JP2014158607A - Pharynx stimulation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a pharynx stimulation device capable of enhancing the effect of medical treatment for functional disorder of a pharynx by using electrical stimulation obtained by the low invasive way for applying electrical stimulation to a pharynx area of a patient where the discomfort of the patient is reduced, thereby enhancing the QOL of the patient is possible, and also the medical treatment for the patient for long time is facilitated.SOLUTION: A pharynx stimulation device includes a transmitter for transmitting electric current for electrical stimulation; electrodes for transmitting the electric current for electrical stimulation, which is transmitted from the transmitter, to a pharynx area of an organism; and stationary portions for fixing the electrodes into the oral cavity of the organism.

Description

  The present invention relates to a pharyngeal stimulation device, and more particularly, to a pharyngeal stimulation device capable of enhancing the QOL of a patient and enhancing the effect of treating pharyngeal dysfunction by electrical stimulation.

  Swallowing dysfunction and sleep apnea syndrome are known as pharyngeal dysfunction resulting from dull reflexes to sensory stimulation in the pharyngeal region of a patient due to cerebral infarction or the like.

  For example, as a treatment method for a patient having a swallowing dysfunction, a method of applying electrical stimulation to the pharyngeal region of the patient is known. According to this method, the sensory nerve is activated by electrical stimulation to make it more sensitive, thereby promoting the swallowing reflex of the patient and promoting the recovery of the swallowing function (see Patent Document 1). ). As a pharyngeal stimulation device used for treatment of swallowing dysfunction, a transmitter (oscillator that oscillates a pulse for electrical stimulation) that transmits an electric stimulation current, and an electric stimulation current transmitted from the transmitter is used as a pharynx of a living body. Devices having electrodes that communicate to the area are known. In this device, the electrode is placed in the pharyngeal region by inserting a catheter having an electrode at the tip into the pharyngeal region nasally or orally.

JP 2012-200558 A

  However, in the conventional pharyngeal stimulation device, since the method of applying electrical stimulation to the pharyngeal region of the patient is highly invasive, patient discomfort is high. As a result, the patient's QOL is low and it is difficult to treat the patient for a long time. Therefore, the effect of treating pharyngeal dysfunction by electrical stimulation was not sufficient.

  Therefore, the present invention makes it possible to increase the patient's QOL by reducing the patient's discomfort by making the method of applying electrical stimulation to the pharyngeal region of the patient less invasive, and to treat the patient. An object of the present invention is to provide a pharyngeal stimulation device that can be easily performed over a long period of time and can enhance the effect of treatment of pharyngeal dysfunction caused by electrical stimulation.

  The inventors arrived at the present invention based on the knowledge that the end of the pharyngeal constrictor muscle is located behind the upper third molar or the lower third molar (wisdom tooth) from anatomical analysis.

The gist of the present invention is as follows.
The pharyngeal stimulation device of the present invention includes a transmitter (oscillator that oscillates a pulse for electrical stimulation) that transmits an electrical stimulation current, and an electrode that transmits the electrical stimulation current transmitted by the transmitter to a pharyngeal region of a living body. A pharyngeal stimulation device for applying electrical stimulation to the pharyngeal region, characterized by having a fixing part for fixing the electrode in the oral cavity of the living body. According to the pharyngeal stimulation device of the present invention, since the method of applying electrical stimulation to the pharyngeal region of the patient can be made less invasive and the patient's discomfort can be reduced, the patient's QOL can be increased, and , Making it easy to treat a patient for a long time. Therefore, the effect of treatment of pharyngeal dysfunction caused by electrical stimulation can be enhanced.

  In the pharyngeal stimulation apparatus of the present invention, it is preferable that the fixing unit fixes the electrode between the upper second molar and the palatopharyngeal muscle or between the lower second molar and the palatopharyngeal muscle. . With the above configuration, electrical stimulation can be easily applied to the pharyngeal region.

  Furthermore, in the pharyngeal stimulation device of the present invention, it is preferable that the fixing portion includes a dentition mounting portion for mounting on at least a part of the teeth and gums of the upper and lower jaws. With the above configuration, electrical stimulation can surely be applied to the pharyngeal region.

  Furthermore, in the pharyngeal stimulation device of the present invention, it is preferable that the fixing portion includes a back tooth mounting portion that is mounted on the upper second molar, the lower second molar, the upper third molar, or the lower third molar. . With the above configuration, electrical stimulation can be reliably applied to the pharyngeal region.

  Furthermore, in the pharyngeal stimulation device of the present invention, it is preferable that the fixing portion includes an incisor attached to a portion of the upper second molar, the lower second molar, the upper third molar, or the lower third molar. . With the above configuration, electrical stimulation can be reliably applied to the pharyngeal region.

  Furthermore, in the pharyngeal stimulation device of the present invention, the pharyngeal region includes the nasopharyngeal constrictor muscle, the oropharyngeal constrictor muscle, the hypopharyngeal constrictor muscle, the palatopharyngeal muscle, the palatal lingual muscle, the palatal levator ani muscle, the genioglossus muscle, the geniohyoid bone It is preferably at least one muscle or organ selected from the group consisting of muscle, soft palate, epiglottis. If it is the said structure, the effect which improves the pharyngeal dysfunction by electrical stimulation can be heightened.

  Furthermore, in the pharyngeal stimulation device of the present invention, the pharyngeal region is preferably the nasopharyngeal constrictor muscle, the oropharyngeal constrictor muscle, the hypopharyngeal constrictor muscle, the palatopharyngeal muscle, the soft palate, or the epiglottis. If it is the said structure, the effect which improves the pharyngeal dysfunction by electrical stimulation can further be heightened.

  Furthermore, in the pharyngeal stimulation apparatus of the present invention, the electrode has two groups of one electrode group including a first electrode and a second electrode, and the first electrode applies electrical stimulation to the nasopharyngeal constrictor muscle, The second electrode preferably applies electrical stimulation to the hypopharyngeal constrictor muscle. With the above configuration, electrical stimulation to the upper, middle, and lower pharyngeal constrictor muscles is possible, and the effect of treating pharyngeal dysfunction caused by electrical stimulation can be particularly enhanced.

