TR2021006400A2

TR2021006400A2 - DEVICE AND METHOD TO EVALUATE THE UTRICULE AND PICCULA DUE TO THE MIDDLE EAR REFLEX

Info

Publication number: TR2021006400A2
Application number: TR2021/006400
Authority: TR
Inventors: Uz Yilmaz O
Original assignee: Oğuz Yilmaz
Filing date: 2021-04-09
Publication date: 2021-06-21

Abstract

Buluş, periferik vestibüler yapılar arasında yer alan otolit organ olan sakkül veThe invention is related to the saccule and saccule, which is the otolith organ located between the peripheral vestibular structures.

Description

TARIFNAME ORTA KULAK REFLEKSINE BAGLI OLARAK UTRIKÜL VE SAKKÜLÜN DEGERLENDIRILMESINI SAGLAYAN CIHAZ VE YÖNTEM TEKNIK ALAN Bulus, periferik vestibüler yapilar arasinda yer alan otolit organlarin özellikle sakkül ve utrikülün degerlendirilmesini saglayan cihaz ve yöntemi ile ilgilidir. DESCRIPTION DUE TO MIDDLE EAR REFLEX, UTRICULE AND PICCULA THE DEVICE AND METHOD OF EVALUATION TECHNICAL FIELD The invention shows that the otolith organs located between the peripheral vestibular structures, especially the saccule and the device and method that provides the evaluation of the utricle.

TEKNIGIN BILINEN DURUMU Denge sistemi, bireylerin iki ayak üzerinde durmasini ve görsel sabitligi saglamakta olan bir yapidir. Bu yapinin komponentlerinden bir tanesi de periferik vestibüler sistemdir. Periferik vestibüler yapilar iç kulagimizda yer almakta ve temel olarak 5 kisimdan olusmaktadir. 3 adet yarim daire kanali, utrikül ve sakkül adi verilen otolit organlar yer almaktadir. KNOWN STATE OF THE TECHNIQUE The balance system enables individuals to stand on two legs and provides visual stability. it is a structure. One of the components of this structure is peripheral vestibular. is the system. Peripheral vestibular structures are located in our inner ear and basically consist of 5 consists of me. 3 semicircular canals, utricle and otolith called saccule organs are included.

Vestibüler (iç kulak) yetmezlikleri bas dönmesi, vertigo, denge kaybi, isitme degisiklikleri, mide bulantisi, bitkinlik, anksiyete, konsantrasyon güçlügü ve diger semptomlara ve bir kisinin günlük islevlerinde, çalisma becerisinde, aile ve arkadaslariyla iliskilerinde ve yasam kalitesinde muhtemel sorunlara yol açabilir. Vestibular (inner ear) deficiencies, dizziness, vertigo, loss of balance, hearing changes, nausea, fatigue, anxiety, difficulty concentrating, and other symptoms and a person's daily functioning, ability to work, family and It can cause potential problems in relationships with friends and quality of life.

Vestibüler uyarilmis miyojenik potansiyeller (VEMP) kisaca vestibülokolik refleksi degerlendiren yüksek sese cevaben boyun kaslarindan ya da ekstraoküler kaslardan kaydedilen inhibitör bir potansiyeldir. VEMP testinin amaci iç kulakta denge organindaki sakkül ve utrikül fonksiyonlarini degerlendirmektir. Vestibular evoked myogenic potentials (VEMP) for short, the vestibulocolic reflex from neck muscles or extraocular It is an inhibitory potential recorded from the muscles. The purpose of the VEMP test is in the inner ear. To evaluate the saccule and utricle functions in the balance organ.

Sternokleidomastoid (SKM) adeleden kaydedilen VEMP cevaplarina servikal C- VEMP, inferior rektus adelesinden kaydedilen VEMP cevaplarina ise oküler O- VEMP adi verilmektedir. VEMP responses recorded from the sternocleidomastoid (SCM) VEMP was added to VEMP responses recorded from the inferior rectus muscle, while ocular O- It is called VEMP.

C-VEMP testinde hastanin kulagina ses verilirken ayni anda bu sese cevap olarak boyundaki adelelerde meydana gelen refleks boyuna yerlestirilen elektrodlarla kaydedilir. C-VElVlP yüksek sesli akustik uyarana cevaben Sternokleidomastoid adeleden yapilan elektromiyografik kayitta elde edilen bifazik dalgadir. Aslinda test vestibülokolik refleksi degerlendirir. C-VEMP testi refleks arkindan da anlasilacagi üzere sakkül, inferior vestibüler sinir ve alt beyin sapinin fonksiyonunu degerlendirmektedir. In the C-VEMP test, while a sound is given to the patient's ear, at the same time, it responds to this sound. reflex occurring in the muscles of the neck, with electrodes placed in the neck saved. C-VElVlP Sternocleidomastoid in response to loud acoustic stimulus It is the biphasic wave obtained in the electromyographic recording made from the muscle. actually test Evaluates the vestibulocolic reflex. C-VEMP test can also be understood from the reflex arc. functions of the saccule, inferior vestibular nerve, and lower brain stem. is evaluating.

