WO2005044368A1

WO2005044368A1 - Device for carrying out local electrostimulation of the suprahyoid musculature on the mouth floor

Info

Publication number: WO2005044368A1
Application number: PCT/EP2004/012530
Authority: WO
Inventors: Ludwig Arwed; Oliver-Taghi Monzavifar; Detlef Diederich
Original assignee: Ludwig Arwed; Oliver-Taghi Monzavifar; Detlef Diederich
Priority date: 2003-11-07
Filing date: 2004-11-05
Publication date: 2005-05-19
Also published as: DE10352007B4; DE10352007A1

Abstract

The invention concerns a device for stimulating the suprahyoid musculature (9) on the mouth floor (8), comprising: a body (1) to be placed via a surface (2) onto the mouth floor (8); a conductive electrode surface on the surface (2) of the body (1) to be placed onto the mouth floor (8), and; a number of projections (5) of the surface (2) of the body (1), which is to be placed onto the mouth floor (8), that project beyond adjacent areas of the surface (2). These projections (5) have a height greater than a maximum diameter of their cross-sectional area. The conductive electrode surface can be passed through by the projections (5) so that the projections (5) comprise parts of the conductive electrode surface.

Description

DEVICE FOR LOCAL ELECTROSTIMULATION OF THE SUPRAHYOIDAL MUSCULATORS ON THE MOUTH FLOOR

The invention relates to a device for electrostimulation of the suprahyoid muscles on the floor of the mouth.

STATE OF THE ART

For example, the stimulation of the suprahyoid muscles on the floor of the mouth can serve the purpose of increasing the tone of these muscles. For example, patients with insufficient tone of the suprahyoid muscles tend to have obstructive sleep apnea. However, the present invention is not limited to devices for treating sleep apnea. Rather, the stimulation of the suprahyoid muscles can also take place for other reasons.

From WO 00/29063 a device for electrostimulation of the suprahyoid muscles on the floor of the mouth is known, which is used for electrostimulation of the suprahyoid muscles with the aim of treating respiratory malfunctions. In this case, several individual electrodes are formed on the device, which are to be arranged on both sides of the jaw arch in rows running parallel to the posterior molars on the floor of the mouth. As a result, different areas of the suprahyoid muscles can be stimulated with the individual electrodes by applying voltages to them.

A device for electrostimulation of the suprahyoid muscles on the floor of the mouth is known from US Pat. No. 6,618,627 B2, in which individual electrodes of approx. 10 Square millimeter surface are arranged one behind the other on a base body. The individual electrodes have a rounded profile a little, ie by less than half their extension parallel to the base body, over the base body made of insulating material and are provided for arrangement on the floor of the mouth and for separate control.

When electrostimulating the suprahyoid muscles on the floor of the mouth, it turns out to be difficult to keep the electrodes in flat contact with the floor of the mouth in order to ensure reliable transmission of stimuli to the suprahyoid muscles. If the contact area becomes too small, there is a risk that the irritation will become excessive in the area of the actual contact area while the stimulation current remains the same. If, on the other hand, the maximum contact area is present, the overall irritation can remain too low if the stimulation current is tailored to smaller contact areas.

From DE 101 44 957 A1 it is known in a device for submental electrostimulation of the suprahyoid muscles on the floor of the mouth to individually adapt a base body surface facing the floor of the mouth to the floor of the individual patient. This known device has a single flat electrode which covers the essential part of the mouth bottom, but omits the area of the tongue band.

OBJECT OF THE INVENTION

The invention has for its object to provide a device for stimulating the suprahyoid muscles on the floor of the mouth, in which the stimulus is reliably transmitted to the floor of the mouth, even if the body of the device is not individually adapted to the floor of the mouth.

SOLUTION

The object of the invention is achieved by a device with the features of claim 1. Advantageous embodiments of this device are described in subclaims 2 to 10. DESCRIPTION OF THE INVENTION

In the new device, a surface of a base body to be arranged on the floor of the mouth forms a plurality of stimulation points in the area of a conductive electrode surface in the form of projections protruding from adjacent areas of the surface, the height of which is at least as large as its maximum diameter. Such projections can also be kept in direct contact with the floor of the mouth if such a contact cannot be maintained with the electrode surface as a whole. Moreover, such a protrusion can partially displace the mucous membranes covering the floor of the mouth to the side, so that the stimulus transmission takes place closer to the suprahyoid muscles and is less strongly dampened by the mucous membranes.

In the new device, stimulation points or stimulation areas of the electrode surface can also be provided, in which the surface does not form any projections. However, it is preferred if the electrode surface has stimulation points everywhere.