  Furthermore, in the pharyngeal stimulation device of the present invention, the electrode includes two groups of one electrode group including a first electrode, a second electrode, and a third electrode, and the first electrode is electrically connected to the nasopharyngeal constrictor muscle. The second electrode provides electrical stimulation to the geniohyoid muscle, geniohyoid muscle, maxillohyoid muscle, stylohyoid muscle, or digastric muscle, and the third electrode serves the hypopharyngeal constrictor muscle. It is preferable to apply electrical stimulation. If it is the said structure, the effect of the treatment of the pharyngeal dysfunction by electrical stimulation can further be heightened especially.

  Furthermore, in the pharyngeal stimulation apparatus of the present invention, it is preferable that the waveform of the electric stimulation current is a rectangular wave or a sine wave. With the above configuration, muscles and nerves can be stimulated efficiently.

  Furthermore, in the pharyngeal stimulation device of the present invention, it is preferable that the waveform of the electric stimulation current is a sine wave of two medium frequencies having different frequencies. If it is the said structure, strong electrical stimulation can be implement | achieved in the pharyngeal area | region center part.

  Furthermore, it is preferable that the pharyngeal stimulation device of the present invention further includes a communication device for transmitting information related to the electrical stimulation current to the transmitter. If it is set as the said structure, the operation | movement outside a living body can be enabled and the usability of a pharyngeal stimulation apparatus can be improved.

  According to the pharyngeal stimulation device of the present invention, since the method of applying electrical stimulation to the pharyngeal region of the patient can be made less invasive and the patient's discomfort can be reduced, the patient's QOL can be increased, and The treatment for the patient can be easily performed for a long time, and the effect of treating the pharyngeal dysfunction caused by electrical stimulation can be enhanced.

(A) is a figure which shows the pharyngeal stimulator which concerns on 1st embodiment of this invention with the sagittal cross section of a pharyngeal area | region, (b) is a pharyngeal area | region which shows the pharyngeal stimulator which concerns on 1st embodiment of this invention. (C) shows the pharyngeal stimulation device according to the first embodiment of the present invention together with the body axis section of the pharyngeal region, in which the fixing unit fixes the electrode using magnetic attraction. FIG. (A) is a figure which shows the pharyngeal stimulation apparatus which concerns on 2nd embodiment of this invention which has a dentition mounting part with the body-axis cross section of a pharyngeal area | region, (b) is a dentition mounting part shown to (a). (C) is a figure which shows the modification of the dentition mounting part shown to (a), (d) shows the further modification of the dentition mounting part shown to (a). FIG. (A) is a figure which shows the pharyngeal stimulation apparatus which concerns on 3rd embodiment of this invention which has a back tooth mounting part with the body-axis cross section of a pharyngeal area | region, (b) and (c) are back teeth shown to (a). It is a figure which shows a mounting part. (A) is a figure which shows the pharynx stimulating device which concerns on 4th embodiment of this invention which has an indentation with the body-axis cross section of a pharyngeal area | region, (b) and (c) show the indentation shown to (a). FIG. (A) is a figure which shows the pharynx stimulating device which concerns on 5th embodiment of this invention which has two groups of electrodes with the sagittal cross section of a pharyngeal area | region, (b) is a pharyngeal stimulating device shown to (a). It is a figure which shows the outline of the pharynx area | region where electrical stimulation is given by. (A) is a figure which shows the pharyngeal stimulation apparatus which concerns on 6th embodiment of this invention which has three groups of electrodes with the sagittal cross section of a pharyngeal area | region, (b) is a pharyngeal stimulation apparatus shown to (a). It is a figure which shows the outline of the pharynx area | region where electrical stimulation is given by. (A) is a figure which shows the pharyngeal stimulation apparatus which concerns on 7th embodiment of this invention which has a communication apparatus with the sagittal cross section of a pharyngeal area | region, (b) is a pharyngeal area | region which shows the pharyngeal stimulation apparatus shown to (a). It is a figure shown with a body-axis cross section. (A) is a figure which shows the outline of the pharyngeal area | region where electrical stimulation is given by the pharyngeal stimulator of this invention in the sagittal cross section of a pharyngeal area | region, (b) is electrical stimulation by the pharyngeal stimulator of this invention. It is a figure which shows the outline of the pharyngeal area | region given in the body-axis cross section of a pharyngeal area | region, (c) is a figure which shows the outline of the pharyngeal area | region to which an electrical stimulation is given by the pharyngeal stimulation apparatus of this invention in the left side surface of a biological body. (D) is a figure which shows the outline of the pharyngeal area | region where an electrical stimulation is given by the pharyngeal stimulation apparatus of this invention in the coronal cross section of a biological body.

(Pharyngeal stimulator)
The pharyngeal stimulation device of the present invention is a device for treating pharyngeal dysfunction by applying electrical stimulation to the pharyngeal region. Here, the pharyngeal dysfunction includes, for example, pneumonia caused by swallowing dysfunction, sleep apnea syndrome, pharyngeal dysfunction (occurs due to foreign matter mixed in the lung because cough cannot be produced), and the like.

Hereinafter, embodiments of the pharyngeal stimulation device of the present invention will be described in detail with reference to the drawings.
1 (a) and 1 (b) show a pharyngeal stimulation device 1 according to a first embodiment of the present invention. The pharyngeal stimulation device 1 has a function of applying electrical stimulation to the pharyngeal region 20. This device 1 includes one transmitter 2 that transmits an electrical stimulation current, and a pair of left and right electrodes 3a and 3b that transmit the electrical stimulation current transmitted by the transmitter 2 to a pharyngeal region 20 of a living body 19. Generally represented by 3).

  Here, the pharyngeal stimulation device 1 has a fixing portion 4 for fixing the electrode 3 in the oral cavity 5 of the living body 19. In FIG. 1, the electrodes 3a and 3b are fixed by fixing portions 4a and 4b, respectively.

The current passed through the electrode 3 can apply electrical stimulation to a region located at a certain distance from the electrode 3.
Here, as shown in FIG. 1 (b), as the inventors have found, anatomically, the upper pharyngeal constrictor muscle 21b is placed behind the upper third molar (not shown) or the lower third molar 8d. The end of (see FIG. 8A) is located. Therefore, when the fixing part 4 fixes the electrode 3 in the oral cavity 5, it becomes possible to apply electrical stimulation to the end of the nasopharyngeal constrictor muscle 21b.
Here, it is known that the current flows predominantly in the muscle fiber direction. Therefore, with the above configuration, the electrode 3 comes into contact with the end of the nasopharyngeal constrictor muscle 21b, and thus exists so as to overlap the nasopharyngeal constrictor muscle 21b, the palatine tongue muscle 21e, and the nasopharyngeal constrictor muscle 21b. Electrical stimulation can be performed on the entire pharyngeal region 20 mainly by the oropharyngeal constrictor muscle 21c (see FIG. 8A).