O-VEMP testinde ise hastanin kulagina ses verilirken diger taraftaki göz altina yerlestirilen elektrotlarla göz kasindaki kasilmalar kaydedilir. O-VEMP yüksek siddetli akustik uyarana cevaben kontralateral ekstraoküler göz kaslarindan elde edilen miyojenik potansiyellerdir. Miyojenik cevabin büyük oranda utrikül ve süperior vestibüler sinir cevabini yansittigi düsünülmektedir. Hastalarin o-VEMP testi esnasinda devamli olarak yukari bakmasi gerekmektedir. Söz konusu pozisyon için hastalarin sabit durmasi ve/veya efor sarf etmesi hastalar için zorluk yaratmaktadir. Hastalarda yasanan göz kirpmalari o-VEMP testinde dogru bir degerlendirme yapilmasini engelleyebilmektedir. In the O-VEMP test, while sound is heard in the patient's ear, the other side is under the eye. The contractions in the eye muscle are recorded with the electrodes placed. O-VEMP high Obtained from the contralateral extraocular eye muscles in response to intense acoustic stimulus. the myogenic potentials. The myogenic response is largely due to the utricle and It is thought to reflect the superior vestibular nerve response. Patients' o-VEMP During the test, it should constantly look up. Aforementioned Difficulty for patients to stand still and/or exert effort for the position creates. Blinks experienced in patients are not an accurate test in the o-VEMP test. may prevent evaluation.

VEMP testi de birçok vestibüler fonksiyon testi gibi direkt tani koydurucu olmaktan ziyade vestibüler sistemin fonksiyonlari hakkinda bilgi verir. Diger testlere göre en büyük avantaji vestibüler sistemin sinirli bir bölgesine (otolit organlar, vestibüler sinir ve beyin sapi) spesifik olmasidir. VEMP test, like many vestibular function tests, is not directly diagnostic. rather, it gives information about the functions of the vestibular system. According to other tests Its great advantage is to a nervous area of the vestibular system (otolith organs, vestibular nerve and brain stem) is specific.

Yukarida bahsedilen VEMP sistemlerinde kas hareketlerinin ve buna bagli olarak otolit organlarin fonksiyonlarinin test edilmesi amaciyla vücuda yapistirilan elektrotlar uygulamada zorluklara sebep olmaktadir. Her hasta için elektrotlar ve deri temizleyici jeller kullanilmaktadir. Söz konusu elektrotlar testi uygulayan kisi tarafindan kaslarin deri üzerindeki iz düsümüne bakilip tahmin edilerek yapistirilmaktadir. In the above-mentioned VEMP systems, muscle movements and, accordingly, affixed to the body to test the functions of otolith organs. electrodes cause difficulties in application. electrodes for each patient and leather cleansing gels are used. The electrodes in question are the person performing the test. by looking at the projection of the muscles on the skin and estimating is being pasted.

VEMP sistemleri, denge sisteminde yasanan degisimlerin degerlendirilebilmesi için kas kasilmalarini baz alarak çalismaktadir. Söz konusu kasilmalar elektrotlari yerlesim yerine, kas kitlesine, yas ve farkli hastaliklara bagli olarak degisebilmektedir. Bu degisimler, kayit alinmasinda ve degerlendirmede zorluklara neden olabilmektedir. VEMP systems are used to evaluate the changes in the balance system. It works based on muscle contractions. The contraction electrodes in question depending on location, muscle mass, age and different diseases can change. These changes cause difficulties in recording and evaluation. may cause.

Sonuç olarak utrikül ve sakkül gibi otolit organlarin degerlendirilmesi için direkt olarak kulaktan test yapabilmeyi saglayan cihaz ve yönteminin gelistirilmesi gerekli görülmektedir. As a result, direct evaluation of otolith organs such as utricle and saccule It is necessary to develop a device and method that enables ear testing. is seen.

BULUSUN AÇIKLAMASI Mevcut bulus; yukarida bahsedilen gereksinimleri karsilayan, tüm dezavantajlari ortadan kaldiran ve ilave bazi avantajlar getiren, özellikle odyoloji alaninda kullanilabilecek cihaz ve yöntemi ile ilgilidir. DESCRIPTION OF THE INVENTION The present invention; meets the above-mentioned requirements, all the disadvantages especially in the field of audiology, which eliminates It is related to the device and method that can be used.

Denge sistemi, bireylerin iki ayak üzerinde durmasini ve görsel sabitligi saglamakta olan bir yapidir. Bu yapinin komponentlerinden biri de periferik vestibüler sistemdir. The balance system enables individuals to stand on two legs and provides visual stability. it is a structure. One of the components of this structure is the peripheral vestibular system.

Periferik vestibüler yapi, iç kulakta yer almakta ve temel olarak 5 kisimdan olusmaktadir. Iç kulakta yer alan bu yapilar; 3 adet yarim daire kanali, utrikül ve sakkül adi verilen otolit organlardir. Peripheral vestibular structure is located in the inner ear and basically consists of 5 parts. is formed. These structures in the inner ear; 3 semicircular canals, utricle and are otolith organs called saccule.

Bulusa konu olan cihazla degerlendirme sakkül ve utrikül isimli otolit organlar degerlendirilmektedir. Sakkül özellikle bireylerin yukari ve asagi yönlü hareketlerinin algilanmasinda (asansörde hareket algilanmasi), utrikül ise yatay düzlemde hareket algilanmasinda (ön/arka, sag/sol hareketeler) rol oynamaktadir. Evaluation with the device, which is the subject of the invention, otolith organs named saccule and utricle is being evaluated. The saccule, especially in the upward and downward direction of individuals in the perception of movements (movement in the elevator), the utricle is horizontal It plays a role in the perception of motion in the plane (front/back, right/left movements).

Bulusun amaci hastalara kulaktan uygulama yapilarak her iki periferik vestibüler yapinin degerlendirmesini yapan isitme testi cihazi ve yönteminin elde edilmesidir. The aim of the invention is to apply by ear to the patients, both peripheral vestibular It is the acquisition of the hearing test device and method that evaluates the structure.

Bulusun diger bir amaci ise kulak kaslari yardimiyla periferik vestibüler yapinin degerlendirmesidir. Another purpose of the invention is the peripheral vestibular structure with the help of ear muscles. is the assessment.