Preferred dimensions of the projections comprise an average cross-sectional area smaller than 5 mm ² . A mean cross-sectional area of less than 4 mm ² is particularly preferred. A lower limit is 2 to 1 mm ² , depending on the height of the protrusions. The mean cross-sectional area means the cross-sectional area parallel to the adjacent areas of the surface on average over the height of the respective projection. At a typical height of at least 1 mm, preferably at least 2 mm and even more preferably at least 3 mm, the projections are often essentially cylindrical with a rounded tip and base, the average cross-sectional area of the projections also being halfway up. The density of the protrusions can be so great that the distance of the protrusions comes down to the order of magnitude of the diameter of the protrusions.

In the new device, the stimulation points, in addition to the electrostimulation, in which the advantage of an electrode area enlarged by the projections is used, cause the transmission of mechanical stimuli to the floor of the mouth. Different stimuli can be provided.

For physical stimulation of the suprahyoid muscles in the sense of a transmission of mechanical stimuli, it may be sufficient for the base body of the device as a whole or the surface to be turned towards the floor of the mouth with the projections relative to these muscles, for example vibratingly moved. This means that there is no need for the individual projections to be movable with respect to the adjacent surface areas. Such mobility is preferred. It is particularly preferred if the projections can be driven to move relative to the adjacent surface areas. Here too, the vibration of the projections is a possible form of movement.

The principle of a conductive surface provided with projections can not only be used for the new device in the form of a mouth bottom electrode to improve the electrical contact. For example, a counter electrode can also be provided for arrangement on the outside of the skin below the mouth, which has a base body with a surface facing the skin, the surface forming a plurality of projections which protrude from adjacent regions of the surface and which are part of a coherent conductive electrode surface. The current that causes the desired stimulation of the suprahyoid muscles then flows between this electrode and an oral floor electrode arranged on the floor of the mouth.

BRIEF DESCRIPTION OF THE FIGURES

The invention is further explained and described below with reference to preferred exemplary embodiments illustrated in the figures.

Fig. 1 shows the base body of an embodiment of the new device in a view from below of the surface facing the floor of the mouth, which forms a plurality of projections.

2 and 8 each show an embodiment of a projection of the surface of the base body according to FIG. 1.

4 shows the base body of a further embodiment of the new device in a view from below. FIG. 5 shows the counter electrode of an embodiment of the new device in a view from above.

6 shows the counter electrode of a further embodiment of the new device in a view from above. DESCRIPTION OF THE FIGURES

1 shows a view from below of a base body 1 of a device for stimulating the suprahyoid muscles on the floor of the mouth. The surface 2 of the base body under consideration is to be arranged on the floor of the mouth when the device is used. It then points down. The base body 1 is guided upwards in the mouth through the tongue and laterally through the jaw arch of the lower jaw. It can also be supported on the teeth of the lower jaw via a bandage plate 3 indicated here by dashed lines. The base body 1 has a plurality of locally limited stimulation points 4 for the transmission of stimuli to the suprahyoid muscles. In each of the stimulation points 4, the surface 2 forms a projection 5, which projects downward over the adjacent areas of the surface 2 towards the floor of the mouth. In stimulation points 4, physical stimuli are transmitted to the floor of the mouth or the suprahyoid muscles located there under the mucous membranes. The entire surface 2 to be arranged on the floor of the mouth, including the projections 5, is designed as a conductive electrode surface which is connected to a line 6, except for an area 7 which is arranged above the tongue band on the floor of the mouth. In spite of the electrode passing through the majority of the protrusions 5, the electrostimulation of the floor of the mouth is concentrated on the stimulation points 4 solely because of the geometry of the arrangement of the device in the mouth. The area 7 is here excluded from the electrode surface with the stimulation points 4 because an irritation of the Tongue strap is usually undesirable. However, there may be special applications in which physical stimuli are also to be transmitted, or in particular in this area. Then stimulation points 4 are to be formed there.

2 and 3 outline two different embodiments of a stimulation point

4. What they have in common is that the surface 2 of the base body 1 and thus the electrode surface in the stimulation point 4 forms a projection 5 opposite protrudes the adjacent areas of the surface 2. The projection 5 can be essentially cylindrical with a rounded tip and a rounded base. However, this is not mandatory. Fig. 2 outlines the simplest case of rigid projections. Such projections 5 exert local pressure on the floor of the mouth 8. You can partially displace the mucous membrane 10 covering the suprahyoid muscles 9 there laterally, so that this pressure also acts directly on the suprahyoid muscles 9 and irritates them. When the entire base body 1 moves relative to the floor of the mouth 8, the projections 5 also move relative to the floor of the mouth 8. Such a movement, which is indicated by a double arrow 11 in FIG Lower jaw triggered but also by different tension of the suprahyoid muscles, which can lead to a relative movement of the floor of the mouth 8 with respect to the jaw arch.