  According to the pharyngeal stimulation device 1, since the electrode 3 is fixed in the oral cavity 5, an electrical stimulation can be applied to the pharyngeal region 20 of the patient. Can significantly reduce discomfort for patients undergoing treatment for pharyngeal dysfunction. Therefore, a patient's QOL can be raised. Moreover, since it becomes possible to perform a treatment with respect to a patient for a long time, the effect of the treatment of the pharyngeal dysfunction by electrical stimulation can be heightened.

With regard to swallowing dysfunction, the swallowing reflex inherently induced by physical stimulation to the pharyngeal region 20 and the laryngeal region (not shown) is impaired, resulting in a decrease in reactivity including a delay in swallowing reflex. Here, if electrical stimulation is given to the pharyngeal region 20, the reactivity of swallowing reflex can be enhanced.
For sleep apnea syndrome, respiratory activity causes a negative pressure stimulus in the pharyngeal airway during upper airway obstruction (obstructive sleep apnea symptoms) during sleep, and this stimulation triggers It has been reported that the activity (upper airway reflex) of the pharyngeal airway dilator muscle group centering on the tongue muscle 21g is reduced. Here, if electrical stimulation is given to the pharyngeal region 20, the muscle activity of the pharyngeal airway dilator muscle group caused by the upper airway reflex can be enhanced.

  Hereinafter, each component which comprises the pharyngeal stimulation apparatus 1 is demonstrated in detail.

  In the pharyngeal stimulation device 1 shown in FIG. 1, the fixing unit 4 has the electrode 3 between the upper third molar (not shown) and the palatopharyngeal muscle 21 a (see FIG. 8B) or the third upper jaw. Fix between the molar 8d and the palatopharyngeal muscle 21a. If it does so, the electrode 3 can be fixed to the position close | similar to the pharyngeal area | region 20 containing the nasopharyngeal constriction muscle 21b in the oral cavity 5, and electrical stimulation can be easily given with respect to the pharyngeal area | region 20. FIG.

  The fixing unit 4 may fix the electrode 3 between the maxillary second molar (not shown) and the palatopharyngeal muscle 21a or between the mandibular second molar 8b and the palatopharyngeal muscle 21a. The above effects can be obtained.

  Here, the term “between the second molar and the palatopharyngeal muscle” is a strict meaning and does not refer to the straight line connecting the position of the second molar and the position of the palatopharyngeal muscle. It also refers to a region between a straight line that passes through the position of the molar and is orthogonal to the straight line, and a straight line that passes through the position of the palatopharyngeal muscle and is orthogonal to the straight line. Also, “between the second molar and the palatopharyngeal muscle” means that if the patient does not have the maxillary second molar or the mandibular second molar, “the position of the second molar and the palatopharynx "Between muscle".

  In addition, the fixing | fixed part 4 itself should just be mounted | worn with at least one part of the tooth | gear 8 and the gum 7, for example, may be mounted | worn with the one or several teeth 8. FIG. Moreover, the fixing | fixed part 4 may cover at least one part of the tooth | gear 8 and the gum 7, and may be mounted on it.

Furthermore, it is preferable that the fixing part 4 fixes the electrode 3 on the mucous membrane near the palatopharyngeal muscle 21a.
With the above configuration, the electrode 3 can be fixed at a position closer to the pharyngeal region 20 including the nasopharyngeal constrictor muscle 21 b in the oral cavity 5, and electrical stimulation can be more easily applied to the pharyngeal region 20. .
Specifically, the mucosal surface is always wet with mucous secretions, and the transmucosal impedance is small compared to that of the transcutaneous, so it penetrates into the conductive gel, adhesive substances, and the inside that are necessary for the transcutaneous. Strong electrical stimulation is not required. Since the mucous membrane is vulnerable to external stimulation as compared with the skin, it is preferable to use a rounded electrode or a non-irritating electrode (an electrode made of a sponge member or the like) as the electrode 3.

  Moreover, as shown in FIG.1 (c), the pharyngeal stimulation apparatus 1 can also be comprised by the electrode 3 containing ferromagnetic materials, such as stainless steel, and the fixing | fixed part 4 containing a magnet. Here, the electrode 3 is affixed on the mucous membrane in the oral cavity 5 and the fixing portion 4 is attached to the outer surface of the cheek, so that the electrode 3 is transcutaneously applied to the epipharyngeal constrictor muscle 21b using magnetic attraction. It can be fixed near the end.

2 (a) and 2 (b) show a pharyngeal stimulation device 50 according to a second embodiment of the present invention. Below, the same code | symbol is attached | subjected to the element similar to the pharyngeal stimulation apparatus 1 which concerns on 1st embodiment of this invention shown in FIG. 1, and the description is abbreviate | omitted.
In the pharyngeal stimulation device 50 shown in FIG. 2A, the fixing unit 4 has a dentition mounting part 4c for mounting on the dentition of the lower jaw 6b from the side incisors 8f to the third molar 8d. If the dentition mounting part 4 c is provided, the electrode 3 can be reliably fixed in the vicinity of the dentition, and electrical stimulation can surely be applied to the pharyngeal region 20.
In this pharyngeal stimulation device 50, the fixing unit 4 may have a dentition mounting part 4 c for mounting on the upper jaw (not shown), and a dentition mounting part for mounting on the gum 7. 4c may be included. In the pharyngeal stimulation device 50, the dentition mounting part 4c may be mounted on at least a part of the teeth 8 and the gums 7, and may be mounted on one or a plurality of teeth 8, for example. . Moreover, the fixing | fixed part 4 may cover at least one part of the tooth | gear 8 and the gum 7, and may be mounted on it.