Bulusun diger bir amaci ise orta kulak kas yapilarinda sesli uyarana bagli olarak kasilma/gevseme miktarinda yasanan degisimler ile utrikül ve sakkülün degerlendirilmesidir. Another aim of the invention is to detect the stimulus in the middle ear muscle structures depending on the audible stimulus. with changes in the amount of contraction/relaxation of the utricle and saccule. is the evaluation.

Bulusun diger bir amaci ise hastalara tek bir uygulama yapilmasi sayesinde her iki periferik vestibüler yapinin degerlendirilmesidir. Another aim of the invention is to make a single application to the patients, both of them. evaluation of the peripheral vestibular structure.

Bulusun diger bir amaci ise tercihen ses üreteci, A/D dönüstürücü, islemci, manometre, ekran ve kulaklik içeren bir isitme testi cihazi elde edilmesidir. Another object of the invention is preferably a sound generator, A/D converter, processor, It is the acquisition of a hearing test device that includes a manometer, display and earphones.

Bulusun diger bir amaci ise tercihen farkli siddetlerde sesin hastaya verilmesini saglayan iki adet hoparlör ve yansiyan sesi alan mikrofon içeren insert kulakligin elde edilmesidir. Another purpose of the invention is to give the patient a sound, preferably at different intensities. insert earphones with two speakers that provide is to be obtained.

Bulusun diger bir amaci ise elektrot gibi sarf malzeme kullanimina gerek olmadan denge sisteminde yasanan degisimlerin alinip degerlendirilebilmesidir. Another aim of the invention is without the need for consumables such as electrodes. It is the ability to take and evaluate the changes in the balance system.

Bulusun diger bir amaci ise testi hastaya uygulayan kisinin elektrot yerlesim yerlerini belirlenmesinden dolayi ortaya çikan hatalarin en aza indirgenmesi ve/veya ortadan kaldirilmasidir. Another purpose of the invention is the electrode placement of the person who performs the test on the patient. minimizing the errors that occur due to their location and/or elimination.

Bulusun diger bir amaci ise elektrotlarin yerlesim yerine, kas kitlesine, yas ve farkli hastaliklara bagli olarak test sonuçlarinin degismesinden kaynaklanan kayit sorunlarinin ve degerlendirme zorluklarinin önüne geçilmesidir. Another aim of the invention is to determine the location of the electrodes, muscle mass, age and different record due to changes in test results due to diseases problems and assessment difficulties.

Bulusun diger bir amaci ise isitme testi sirasinda hastalara zorluk yaratan test pozisyonu için hastalarin sabit durmasi ve/veya sabit durmak için efor sarf etmelerinin önüne geçilmesidir. Another purpose of the invention is the test that creates difficulties for the patients during the hearing test. for the patient to stay still and/or make an effort to stay still. is to prevent them.

Bulusun diger bir amaci ise hastalarda test sirasinda yasanan pozisyon farkliliklarindan kaynaklanan test sonuçlarinin yanlis olmasi buna bagli olarak da yanlis degerlendirme ve/veya yanlis ölçüm yapilmasinin engellenmesidir. Another aim of the invention is the position experienced in the patients during the test. Incorrect test results due to differences in It is to prevent wrong evaluation and/or wrong measurement.

Bulusun diger bir amaci ise kablo ve sarf malzemesi kullanimi gerektirmeyen ve hasta katiliminin daha sinirli olmasina bagli olarak daha objektif degerlendirme yapilmasidir. Another aim of the invention is to use cables and consumables that do not require and more objective evaluation due to more limited patient participation is to be done.

Sekillerin Açiklamasi Yukarida kisaca anlatilan ve asagida daha detayli ele alinan mevcut bulusun, bir veya daha fazla düzenlemelere uygun olarak, çizimlerde belirtilen örnek uygulamalar sadece açiklama amaciyla verilmistir ve sadece bulusun bazi örneklerini ve/veya dizaynlarini göstermektedir. Bu çizimler, okuyucunun bulusu anlayisini kolaylastirmak için saglanmistir ve bulusun kapsamini ve uygulanabilirligini sinirlandirmasi olarak düsünülmemelidir. Description of Figures The present invention, briefly described above and discussed in more detail below, is a or in accordance with further regulations, the sample specified in the drawings applications are provided for illustrative purposes only and only some of the shows examples and/or designs. These drawings are the reader's invention. provided to facilitate understanding and should not be considered as limiting its applicability.

Sekil 1: insert/hoparlör kulakligin dizaynini göstermektedir. Figure 1: shows the design of the insert/speaker headset.

Referans Listesi )Ses Üreteci )Islemci )Ekran 40)Insert Kulaklik 41)Kalibre Edilmis Hoparlör 42)Mikrofon 50)A/D Çevirici 60)Manometre 70)Hoparlör Kulaklik 80)Basinç tüpü BULUSUN DETAYLI AÇIKLAMASI Bulusun bu yapilanmasinda bulus konusu periferik vestibüler yapilar arasinda yer alan otolit organlarin özellikle sakkül ve utrikülün degerlendirilmesini saglayan cihaz ve yöntemi, sadece konunun daha iyi anlasilmasina yönelik olarak ve hiçbir sinirlayici etki olusturmayacak sekilde açiklanmaktadir. Referance list )Sound Generator )Processor )Screen 40)Insert Headphones 41) Calibrated Speaker 42)Microphone 50)A/D Converter 60) Manometer 70)Speaker Headphones 80)Pressure tube DETAILED DESCRIPTION OF THE INVENTION In this structuring of the invention, the subject of the invention is located between the peripheral vestibular structures. The device that enables the evaluation of otolith organs, especially the saccule and utricle, and method, only for a better understanding of the subject and without any It is explained in a way that does not have a restrictive effect.