The projections 5 can also be movable relative to the adjacent areas of the surface 2, both passively and in particular also actively, in order to increase the mechanical irritation of the floor of the mouth. This is outlined in Fig. 3. A double pivot arrow 12 indicates here how a projection 5 made of elastic material can be moved relative to the adjacent regions of the surface 2 by an embedded rod which is moved back and forth within the base body 1.

FIG. 4 shows a bottom view of the surface 2 of a base body 1 of a further embodiment of the new device for stimulating the suprahyoid muscles on the floor of the mouth. Here, the base body 1 is skeletonized compared to the embodiment according to FIG. its surface 2 facing the floor of the mouth only covers the areas next to the tongue band within the arch of the lower jaw where stimulation is to be transmitted to the floor of the mouth. The electrode surface, including the stimulation points 4 and corresponding projections 5, in the front region of the base body to which the line 6 is connected can be dispensed with. For this reason, the stimulation points 4 and projections 5 are only indicated with dashed lines.

A counter electrode 22 for the electrostimulation of the suprahyoid muscles is sketched in FIG. 5. The counterelectrode 22 also has a base body 1 with a surface 2, the entirety of which comprises a protrusion 55, which is continuously conductive Forms electrode surface. The projections 5 improve the electrical contact of the counter electrode 22 with the skin below the floor of the mouth, where the counter electrode 22 is to be arranged on the side of the superhyoid muscles opposite the floor of the mouth. 5 also of circular dimensions and therefore not matched to the arrangement of the stimulation points on the floor of the mouth.

The situation is different with the counterelectrode 22 according to FIG. 6. Due to its arc shape, this is more closely related to the anatomy, i.e. the three-dimensional curvatures of the skin, adjusted below the floor of the mouth. In addition, the distribution of the projections 5 here can correspond to that of the projections 5 and stimulation points 4 on the floor of the mouth.

It is understood that the advantages of an electrode provided with projections in the electrical contacting of a skin or mucous membrane exist regardless of whether the suprahyoid muscles on the floor of the mouth or other muscles or tissues are stimulated or whether tensions or currents are to be tapped from the respective skin. In any case, the projections ensure more intensive contact between the skin and the electrode in the area of its tips. At the same time, they enlarge the surface of the electrode and thus the available contact area. This reduces the contact resistance by calculation alone, since the respective current can flow over a larger cross-sectional area.

LIST OF REFERENCE NUMBERS

Basic body 11 double arrow

Surface 12 double swivel arrow

Bandage plate

stimulation point

head Start

management

Area

Floor of the mouth suprahyoid muscles

mucous membrane

Counter electrode lead electrode surface

Claims

PATENT CLAIMS

1. Device for stimulating the suprahyoid muscles (9) on the floor of the mouth (8) with: - a base body (1) to be arranged with a surface (2) on the floor of the mouth (8), - a conductive electrode surface on the floor of the mouth (8) to be arranged surface (2) of the base body (1) and - a plurality of projections (5) of the surface (2) of the base body (1) to be arranged on the mouth bottom (8), which protrude from adjacent regions of the surface (2), - wherein the projections (5) have a height which is greater than a maximum diameter of their cross-sectional area, and - the conductive electrode surface being continuous over the projections (5), so that the projections (5) are part of the conductive electrode surface.

2. Device according to claim 1, characterized in that the letable electrode surface is continuous over the entire surface (2) of the base body to be arranged on the floor of the mouth (8).

3. Device according to claim 1 or 2, characterized in that at least one projection (5) has an average cross-sectional area smaller than 5 mm ² .

4. The device according to claim 3, characterized in that at least one projection (5) has an average cross-sectional area smaller than 4 mm ² .

5. The device according to claim 3 or 4, characterized in that the cross-sectional area of the projection (5) is round.

6. Device according to one of claims 1 to 5, characterized in that at least one projection (5) has a height of at least 2 mm.

7. Device according to one of claims 1 to 6, characterized in that at least one projection (5) has a height of at least 3 mm.

8. The device according to at least one of claims 1 to 7, characterized in that the projection (5) relative to the adjacent regions of the surface (2) is movable.

9. The device according to claim 8, characterized in that the projection (5) relative to the adjacent regions of the surface (2) is drivable for movement.

10. The device according to one of claims 1 to 9, characterized in that a counter electrode (22) is further provided for arrangement outside on the skin below the mouth and has a base body (1) with a surface (2) facing the skin, wherein the surface (2) likewise forms a plurality of projections which protrude from adjacent regions of the surface (2) and which are part of a continuous conductive electrode surface (24).