The dentition mounting portion 4c can be a member that fits the dentition and is detachably mounted on the dentition (FIG. 2B shows the left side of the pair of left and right dentition mounting portions 4c. Only).
Examples of the shape of the dentition mounting portion 4c include a mouthpiece, a denture, a wire, a plate, and the like as shown in FIG.
In the shape of the mouthpiece shown in FIG. 2B, the electrode 3a is coupled to the end of the dentition mounting portion 4c. In the pharyngeal stimulation apparatus 1, as shown in FIG. 2C, the electrode 3a May be coupled to the side surface of the dentition mounting portion 4c.
In particular, a mouthpiece shape having a small contact area with the dentition or gum 7 is preferable from the viewpoint of wearing a saddle and low discomfort, for example, a member that is suitable only for the second molar 8b and / or the third molar 8d. It is preferable to use a combination of a wire member that connects the members and extends along the front of the dentition.
Furthermore, as shown in FIG. 2 (d), from the standpoint of stable electrode fixation, the member should be detachably mounted on the dentition in conformity with both the upper dentition and the lower dentition 6b. Is preferred.
Examples of the material for the dentition mounting portion 4c include, for example, resins made of various vinyl monomers such as polypropylene, polyethylene, PET resin, polyester, acrylic resin, nylon resin, urethane resin, vinyl chloride resin, ethylene vinyl acetate resin, and fluorine. Resins, silicon resins and the like can be mentioned, and fluororesins and silicon resins are particularly preferable from the viewpoint of biocompatibility.
From the viewpoint of stable electrode fixation, the extending length Lc of the dentition mounting portion 4c is 5 mm to 50 mm, the width Wc is 5 mm to 15 mm, and the depth Dc is 3 mm to 20 mm. preferable.

3 (a) to 3 (c) show a pharyngeal stimulation device 60 according to a third embodiment of the present invention. Below, the same code | symbol is attached | subjected to the element similar to the pharyngeal stimulation apparatus 1 which concerns on 1st embodiment of this invention shown in FIG. 1, and the description is abbreviate | omitted.
In the pharyngeal stimulation device 60 shown in FIG. 3A, the fixing portion 4 has a back tooth mounting portion 4d to be mounted on the lower third molar 8d.
In this pharyngeal stimulation device 60, the fixing portion 4 is a back tooth mounting portion for mounting on the maxillary second molar (not shown), the mandibular second molar 8b, and the maxillary third molar (not shown). 4d may be included.
If the back tooth mounting portion 4 d is provided, the electrode 3 can be fixed at a position close to the pharyngeal region 20 in the oral cavity 5, and electrical stimulation can be reliably applied to the pharyngeal region 20.

The back tooth mounting part 4d can be a member that fits the back tooth and is detachably mounted on the back tooth (FIGS. 3B and 3C show only the left side of the pair of left and right back tooth mounting parts 4d. Showing).
As the shape of the back tooth mounting portion 4d, for example, the shape of a bite that sandwiches the back tooth as shown in FIG. 3B, the shape of the socket that surrounds the back tooth as shown in FIG. 3C, and the shape of a clip that sandwiches the back tooth The arch shape continuously extending in the oral cavity 5 along the gap between the dentition and gum 7 and the lips (the electrode 3 provided at the end of the arch shape is pressed against the skin near the palatal tongue muscle 21e. And those having a shape such as a mouthpiece shape that is fixed so as to cover the entire dentition and gum 7. In particular, a clip shape and a mouthpiece shape are preferable from the viewpoint of stable electrode fixation.
Examples of the material of the back tooth mounting portion 4d include, for example, resins made of various vinyl monomers such as polypropylene, polyethylene, PET resin, polyester, acrylic resin, nylon resin, urethane resin, vinyl chloride resin, ethylene vinyl acetate resin, and fluorine resin. In particular, fluororesin and silicon resin are preferable from the viewpoint of biocompatibility.
From the viewpoint of stable electrode fixation, the extended length Ld of the back tooth mounting portion 4d is preferably 5 mm to 20 mm, the width Wd is 5 mm to 15 mm, and the depth Dd is 3 mm to 20 mm. .

4 (a) to 4 (c) show a pharyngeal stimulation device 70 according to a fourth embodiment of the present invention. Below, the same code | symbol is attached | subjected to the element similar to the pharyngeal stimulation apparatus 1 which concerns on 1st embodiment of this invention shown in FIG. 1, and the description is abbreviate | omitted.
The pharyngeal stimulation device 70 shown in FIG. 4 (a) has an incisor 4e attached to the part of the lower third molar 8d (see FIGS. 1 to 3). If the insertion tooth 4 e is provided, the electrode 3 can be fixed at the position of the tooth 8 growing near the pharyngeal region 20, and electrical stimulation can be reliably applied to the pharyngeal region 20. In addition, the tooth 4e is convenient for the patient because both the electrode 3 and the tooth 4e can be removed at the same time when inactive, such as at bedtime.
In this pharyngeal stimulation device 70, the fixing portion 4 is a denture attached to a portion of the maxillary second molar (not shown), the mandibular second molar 8b, or the maxillary third molar (not shown). 4e may be included.

The insertion tooth 4e can be a general one adapted to the above-mentioned part and detachably attached to the part.
As the shape of the insertion tooth 4e, for example, it can be an insertion tooth shape that can be inserted into a tooth root or a part of the tooth as shown in FIG. 4 (b). It can be in the shape of an implant that can be embedded in the jaw bone as shown.
Examples of the material of the insertion teeth 4e include metal oxides, silicides, nitrides, fluorides, borides, polymer materials, and the like. In particular, from the viewpoint of preventing leakage of electrical stimulation current, non-conductive materials are used. preferable. In particular, in the case of an implant type shape, the embedded portion and the tooth portion can be configured to be magnetically detachable. Examples of the material of the embedded portion include metal oxides, silicides, nitrides, fluorides, borides, pure titanium, titanium alloys, and the like. Generally, oxides are preferable, and zirconium oxide is particularly preferable. .
The outer diameter de of the insertion teeth 4e is preferably 5 mm to 20 mm from the viewpoint of ease of removal.

  In the pharyngeal stimulation devices 1, 50, 60, and 70 according to the above embodiments, the fixing unit 4 may be attached with a suction tube. With the above configuration, since saliva is easily secreted when stimulating the pharyngeal region, the patient feels suffering, and the surplus saliva can be aspirated, so that the patient's suffering can be eased.

  In the pharyngeal stimulation device 1, 50, 60, 70 according to each of the above embodiments, the electrode 3 and the fixing unit 4 are combined. For example, the electrode 3 and the fixed portion 4 can be formed as a single unit physically composed of the same member, or by a magnetic force by introducing a magnet (not shown) into at least one of them. It can also be a separated type. In particular, if the separation type is used, only the electrode 3 can be detached from the fixing portion 4 outside the treatment time.