Sakkül ve utrikülün degerlendirilmesini saglayan cihaz; ses üreteci (10), islemci kulaklik (70) içermektedir. Söz konusu insert kulaklik (40), periferik vestibüler yapilara ses iletilmesini kalibre edilmis hoparlör (41) bu yapilardan yansiyan seslerin toplanmasini saglayan mikrofon (42), hoparlör kulaklik (70) ve basinç tüpü (80) içermektedir. Hoparlör kulaklik (70) ise islemci ve ekrana bagli diger kulaktan ses üreteci (10) ve hoparlör (41) içermektedir. The device that provides the evaluation of the saccule and utricle; sound generator (10), processor headset (70). Said insert earpiece (40), peripheral vestibular calibrated loudspeaker (41) transmitting sound to structures reflected from these structures microphone (42), speaker earphone (70) and pressure tube that provide sound collection (80) include. The speaker earphone (70) is the other ear connected to the processor and the screen. it includes a sound generator (10) and a loudspeaker (41).

Basinç tüpü (80) ve bagli olan manometre (60), orta kulak basinci ile dis kulak yolu basinçlarini esitleyerek dis kulak yoluna aktarilan sesin en etkin sekilde verilmesini saglamaktadir. Pressure tube (80) and connected manometer (60) It ensures that the sound transferred to the external ear canal is given in the most effective way by equalizing the pressures. it provides.

Her iki kulak için ayri ayri kalibre edilmis ve bulus konusu isitme testi cihazi için ses üretilmesini saglayan ses üreteci (10), dis kulak yoluna yerlestirilen insert kulaklik (40) içinde bulunan ve üretilen sesin periferik vestibüler yapilara iletilmesini saglayan tercihen iki adet kalibre edilmis hoparlör (41) ve orta kulaktan yansiyan seslerin alinmasini saglayan mikrofon (42) ve dis kulak yoluna basinç uygulayabilen manometreye bagli hoparlör sistemi (43) ile karsi kulaktan ses verilmesini saglayan ses üreteci (10) ve kalibre edilmis ses verilmesini saglayan hoparlör kulaklik (70) cihazin önemli unsurlaridir. iletilmesini saglayan tercihen iki adet kalibre edilmis hoparlör (41) asagidaki islevleri yerine getirmektedir. o Insert kulaklik içinde bulunan kalibre edilmis hoparlörlerden (41 ) tercihen bir tanesi devamli olarak (continuous) 226 Hz'de 85 dB SPL ses seviyesinde ses verilmesini (akustik uyaran) saglamaktadir. o Insert kulaklik içinde bulunan kalibre edilmis hoparlörlerden (41) tercihen bir tanesi 60 saniye boyunca white noise ses verilmesini saglamaktadir. White noise uyaran ile orta kulak kasini kasilmasi saglanmakta ya da utrikül/sakkül cevabi için tercihen uzmanin tercihine göre farkli frekans ve siddetlerde ses verilmesini saglamaktadir. The sound for the hearing test device, which is the subject of the invention, is separately calibrated for both ears. sound generator (10), which allows the (40) transmitting the sound produced and contained in it to the peripheral vestibular structures. preferably two calibrated speakers (41) and microphone (42) that allows the reception of sounds and pressure to the external ear canal sound from the opposite ear with the loudspeaker system (43) connected to the manometer that can apply sound generator (10), which provides speaker, earpiece (70) are important elements of the device. Preferably two calibrated loudspeakers (41) providing the following functions fulfills. o Preferably one of the calibrated speakers (41) in the insert earphones one continuously (continuous) at 226 Hz at 85 dB SPL sound level It provides sound (acoustic stimulus). o Preferably one of the calibrated speakers (41) in the insert earphones one of them provides white noise for 60 seconds. white With the noise stimulus, the middle ear muscle is contracted or the utricle/sacculi for the answer, preferably at different frequencies and intensities according to the preference of the expert. provides to be given.

Hoparlör kulaklik (70) içinde bulunan ses üreteci (10) ve tercihen 1 adet kalibre edilmis hoparlör (41) ise testin niteligine bagli olarak insert kulaklikta yer alan hoparlörden ses verilmemesi durumunda utrikül/sakkül cevabi için tercihen uzmanin tercihine göre farkli frekans ve siddetlerde ses verilmesini yada 60 saniye boyunca white noise saglamaktadir. The sound generator (10) in the speaker earpiece (70) and preferably 1 caliber The speaker (41) is the one in the insert earphone, depending on the nature of the test. preferably for utricle/saccule response in case of no sound from speaker sound at different frequencies and intensities according to the preference of the specialist or for 60 seconds. It provides white noise throughout.

Yukarida bahsedilen unsurlarin çalismasini ve yönetimini saglayan islemci (20) yer almaktadir. Söz konusu islemci (20), ses olarak verilen uyaranin siddetinin ve frekans gibi özelliklerinin ayarlanabilmesini saglamaktadir. A/D çeviriciler (50), mikrofondan (42) gelen analog sinyalleri dijital veriye çevirir. Test sirasinda ve/veya sonrasinda elde edilen verilerin aktarildigi ekran (30) bulunmaktadir. Ekran (30) gerekli ara baglantilarla tercihen kablo ile sisteme entegre edilmistir. Söz konusu ekranda (30), mikrofondan (42) alinan ve A/D çevirici (50) ile dijital veriye çevrilen veriler testi uygulayan kisiye sunulmaktadir. The processor (20) that provides the operation and management of the above-mentioned elements is located. takes. Said processor (20) determines the intensity and frequency of the stimulus given as sound. It allows to adjust features such as frequency. A/D converters (50), converts the analog signals coming from the microphone 42 into digital data. during testing and/or Afterwards, there is a screen (30) where the data obtained is transferred. Display (30) It is integrated into the system with the necessary interconnections, preferably with a cable. Aforementioned on the screen (30), received from the microphone (42) and converted into digital data with the A/D converter (50). The data are presented to the person administering the test.

