Patent Application
20150011920
The present invention pertains generally to the treatment of balance disorders. More particularly, the present invention pertains to systems and methods for treating balance disorders that are caused by complications in the inner ear of a patient. The present invention is particularly, but not exclusively, useful as a system that can be used to treat a balance disorder by repositioning detached canaliths in the inner ear of a patient.
It is widely understood there is a mechanism located in a person's inner ear that provides the individual with his/her sense of balance. Anatomically, this mechanism is made up of clusters of sensory hair cells that are specifically oriented and aligned inside the inner ear. Further, each hair cell in a cluster includes an otolith (i.e. a “stone” or a “crystal”) which is coupled with the hair cell.
In their operation, clusters of the balance sensing mechanism sense gravity and linear accelerations as they are experienced by the individual. To do this, some clusters are aligned in the utricle with a generally horizontal orientation (i.e. in the axial plane). Other clusters are aligned in the saccule with a generally vertical orientation (i.e. the parasagittal plane). Within this structure, whenever there are changes in the forces acting on the otoliths, they are accelerated relative to the hair cell. These accelerations (i.e. force changes) are then transmitted via the hair cell to the brain for the purposes of providing a sensory perception of balance.
For any number of reasons, an otolith (crystal) can become decoupled from its hair cell (e.g. disease, age, or trauma). In its decoupled or detached condition, the formerly called otoliths are thereafter more specifically referred to as “canaliths.” In the event, the canaliths remain unrestrained inside the canals of the inner ear where they are capable of being disruptive in a manner that leads to balance disorders.
Heretofore, the most commonly used technique for alleviating or avoiding the disruptive effects of loose canaliths in the inner ear has been to perform specified head movements, such as the Dix Hallpike Maneuver. The intent here has been to reposition the canaliths to other locations in the inner ear where their adverse consequences are effectively nullified. It can happen however, that conditions inside the inner ear may hinder or impede the movement of canaliths through the canals. In particular, such an obstruction may result as canaliths “clump” together, and/or “stick” to the walls of the canals.
In light of the above it is an object of the present invention to provide a system and method for repositioning detached otoliths (i.e. canaliths) in the inner ear of a patient to obviate a balance disorder. Another object of the present invention is to treat a balance disorder by rapidly moving the head of a patient in accordance with a predetermined protocol to generate elevated forces (i.e. hyper-G forces) inside the canals of the inner ear that will move and reposition, otherwise immobile, canaliths that have been refractory to standard repositioning protocols. Still another object of the present invention is to provide a system and method for relocating canaliths inside the inner ear of a patient to obviate a balance disorder that is easy to use and comparatively cost effective.
In accordance with the present invention, a system for repositioning canaliths in the inner ear of a patient to treat a balance disorder includes a base member, a patient support and a connecting assembly. Also for the system, motors are included to move the patient support (and patient) at relatively high angular velocities, from one patient position to the next, in accordance with a predetermined protocol such as the so-called Epley maneuver.
In more structural detail, the patient support is mounted on the connecting assembly and the connecting assembly is engaged with the base member. In one embodiment, the connecting assembly can include a substantially U-shaped loop member that has a first end and a second end. With this arrangement, the system defines a first rotation axis that extends through the first and second ends of the loop member. Specifically, a motor can be affixed to one end of the loop member and a mount affixed to the other end of the loop member. The patient support is positioned between the ends of the loop member and operably attached to both the mount and motor to allow the patient support to be rotated through selected angles, θ1, about the first axis by the motor. In more quantitative terms, it is envisioned for the present invention that the motor will rotate the patient support (and patient) through a selected angle, θ1, about the first axis at an angular velocity, ω1, that is in the range of about 20 to 50 revolutions per minute (rpm).
The patient support (and patient) can also be rotated about a second axis that is perpendicular to the first axis. To provide this rotation, a motor is mounted on the base member having a motor shaft aligned with the second axis. A swivel joint is also mounted on the base member and positioned on the second axis. The motor shaft passes through the swivel joint and engages the loop member at an attachment point that is established on the loop member midway between the ends of the loop member. This arrangement allows the patient support to be rotated through selected angles, θ2, about the second axis by the motor. In more quantitative terms, it is envisioned for the present invention that the motor will rotate the patient support (and patient) through a selected angle, θ2, about the second axis at an angular velocity, ω2, that is in the range of about 20 to 50 revolutions per minute (rpm).
Also for the system of the present invention, a controller is provided for selectively activating the motors to rotate the patient support (and patient) about the first and second axis and relative to the base member. Typically, the patient is moved through a sequence of positions by the system in accordance with a predetermined protocol (such as the Epley maneuver protocol). During the maneuver, to move the patient from one position to the next, one or both of the motors are activated to selectively rotate the patient through appropriate angles θ1, θ2, at respective angular velocities ω1 and ω2. A computer can be connected with the controller to execute a set of programmed instructions (i.e. software code) to operate the system in accordance with the predetermined protocol.
The novel features of this invention, as well as the invention itself, both as to its structure and its operation, will be best understood from the accompanying drawings, taken in conjunction with the accompanying description, in which similar reference characters refer to similar parts, and in which:
Referring initially to
For the system 10 shown in
As best seen in
Typically, the patient 12 shown in
1. patient has head centered (θ1, =90°, θ2=0°);
2. patient sits with head 45 degrees to the right (θ1, =45°, θ2=0°);
3. patient lays back with head 45 degrees to the right and held in approximately 20 degrees of extension (θ1, =45°, θ2=110°);
4. patient returns with head centered (θ1, =90°, θ2=0°);
5. patient sits with head 45 degrees to the left (θ1, =135°, θ2=0°);
6. patient lays back with head 45 degrees to the left and held in approximately 20 degrees of extension (θ1, =135°, θ2=110°); and
7. patient sits back up with head centered (θ1, =90°, θ2=0°).
During the maneuver, involuntary eye movement (Nystagmus) can be monitored by the clinician. In some cases, the patient 12 can wear a goggle system (not shown) during the procedure to assist the clinician in diagnosing a balance disorder. For example, the patient 12 can wear a goggle system as described and claimed in co-pending, co-owned U.S. patent application Ser. No. 13/929,572, filed Jun. 27, 2013, titled “Goggles for Emergency Diagnosis of Balance Disorders,” the entire contents of which are hereby incorporated by reference herein.
While the particular System for Dynamically Generating Hyper-G Forces to Relocate Detached And Impeded Canaliths in the Inner Ear as herein shown and disclosed in detail is fully capable of obtaining the objects and providing the advantages herein before stated, it is to be understood that it is merely illustrative of the presently preferred embodiments of the invention and that no limitations are intended to the details of construction or design herein shown other than as described in the appended claims.