  In the pharyngeal stimulation device 1, 50, 60, 70 according to each of the above embodiments, the transmitter 2 is, for example, the control unit 2a, the storage unit 2b, the display unit 2c, and the operation unit 2d (represented by FIG. 1A). Provided).

Here, the control unit 2a controls the electrical stimulation current transmitted to the electrodes 3a and 3b.
Examples of the storage unit 2b include ROM, RAM, flash memory, and other storage media. The storage unit 2b stores, for example, various programs including a program for causing the control unit 2a to function, various data including electrical stimulation current data, and the like. These programs and data are read from the storage unit 2b as necessary.
Examples of the display unit 2c include a liquid crystal panel, an organic EL panel, and an LED lamp.
As the operation unit 2d, for example, a switch for performing various operations and a dial for performing various settings, including a switch for turning on / off the electrical stimulation current, are provided. Each signal output from the operation unit 2d is input to the control unit 2a, and the control unit 2a executes processing according to the signal.

  The transmitter 2 may be provided in the oral cavity 5 and may be provided outside the living body 19 as long as it is electrically connected to the electrode 3. The transmitter 2 can be provided in the oral cavity 5 by being integrated with the member 11 provided in the oral cavity 5 by a patient having a pharyngeal dysfunction such as a bite block (representative in FIGS. 7A and 7B). To show).

In the pharyngeal stimulation device 1, 50, 60, 70 according to each of the above embodiments, the electrode 3 is made of silver, gold, platinum, stainless steel, a conductive polymer, an open cell type foamed sponge impregnated with an electrolyte, rubber, or the like. It can be composed of the following general materials. In particular, it is preferable to use an electrode having a shape, material, and design that does not damage the mucous membrane from the viewpoint of being applied to the mucosa near the palatopharyngeal muscle 21a and surely applying electrical stimulation to the pharyngeal region 20.
Examples of the shape of the electrode 3 include a metal plate having a curved surface, a sandwich structure using a metal plate and a sponge. Among these, a combination of an elastic member and a metal electrode is particularly preferable from the viewpoint of reducing physical damage to the oral mucosa.
As the material for the electrode 3, sponge, rubber, or the like made of silver, gold, platinum, stainless steel, urethane, and / or silicon is particularly preferable from the viewpoints of oxidation prevention, corrosion prevention, low toxicity, and easy processing.

The pharyngeal stimulation device 1, 50, 60, 70 according to each of the above embodiments includes a power source (not shown). One power supply may be provided for the entire pharyngeal stimulation device, or may be provided for each component.
The power source may be provided in the oral cavity 5 and may be provided outside the living body 19 as long as it is electrically connected to the electrode 3.

In the pharyngeal stimulation device 1, 50, 60, 70 of each embodiment of the present invention described above, it is preferable to further include a communicator 9 for transmitting information related to the electrical stimulation current to the transmitter 2 (FIG. 7A). ), Typically shown in (b)). 7A and 7B, the transmitter 2 includes only the control unit 2a, and the communication device 9 includes a storage unit 9b, a display unit 9c, and an operation unit 9d. Thus, if the communication device 9 is provided, it is possible to separate the control unit 2a and other parts than the control unit 2a such as the operation unit 9d. Therefore, the information regarding the electric stimulation current according to the content of the treatment of the pharyngeal dysfunction can be transmitted to the transmitter 2 by the operation outside the living body 19, and the pharyngeal stimulation devices 1, 50, 60, 70 are easy to use. Will improve. The transmitter 2 receives information from the communication device 9 and controls the electrical stimulation current.
The communication device 9 is preferably provided outside the living body 19 from the viewpoint of improving usability. In this case, the communication device 9 can be provided outside the living body 19 by, for example, being placed on the patient's ear.
The communication device 9 can also have a function of supplying power to the transmitter 2 as well as information related to the electrical stimulation current. In this case, the communication device 9 is installed in the vicinity of the transmitter 2, and the communication device 9 supplies power to the transmitter 2 by non-contact power feeding.

  As shown in FIG. 8, the pharyngeal region 20 to which the electrical stimulation current transmitted from the transmitter 2 is transmitted includes the nasopharyngeal constrictor muscle 21b, the oropharyngeal constrictor muscle 21c, the hypopharyngeal constrictor muscle 21d, the palatopharyngeal muscle 21a, and the palate. Examples include the muscle group having sensory nerves that induce swallowing reflexes, such as the tongue muscle 21e, palatal levator muscle 21f, genioglossus muscle 21g, and geniohyoid muscle 21h, and other muscles involved in swallowing movements. The muscles may be a single type or a combination of two or more types.

  Further, examples of the pharyngeal region 20 include organs including a soft palate 21m and a epiglottis 21n.

  Among these, in particular, the nasopharyngeal constrictor muscle 21b, the oropharyngeal constrictor muscle 21c, the hypopharyngeal constrictor muscle 21d, the palatopharyngeal muscle 21a, the palatine and lingual muscle 21e, the palatal levator muscle 21f, the genioglossus muscle 21g, and the geniohyoid muscle 21h, soft palate 21m, and epiglottis 21n are preferable. These muscles are highly effective in improving pharyngeal dysfunction when given electrical stimulation. In addition, the said muscle or organ may be single 1 type, and is good also as a 2 or more types of combination.

  As the pharyngeal region 20, the nasopharyngeal constrictor muscle 21b, the oropharyngeal constrictor muscle 21c, the hypopharyngeal constrictor muscle 21d, the palatopharyngeal muscle 21a, the soft palate 21m, and the epiglottis 21n have an effect of improving pharyngeal dysfunction when subjected to electrical stimulation. Is particularly expensive.

Examples of the pharyngeal region 20 include a wing pharyngeal head, cheek pharynx, glossopharyngeal head, thyroid pharynx, ring-shaped pharynx, pharyngeal mouth, and pharyngeal larynx (not shown). In addition, the said site | part may be single 1 type, and is good also as 2 or more types of combinations.
Among these, the wing pharyngeal head, thyroid pharynx, ring-shaped pharynx, pharyngeal mouth, and pharyngeal larynx are particularly preferable. These sites are highly effective in improving pharyngeal dysfunction when given electrical stimulation.

