their entirety.
Number | Date | Country | |
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61939759 | Feb 2014 | US |
Number | Date | Country | |
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Parent | 14621722 | Feb 2015 | US |
Child | 15278285 | US |