Söz konusu cihaz, sakkül ve utrikül yapilarinin degerlendirilmesi saglamaktadir. The device in question provides the evaluation of saccule and utricle structures.

Ayrica cihazda bulunan basinç borusu (43), manometre (60) ve/veya basinç tüpü (80) söz konusu cihazin timpanometri olarak kullanilabilmesine olanak saglamaktadir. In addition, the pressure pipe (43), manometer (60) and/or pressure tube in the device (80) allows the device in question to be used as tympanometry. it provides.

Bulusa konu cihaza iliskin yöntem: Söz konusu yöntem, periferik vestibüler yapilarin (utrikül ve sakkülün) dis kulak yoluna yerlestirilen insert kulaklik ile alinan verilerle degerlendirilmesini mümkün kilmaktadir. Method regarding the subject device of the invention: The method in question is the outer ear of the peripheral vestibular structures (utricle and saccule). It is possible to evaluate it with the data received with the insert earphone placed on the path. it builds.

Iç kulakta yer alan bu 5 yapinin ayri ayri degerlendirilmesi, hastaliklarin ortaya konulmasi ve bu buna bagli olarak tedavilerin planlanmasinda kritik öneme sahiptir. Evaluating these 5 structures in the inner ear separately, revealing the diseases It is of critical importance in the treatment and, accordingly, in the planning of treatments.

Bulus kapsaminda elde edilen cihaz ve yöntem, hastalara verilen bir uyaran sonrasi denge sisteminde yasanan degisimlerin takip edilmesini saglamaktadir. The device and method obtained within the scope of the invention are used after a stimulus given to the patients. It allows the changes in the balance system to be followed.

Bulusta kullanilan bazi terimlerin açiklamasi: Test edilen kulak: Akustik uyarana bagli olarak utrikül ve/veya sakkül cevaplarinin alindigi kulaktir. Explanation of some terms used in the invention: Tested ear: Depending on the acoustic stimulus, utricle and/or saccule responses it is the ear it is taken.

Test edilmeyen kulak: Akustik uyaran gönderilip utrikül ve/veya sakkül cevaplarinin beklenmedigi tespit edilen kulaktir. Untested ear: Acoustic stimulus is sent and utricle and/or saccule responses It is the ear that is detected unexpectedly.

Bulus kapsaminda; kisilere hoparlör ile test edilen ve/veya test edilmeyen kulaktan ses verilmesi (akustik uyaran) ile orta kulakta yer alan M. Stapedius kasinda kasilma saglanmaktadir. Burada uygulanan akustik uyaran tercihen 60 saniye süre ile genis bant gürültü olacak sekilde verilmektedir. Ses siddeti tercihen akustik refleks esiginin 10 dB SL üzerinde olmaktadir. Bu kasilma esnasinda test edilen ve/veya test edilmeyen kulaktan kulaktan insert (40) ya da hoparlör kulaklikta (70) bulunan kalibre edilmis hoparlör (41) ile verilen akustik uyaran ile tercihen 100 dB SPL (Sound Pressure Level)'de 500 Hz*de saniyede tercihen 5,1 hizinda uyarim gönderilmesi saglanmaktadir. Akustik uyarana bagli olarak olusan utrikül ve/veya sakkülün uyarilmasina bagli olarak ortaya çikan kas cevaplarin orta kulak kasindaki (M. Stapedius) kasilma degisimlerine neden olmaktadir. Bu kas kasilmasi degisimleri orta kulagin sese geçirgenliginde degisimlere sebep olmaktadir. Bu degisimler test edilen ya da edilmeyen kulakta yer alan insert kulaklik (40) vasitasi verilen tercihen 226 Hz'de 85 dB SPL ses seviyesinde verilen sesin kulak zarindan geri dönüsümünde yasanan degisimi sisteme bagli mikrofon (42) araciligi ile almasi sayesinde ölçmektedir. Yapilan ölçüm sonuçlarinda artefakt dislama sonrasinda test edilen kulaktan verilen akustik uyaran ile tercihen 100 dB SPL (Sound Pressure Level)'de 500 Hz'de saniyede tercihen 5,1 hizinda uyarim verilis zamanina göre zamansal olarak averajlama yapilmaktadir. Akustik uyaran, kullanici tarafindan ses siddeet seviyesi ve frekans özellikleri ve verilis hizi degistirilebilirdir. Söz konusu averajlama islemi; uyarinin yüzlerce kez tekrarlanmasi ve yinelenen uyarilarla elde edilen sinyallerin üst üste kayitlanarak ortalamasinin bulunmasi islemidir. Bu sayede periferik vestibüler yapilarin uyarilmasi sonucunda ortaya çikan kas degisimlerine bagli olarak ortaya çikan etkiler degerlendirilebilmektedir. Within the scope of the invention; to persons with tested and/or untested ear in the M. Stapedius muscle in the middle ear with sound (acoustic stimulus) contraction is provided. The acoustic stimulus applied here is preferably 60 seconds. It is given as broadband noise. Loudness preferably acoustic is 10 dB SL above the reflex threshold. During this contraction tested and/or untested ear-to-ear insert (40) or speaker in the headset (70) Preferably 100 dB with acoustic stimulus given by calibrated loudspeaker (41) I stimulate at 500 Hz* at SPL (Sound Pressure Level), preferably at a rate of 5.1 per second sending is provided. The utricle and/or In the middle ear muscle, the muscle responses that occur due to the stimulation of the saccule (M. Stapedius) causes contraction changes. This muscle contraction changes cause changes in the sound permeability of the middle ear. This changes via the insert earpiece (40) in the tested or untested ear from the eardrum of the sound given at 85 dB SPL, preferably at 226 Hz. Receiving the change in recycling through the microphone (42) connected to the system by measuring. After artifact exclusion in the measurement results, preferably 100 dB SPL (Sound Pressure) with the acoustic stimulus given by the tested ear Level) at 500 Hz, preferably at a rate of 5.1 per second, according to the time of stimulation Temporal averages are made. Acoustic stimulus, sound by user The severity level and frequency characteristics and delivery rate are changeable. Aforementioned averaging process; It is obtained by repeating the warning hundreds of times and by repeated warnings. It is the process of finding the average of the signals recorded on top of each other. This In this way, the muscle that emerges as a result of the stimulation of the peripheral vestibular structures The effects that occur depending on the changes can be evaluated.