Examples of the pharyngeal region 20 include a trigeminal nerve, a glossopharyngeal nerve, a vagus nerve, a facial nerve, and a sensory nerve (not shown) in the epiglottis mucosa cartilage tissue. The nerves may be one kind alone or a combination of two or more kinds.
Among these, the glossopharyngeal nerve and the vagus nerve are particularly preferable, and more specifically, the pharyngeal plexus and the superior laryngeal nerve inner branch are preferable. These nerves are highly effective in improving pharyngeal dysfunction when given electrical stimulation.

  The pharyngeal stimulation devices 1, 50, 60, and 70 according to the embodiments of the present invention may further include an implant member 10 that induces electrical stimulation (typically shown in FIG. 1B). ). With the implant member 10, stronger electrical stimulation can be applied to the pharyngeal region 20.

Examples of the site to which the implant member 10 is transplanted include the buccal muscle, masseter, medial pterygoid muscle, wing-projectile mandibular sewn portion, nasopharyngeal constrictor muscle, mandibular mandibular branch, and the like. From the viewpoint of stable fixation of the member, the end of the nasopharyngeal constrictor muscle, the wing-projecting mandibular sewn portion, and the inner surface of the mandibular mandibular branch are preferred.
Examples of the conductive member of the implant member 10 include titanium, stainless steel, platinum, nickel alloy, chromium alloy, and molybdenum alloy. In addition, from the viewpoint of oxidation prevention, corrosion prevention, and conductivity, a material that has been partially coated with a silicon material, a fluororesin material, a polyurethane material, or the like can also be used.

5 (a) and 5 (b) show a pharyngeal stimulation device 80 according to a fifth embodiment of the present invention. Below, the same code | symbol is attached | subjected to the element similar to the pharyngeal irritation | stimulation apparatus 1,50,60,70 which concerns on each embodiment of this invention shown in FIGS. 1-4, The description is abbreviate | omitted.
In the pharyngeal stimulation device 80 shown in FIG. 5A, the electrode 3 includes the first electrode 3G2a and the second electrode 3G2b, as well as the first electrode group 3G1 including the first electrode 3G1a and the second electrode 3G1b. And a second electrode group 3G2. At this time, the first electrode 3G1a of the first electrode group 3G1 and the second electrode 3G2b of the second electrode group 3G2 are arranged on the left side of the living body 19, and the second electrode 3G1b of the first electrode group 3G1 and The first electrode 3G2a of the second electrode group 3G2 is disposed on the right side of the living body 19.

  Here, the first electrode 3G1a of the first electrode group 3G1 and the first electrode 3G2a of the second electrode group 3G2 are fixed by the fixing portions 4G1a and 4G2a, respectively.

  In this pharyngeal stimulation device 80, as shown in FIGS. 5A and 5B, the first electrode 3G1a of the first electrode group 3G1 and the first electrode 3G2a of the second electrode group 3G2 are contracted in the nasopharynx. The muscle 21b is electrically stimulated, and the second electrode 3G1b of the first electrode group 3G1 and the second electrode 3G2b of the second electrode group 3G2 are electrically stimulated to the hypopharyngeal constrictor muscle 21d. That is, in the pharyngeal stimulation device 80, the first electrodes 3G1a and 3G2a apply electrical stimulation to the nasopharyngeal contraction muscle 21b, and the second electrodes 3G1b and 3G2b apply electrical stimulation to the hypopharyngeal contraction muscle 21d.

According to the pharyngeal stimulation device 80, electrical stimulation can be applied to the two sites of the nasopharyngeal constrictor muscle 21b and the hypopharyngeal constrictor muscle 21d included in the pharyngeal region 20, so that the effect of improving pharyngeal dysfunction caused by electrical stimulation is improved. Can be particularly enhanced.
In particular, by forming an electrical stimulation circuit with the electrode 3 placed inside the oral cavity 5 and the electrode 3 placed on the cervical part outside the oral cavity 5 in this way, current flows mainly through the pharyngeal region 20 in the oral cavity 5. . Therefore, efficient electrical stimulation can be applied not only to the nasopharyngeal constrictor muscle 21b and the hypopharyngeal constrictor muscle 21d, but also to the oropharyngeal constrictor muscle 21c, the palatopharyngeal muscle 21a, the soft palate 21m, and the epiglottis 21n.
Further, by arranging the electrode groups 3G1 and 3G2 so as to cross the front and right and left sides, current interference occurs in the central portion of the pharyngeal region 20, and strong electrical stimulation is applied to the central portion of the pharyngeal region 20. Is possible.
Further, the current outputs of the electrode groups 3G1 and 3G2 are mutually changed. Specifically, by increasing the output of the first electrode group 3G1 and simultaneously reducing the output of the second electrode group 3G2, The interference area 20 can be scanned in the front left-right direction. By performing such scanning, it is possible to uniformly apply strong electrical stimulation to the entire pharyngeal region 20, and prevent stimulation familiarity at a specific site.

FIG. 6 shows a pharyngeal stimulation device 90 according to a sixth embodiment of the present invention. Below, the same code | symbol is attached | subjected to the element similar to the pharyngeal irritation | stimulation apparatus 1, 50, 60, 70, 80 which concerns on each embodiment of this invention shown in FIGS. 1-5, and the description is abbreviate | omitted.
In the pharyngeal stimulation device 90 shown in FIG. 6, the electrode 3 includes the first electrode 3G2a, the second electrode, similarly to the first electrode group 3G1 including the first electrode 3G1a, the second electrode 3G1b, and the third electrode 3G1c. 3G2b and a second electrode group 3G2 composed of the third electrode 3G2c. At this time, the first electrode 3G1a and the second electrode 3G1b of the first electrode group 3G1 and the third electrode 3G2c of the second electrode group 3G2 are arranged on the left side of the living body 19, and the first electrode group 3G1 The third electrode 3G1c and the first electrode 3G2a and the second electrode 3G2b of the second electrode group 3G2 are arranged on the right side of the living body 19.

  Here, the first electrode 3G1a of the first electrode group 3G1 and the first electrode 3G2a of the second electrode group 3G2 are fixed by the fixing portions 4G1a and 4G2a, respectively.

  In this pharyngeal stimulation device 90, the first electrode 3G1a of the first electrode group 3G1 and the first electrode 3G2a of the second electrode group 3G2 apply electrical stimulation to the nasopharyngeal constrictor muscle 21b, and the first electrode group 3G1 The third electrode 3G1c and the third electrode 3G2c of the second electrode group apply electrical stimulation to the hypopharyngeal constrictor muscle 21d. The second electrode 3G1b of the first electrode group 3G1 and the second electrode 3G2b of the second electrode group 3G2 include the geniohyoid muscle 21g, the geniohyoid muscle 21h, the maxillohyoid muscle 21i, and the stylohyoid muscle. Electrical stimulation is given to 21j or digastric muscle 21k. That is, in the pharyngeal stimulation device 90, the first electrodes 3G1a and 3G2a apply electrical stimulation to the nasopharyngeal constrictor muscle 21b, and the second electrodes 3G1b and 3G2b include the geniohyoid muscle 21g, the geniohyoid muscle 21h, and the maxillohyoid muscle. 21i, the stylohyoid muscle 21j or the digastric muscle 21k is electrically stimulated, and the third electrodes 3G1c and 3G2c provide the electrical stimulation to the hypopharyngeal constrictor muscle 21d.

According to the pharyngeal stimulation device 90, electrical stimulation can be applied to the three regions including the nasopharyngeal constrictor muscle 21b and the hypopharyngeal constrictor muscle 21d included in the pharyngeal region 20, thereby improving the pharyngeal dysfunction caused by the electrical stimulation. The effect can be particularly enhanced.
In addition, by forming an electrical stimulation circuit with the electrode 3 installed inside the oral cavity 5 and the electrode 3 installed on the neck outside the oral cavity 5, it becomes possible to apply electrical stimulation to the entire pharyngeal region 20 in the oral cavity 5. Is the same as in the fifth embodiment.
Note that the potentials of the second electrodes 3G1b and 3G2b can be synchronized with changes in the potentials of the first electrodes 3G1a and 3G2a and the third electrodes 3G1c and 3G2c. It is also possible to form an independent electrical stimulation circuit between the two second electrodes 3G1b and 3G2b installed under the jaw.

  Examples of the current that flows through the electrode 3 include a continuous current and an intermittent current. In particular, from the viewpoint of preventing habituation to stimulation, the amplitude periodically changes so as to take either the maximum value or the minimum value. Intermittent current is preferred.

As a waveform of continuous current and intermittent current, a rectangular wave, a sine wave, a triangular wave, a sawtooth wave, and the like can be mentioned, in particular, from the viewpoint of efficient muscle stimulation and nerve (peripheral sensory nerve in muscle tissue) stimulation. A rectangular wave or a sine wave is preferred.
In order to minimize damage to the tissue due to electrical stimulation and to ensure equivalence of stimulation by each electrode provided, the current is preferably bipolar.

  When bipolar current is used to ensure the equivalence of rectangular wave break stimulation, the frequency of the rectangular wave current is 1 Hz to 999 Hz (less than 1000 Hz), preferably 1 Hz to 200 Hz. The rectangular wave width is preferably 50 μsec to 5.0 msec. In the case of using a sine wave, the frequency band can be 1000 Hz to 10000 Hz, preferably 1000 Hz to 5000 Hz. In either case, it is possible to modulate the current waveform.

  Here, when the pharyngeal stimulation device has a plurality of electrode groups, a stimulation current having one frequency in the plurality of electrode groups may be used, and a stimulation current having two or more frequencies in the plurality of electrode groups. May be used.

In particular, when the pharyngeal stimulation device has a plurality of electrode groups, it is preferable to use a sinusoidal current having two medium frequencies having different frequencies in the plurality of electrode groups, that is, a medium-frequency current is applied to the electrode 3. It is preferable to flow.
With medium frequency currents at different frequencies, individual circuits formed at different frequencies can cause interference currents in the intersecting areas and can provide stronger electrical stimulation in the center of the pharyngeal area. . In addition, when using a rectangular wave, it is necessary to synchronize the phase of each electrode, but it is possible to enhance stimulation by interference current.

More specifically, when the pharyngeal stimulation device has a plurality of electrode groups, two types of medium-frequency sine wave currents having different frequencies are used in the plurality of electrode groups, and are arranged on one of the left and right sides of the living body 19. In the plurality of electrodes, it is preferable to use a sine wave current of two kinds of frequencies instead of using a sine wave current of one kind of frequency.
Specifically, in the pharyngeal stimulation device 80 shown in FIG. 5, the first electrode 3G1a of the first electrode group 3G1 disposed on the left side of the living body 19 and the first electrode disposed on the right side of the living body 19. The second electrode 3G1b of the electrode group 3G1, that is, a sine wave current of a frequency of 2000 Hz, for example, is used for all the electrodes of the first electrode group 3G1, and is arranged on the right side of the living body 19. The first electrode 3G2a of the second electrode group 3G2 and the second electrode 3G2b of the second electrode group 3G2 arranged on the left side of the living body 19, that is, all the electrodes of the second electrode group 3G2. For example, it is preferable to use a sine wave current having a frequency of 2050 Hz. As a result, the current can be set to an interference middle frequency having a frequency difference of 50 Hz, that is, two types of sine wave currents having different frequencies can be caused to cross and flow in the pharyngeal region 20.
Further, in the pharyngeal stimulation device 90 shown in FIG. 6, the first electrode 3G1a and the second electrode 3G1b of the first electrode group 3G1 and the right side of the living body 19 are arranged on the left side of the living body 19. For example, a sine wave current having a frequency of 2000 Hz is used for the third electrode 3G1c of the first electrode group 3G1, that is, for all the electrodes of the first electrode group 3G1, and arranged on the right side of the living body 19. The first electrode 3G2a and the second electrode 3G2b of the second electrode group 3G2, and the third electrode 3G2c of the second electrode group 3G2 disposed on the left side of the living body 19, that is, the second electrode For example, a sine wave current having a frequency of 2050 Hz is preferably used for all the electrodes of the group 3G2. As a result, the current can be set to an interference middle frequency having a frequency difference of 50 Hz, that is, two types of sine wave currents having different frequencies can be caused to cross and flow in the pharyngeal region 20.

  The frequency difference in the case of the interference middle frequency is preferably 0.1 Hz to 300 Hz, and more preferably 5 Hz to 100 Hz, from the viewpoint of easily generating an interference current in the living body.