Yöntemin çalisma prensipleri; Sistemin hastaya farkli protokollerle uygulanmasi ile utrikül ve/veya sakkül otolit organlari degerlendirebilmektir. Bu kapsamda; 1. Hastanin bir kulagina insert kulaklik (40), diger kulagina ise tek bir hoparlör içeren hoparlör kulaklik (70) dis` kulak yoluna yerlestirilmektedir. Sekil 1'de sistem bilesenleri ve baglantilari gösterilmistir. 2. Söz konusu insert kulaklik (40) ile hastanin orta kulak fonksiyonlari ve refleks esikleri belirlenmektedir. Bu sistem mevcut durumda dis kulak yoluna uygulanan bir basinç degisikligi esnasinda ses geçirgenliginde yasanan degisim üzerinden ve dis kulak yoluna verilen degisik frekanslarda ve siddetlerdeki seslerin orta kulakta yer alan kaslari kasmasina bagli olarak ortaya çikan geçirgenlik degisimden yapilmaktadir. Working principles of the method; With the application of the system to the patient with different protocols, utricle and/or saccule otolith to evaluate organs. In this context; 1. Insert earphone (40) in one ear of the patient and a single speaker in the other ear. The speaker earphone (70) containing it is placed in the outer ear canal. in Figure 1 system components and connections are shown. 2. With the insert earpiece (40), the patient's middle ear functions and reflex thresholds are determined. This system is currently used in the external ear canal. experienced in sound permeability during an applied pressure change. over the exchange and at different frequencies given to the external ear canal and depending on the contraction of the middle ear muscles The resulting permeability is made from the change.

Daha sonra hastanin akustik refleks esikleri; her iki kulak için ayri ayri olacak sekilde beyaz gürültü (white noise) için sistem tarafindan taranmaktadir ve akustik refleks esikleri bulunmaktadir. Then the patient's acoustic reflex thresholds; it will be separately for both ears It is scanned by the system for white noise and There are acoustic reflex thresholds.

Yukaridaki islem adimlari sakkül ve utrikülün degerlendirilmesi için ortak islem adimlaridir. 4. Bu asamadan sonra hastaya sakkül degerlendirmesi amaciyla; Tercihen test edilmeyen kulaktan klasik hoparlör kulaklik (70) araciligi ile yukarida tanimlanan niteliklerde beyaz gürültü akustik uyaran verilerek test edilen kulakta M. Stapedius kasinin kasilmasi saglanmaktadir. The above procedure steps are the common procedure for the evaluation of the saccule and utricle. are the names. 4. After this stage, in order to evaluate the saccule; Preferably via the conventional non-tested ear loudspeaker headset (70) Test by giving a white noise acoustic stimulus of the qualities described above Contraction of the M. Stapedius muscle is provided in the ear.

Tercihen test edilen kulaktan hastaya insert kulaklikta (40) bulunan kalibre edilmis hoparlörlerin (41) tercihen bir tanesi ile akustik uyaran tercihen 'de 500 Hz'de saniyede tercihen 5,1 hizinda uyaran verilmektedir. Preferably the caliber in the tested ear-to-patient insert earpiece (40) The acoustic stimulus is preferably at 500 Hz, preferably at a speed of 5.1 per second, with preferably one of the speakers (41) stimulus is given.

Test edilen kulakta yer alan mikrofon (42) ve insert kulaklikta (40) bulunan kalibre edilmis hoparlörlerin (41) tercihen ikincisiyle bu kulakta olan geçirgenlik degisimleri anlik olarak degerlendirilmektir. Bu kapsamda hastaya insert kulaklikta (40) bulunan kalibre edilmis hoparlörlerin (41) tercihen ikincisi ile 226 Hz'de 85 dB SPL siddetinde ses uygulanan ve kulak zarindan yansiyan sesler mikrofon (42) araciligi ile toplanmaktir. Mikrofon (42) vasitasi ile elde edilen ses verileri A/D çevirici (50) araciligi ile dijitallestirilip ana islemciye (20) aktarilmaktir. Microphone (42) in the tested ear and insert (40) in the ear calibrated speakers (41) preferably in this ear with the second permeability changes are evaluated instantaneously. In this context calibrated speakers (41) in the insert earpiece (40) to the patient. Preferably with the latter, 85 dB SPL at 226 Hz is applied and the ear is applied. The sounds reflected from the membrane are collected by the microphone (42). Microphone The audio data obtained via (42) are transmitted via the A/D converter (50). digitized and transferred to the main processor (20).

Test edilen kulaktan alinan veriler öncelikli olarak tercihen 100 dB SPL (Sound Pressure Level)'de 500 Hz'de saniyede tercihen 5,1 hizindaki akustik uyaranlarindan arindirmak ve artefaktlarin azaltilmasina tabi tutulan ve elde edilen veriler akustik uyaranin verilme zamanina bagli olarak averajlanmaktadir. o Elde edilen averajlama görüntüleri anlik olarak ekran üzerinde kullaniciya es zamanli gösterilmektedir. Data from the tested ear primarily preferably 100 dB SPL (Sound Pressure Level) at 500 Hz, preferably 5.1 per second subjected to removal of acoustic stimuli and reduction of artifacts and the data obtained depend on the time of the acoustic stimulus. is averaged. o Obtained average images are displayed to the user instantly on the screen. time is displayed.

. Utrikülün degerlendirilmesi amaciyla; 0 Test edilmeyen kulaktan yukarida tanimlanan niteliklerde tercihen beyaz gürültü (white nosie) akustik uyaran hastaya insert kulaklikta (40) bulunan kalibre edilmis hoparlörlerin (41) tercihen bir tanesi ile verilerek test edilen kulakta M. Stapedius kasinin kasilmasi saglanmaktadir. . In order to evaluate the utricle; 0 Non-tested ear preferably white in the qualities described above noise (white nosie) tested with preferably one of the calibrated loudspeakers (41) contraction of the M. Stapedius muscle in the ear is provided.

- Test edilen kulaktan hastaya klasik hoparlör kulaklik (70) araciligi ile akustik uyaran tercihen 'de 500 Hz'de saniyede tercihen 5,1 hizinda uyaran verilmektedir. 0 Test edilmeyen kulakta yer alan mikrofon (42) ve insert kulaklikta (40) bulunan kalibre edilmis hoparlörlerin (41) tercihen bir tanesi ile bu kulakta olan geçirgenlik degisimleri anlik olarak degerlendirilmektedir. Bu kapsamda hastaya ikinci hoparlörden 226 Hz'de 85 dB SPL siddetinde ses uygulanmaktadir ve kulak zarindan yansiyan sesler mikrofon (42) araciligi ile toplanmaktadir. Mikrofon (42) vasitasi ile alinan ses verileri A/D çevirici (50) araciligi ile sayisallastirilarak ve ana islemciye (20) aktarilmaktadir. 0 Test edilmeyen kulaktan alinan veriler, öncelikli olarak beyaz gürültüye (white noise) ve diger faktörlere bagli ortaya çikan artefaktlarin azaltilmasina tabi tutulan ve elde edilen veriler akustik uyaranin verilme zamanina bagli olarak averajlanmaktadir. - Acoustic from tested ear to patient through the classic loudspeaker headset (70) stimulus preferably at 500 Hz per second preferably 5.1 speed stimulus is given. 0 Microphone (42) in untested ear and insert earphone (40) in this ear, preferably with one of the calibrated speakers (41) permeability changes are evaluated instantaneously. In this context 85 dB SPL at 226 Hz from the second speaker to the patient is applied and the sounds reflected from the eardrum through the microphone (42) meeting with. Audio data received via microphone (42) A/D converter It is digitized via (50) and transferred to the main processor (20). 0 Data from untested ear is primarily white noise (white noise) and reducing the artifacts caused by other factors The data subjected to and obtained depend on the time of the acoustic stimulus. is averaged.

- Elde edilen averajlama görüntüleri anlik olarak ekran üzerinde kullaniciya es zamanli olarak gösterilmektedir. - The resulting average images are displayed to the user on the screen instantly. displayed in time.

Sonuç ve degerlendirme: Sonuç olarak ekrandan es zamanli olarak alinan verilerle uzman tarafindan periferik vestibüler otolit organlarin direkt olarak kulaktan yapilan test ile degerlendirilmesi mümkün olmaktadir. Testin yapilmasi sirasinda hastanin pozisyonu önemli olmamakla beraber hastanin ekstra bir efor sarf etmesine gerek olmamaktadir. Söz konusu bulus ile orta kulak yapilarinda sesli uyarana bagli olarak kontraksiyon miktarinda yasanan degisimler ile utrikül ve sakkül degerlendirilmektedir. Test sirasinda elektrot gibi sarf malzeme kullanimina gerek olmadan denge sisteminde yasanan degisimlerin alinip degerlendirilebilmektedir. Conclusion and evaluation: As a result, by the expert with the data taken simultaneously from the screen. by direct ear test of peripheral vestibular otolith organs evaluation is possible. During the test, the patient Although the position is not important, the patient does not need to make an extra effort. does not exist. With the invention in question, depending on the audible stimulus in the middle ear structures utricle and saccule with changes in the amount of contraction is being evaluated. No consumables such as electrodes are required during the test. Without it, the changes in the balance system can be taken and evaluated.

Dis kulak yoluna yerlestirilen cihaz yardimiyla gerçeklestirilen testte. testi hastaya uygulayan kisinin elektrot yerlesim yerlerini belirlenmesinden dolayi ortaya çikan hatalarin en aza indirgenmektedir ve/veya ortadan kaldirilmaktadir. Elektrotlarin yerlesim yerine, kas kitlesine, yas ve farkli hastaliklara bagli olarak test sonuçlarinin degismesinden kaynaklanan kayit sorunlarinin ve degerlendirme zorluklarinin önüne geçilmektedir. In the test performed with the help of the device placed in the external ear canal. test patient resulting from the determination of the electrode placements of the person applying it. errors are minimized and/or eliminated. of the electrodes Depending on location, muscle mass, age and different diseases, test results registration problems and assessment difficulties caused by is prevented.

Claims

It is the device that provides the REQUESTS, and its feature is; a sound generator (10) that produces acoustic stimulus, a processor (20) that enables the characteristics of the acoustic stimulus to be determined, a screen (30) on which the test result is displayed with the device, an insert earphone (40) placed in the external ear canal, a calibrated speaker that transmits sound to peripheral vestibular structures (41). ), microphone (42) that collects the sounds reflected from the eardrum, pressure tube (80), A/D converter (50) that enables the digital data to be converted into digital data by digitizing the received data, manometer (60) that allows the device to be used as tympanometry, and speaker earphones (70). is characterized by. 2-It is a suitable ear device according to claim 1, its feature is; It is characterized by the acoustic stimulus that allows the evaluation of both peripheral vestibular structures to be given from the ear and then the reflected sounds from the otolith organs, depending on the amount of contraction, are preferably taken from the ear. 3- It is a suitable ear device according to any of the above claims and its feature is; It is characterized by the insert earphone (40), calibrated speaker (41) and microphone (42) placed in the external ear canal, which ensures that the changes in the balance system are taken and evaluated and that there is no need for the use of consumables such as electrodes that provide environmentally friendly use. 4- It is a suitable ear device according to any of the above claims, and its feature is; It is characterized by the insert earpiece (40), preferably placed in the outer ear canal, which ensures that the errors that occur due to the determination of the electrode placements of the person who applies the test to the patient are minimized and/or eliminated. 5- It is a suitable ear device according to any of the above claims, and its feature is; It is characterized by a sound generator (10) and an insert earphone (40), which enables the determination of middle ear functions and reflex thresholds of the patient. 6- It is a suitable ear device according to any of the above claims and its feature is; It is characterized by insert earphones (40), calibrated speaker (41), microphone (42) and speaker earphones (70) that prevent recording problems and evaluation difficulties caused by changes in test results depending on the placement of the electrodes, muscle mass, age and different diseases. is to be done. Insert earphone (40) containing calibrated speaker (41) and microphone (42) enabling direct test from the ear of the device, which is the subject of the invention, which prevents patients from standing still and/or making effort to stand still for the test position that creates difficulties for the patients, and/or or speaker earphone (70). 8- A suitable ear device and method according to any of the above claims, and its feature is; with insert earphones (40) and/or speaker earphones (70) containing calibrated speakers (41) and microphone (42), which prevent incorrect evaluation and/or incorrect measurement due to incorrect test results due to position differences experienced during the test in patients. is to be characterized. 9- It is a suitable saccule evaluation method according to any of the above claims, and its feature is; - Placing a speaker earpiece (70) containing an insert earphone (40) in one ear of the patient and a single speaker in the other ear, - Determining the middle ear functions and reflex thresholds of the patient with the said insert earphone (40), 0 Then the patient's acoustic reflex thresholds; Scanning by the system with white noise separately for both ears and finding acoustic reflex thresholds, . Contraction of the M. Stapedius muscle in the tested ear by giving a white noise acoustic stimulus of the qualities described above, preferably through the conventional loudspeaker headphones (70) in the untested ear, . Preferably from the tested ear to the patient, preferably with one of the calibrated speakers (41) in the insert earpiece (40), acoustic stimulus is delivered preferably at 100 dB SPL (Sound Pressure Level) at 500 Hz, preferably at a rate of 5.1 per second, In the tested ear Instant evaluation of the permeability changes of the microphone (42) located in the microphone (42) and the calibrated speakers (41) located in the insert earphone (40), preferably with the second one in this ear, Sounds with 85 dB SPL intensity applied and reflected from the eardrum are collected by the microphone (42), The audio data obtained through the microphone (42) are digitized via the A/D converter (50) and transferred to the main processor (20), From the tested ear Primarily, purification of acoustic stimulus and artifacts of the received data, preferably at 100 dB SPL (Sound Pressure Level), at 500 Hz, preferably at a speed of 5.1 per second. It includes the steps of reducing the data obtained, averaging the obtained data depending on the time of the stimulus, showing the obtained average images to the user simultaneously on the screen. method, its feature is; Placing a speaker earpiece (70) containing an insert earphone (40) in one ear of the patient and a single speaker in the other ear, into the external ear canal, Determining the middle ear functions and reflex thresholds of the patient with the said insert earphone (40), Then the patient's acoustic reflex thresholds; Scanning by the system with white noise separately for both ears and finding acoustic reflex thresholds, Preferably white noise (white nosie) acoustic stimulus from the untested ear to the patient (40) in the insert earphones (40). 41) Contraction of the M. Stapedius muscle in the tested ear, preferably by giving with the first one, Preferably at a speed of 5.1 per second at 500 Hz at 100 dB SPL (Sound Pressure Level) from the tested ear to the patient via the classical earphone, 0 In the untested ear instantaneous evaluation of the permeability changes of the calibrated speakers (41) preferably in the second ear with the microphone (42) and the insert earphone (40), - Applying a sound of 85 dB SPL at 226 Hz to the patient from the second speaker, preferably at 226 Hz, and the sounds reflected from the eardrum in the microphone collection via (42) o Audio data received via microphone (42) Digitizing the A/D converter (50) and transferring it to the main processor (20), 0 Reducing the artifacts caused by the untested ear data, primarily white noise and other factors, - Preferably, It includes the process steps of showing the averaging images obtained on the screen simultaneously to the user on the screen. 12- A suitable ear device and method according to any of the above claims, and its feature is; It is characterized by a pressure tube (80) and a connected manometer (60), which equates the pressure in the middle ear with the pressure of the external ear canal, allowing the sound transferred to the outer ear canal to be delivered in the most effective way.