  The stimulation current is preferably 0.1 mA to 25 mA, and more preferably 0.5 mA to 10 mA. When the current is within the above range, the patient's safety can be ensured while applying sufficient electrical stimulation to the patient's pharyngeal region 20 to treat pharyngeal dysfunction.

(Pharyngeal stimulation method)
Hereinafter, the pharyngeal stimulation method using the pharyngeal stimulation apparatus of the present invention will be described.
The pharyngeal stimulation method described below is a method for treating pharyngeal dysfunction by applying electrical stimulation to the pharyngeal region. Here, the pharyngeal dysfunction includes, for example, pneumonia caused by swallowing dysfunction, sleep apnea syndrome, pharyngeal dysfunction (occurs due to foreign matter mixed in the lung because cough cannot be produced), and the like.

The first pharyngeal stimulation method using the pharyngeal stimulation apparatus 1 according to the first embodiment of the present invention shown in FIG. 1 is to fix the electrodes 3a and 3b in the oral cavity 5 of the living body 19 using the fixing portions 4a and 4b. One step, a second step of transmitting electrical stimulation current by the transmitter 2, and a third step of transmitting the electrical stimulation current transmitted by the transmitter 2 to the pharyngeal region 20 of the living body 19 by the electrodes 3a and 3b. Including.
According to this method, by fixing the electrode 3 in the oral cavity 5, it is possible to apply electrical stimulation to the pharyngeal region 20 of the patient, so that the method of applying electrical stimulation becomes less invasive, thereby Discomfort to patients undergoing treatment for pharyngeal dysfunction due to irritation can be greatly reduced, so that the patient's QOL can be increased and treatment for the patient can be performed for a long time. Thus, the effect of treating pharyngeal dysfunction by electrical stimulation can be enhanced.

  In this method, it is preferable to fix the electrode 3 on the skin near the palatopharyngeal muscle 21a using the fixing portion 4. Then, the electrode 3 can be fixed at a position closer to the pharyngeal region 20 including the nasopharyngeal constrictor muscle 21 b in the oral cavity 5, and electrical stimulation can be more easily applied to the pharyngeal region 20.

In the second pharyngeal stimulation method using the pharyngeal stimulation device 50 of the second embodiment of the present invention shown in FIG. 2, the dentition mounting portion 4c is arranged in the dentition from the side incisor 8f of the lower jaw 6b to the third molar 8d. The first step of fixing the electrode 3 in the oral cavity 5 by attaching to the mouth 5, and the same steps as the second and third steps in the first pharyngeal stimulation method are included.
In this pharyngeal stimulation method, the dentition mounting part 4c may be mounted on the upper jaw (not shown), and the dentition mounting part 4c may be mounted on the gum 7. In this pharyngeal stimulation method, the dentition mounting part 4 c may be mounted on at least a part of the teeth 8 and gums 7.
According to this method, the electrode 3 can be reliably fixed in the oral cavity 5, and electrical stimulation can be surely applied to the pharyngeal region 20.

In the third pharyngeal stimulation method using the pharyngeal stimulation device 60 according to the third embodiment of the present invention shown in FIG. 3, the electrode 3 is attached to the oral cavity 5 by mounting the back tooth mounting portion 4d to the lower third molar 8d. A first step of fixing the inside and a step similar to the second and third steps in the first pharyngeal stimulation method.
In this pharyngeal stimulation method, the upper second molar (not shown), the lower second molar 8b, or the upper third molar (not shown) may be attached.
According to this method, the electrode 3 can be fixed at a position close to the pharyngeal region 20 in the oral cavity 5, and electrical stimulation can be easily applied to the pharyngeal region 20.

In the fourth pharyngeal stimulation method using the pharyngeal stimulation device 70 according to the fourth embodiment of the present invention shown in FIG. 4, the electrode 3 is attached to the oral cavity 5 by attaching the incisor 4e to the lower third molar 8d. A first step of fixing within, and a second and third step in the first pharyngeal stimulation method.
In this pharyngeal stimulation method, the upper second molar (not shown), the lower second molar 8b, or the upper third molar (not shown) may be attached.
According to this method, the electrode 3 can be fixed at the position of the tooth 8 growing near the pharyngeal region 20, and electrical stimulation can be easily applied to the pharyngeal region 20.

In the fifth pharyngeal stimulation method using the pharyngeal stimulation device 80 according to the fifth embodiment of the present invention shown in FIG. 5, the first electrode 3G1a of the first electrode group 3G1 and the first electrode group 3G1 using the fixing portions 4G1a and 4G2a, and The first electrode 3G2a of the second electrode group 3G2 is fixed to the left and right sides of the living body 19 in the oral cavity 5 of the living body 19, respectively, and the second electrode 3G1b and the second electrode group of the first electrode group 3G1 are fixed. A first step of fixing the second electrode 3G2b of 3G2 to the right and left sides of the living body 19 of the neck, a second step of transmitting a current for electrical stimulation by the transmitter 2, and the transmitter 2 by the electrode 3 A third step of transmitting the electrical stimulation current transmitted from the throat region 20 of the living body 19 to the pharyngeal region 20. Thereby, electrical stimulation is given to the nasopharyngeal constrictor muscle 21b by the first electrodes 3G1a and 3G2a, and electrical stimulation is given to the hypopharyngeal constrictor muscle 21d by the second electrodes 3G1b and 3G2b.
According to this method, since electrical stimulation can be applied to the two sites of the nasopharyngeal constrictor muscle 21b and the hypopharyngeal constrictor muscle 21d included in the pharyngeal region 20, the effect of improving the pharyngeal dysfunction caused by the electrical stimulation is further enhanced. be able to.

In this method, the first electrode 3G1a of the first electrode group 3G1 disposed on the left side of the living body 19 and the second electrode 3G1b of the first electrode group 3G1 disposed on the right side of the living body 19 That is, the first electrode 3G2a of the second electrode group 3G2 is disposed on the right side of the living body 19 using, for example, a sine wave current having a frequency of 2000 Hz for all the electrodes of the first electrode group 3G1. For example, a sine wave current having a frequency of 2050 Hz is used for the second electrode 3G2b of the second electrode group 3G2 arranged on the left side of the living body 19, that is, for all the electrodes of the second electrode group 3G2. It is preferable. As a result, the stimulation current can be set to a medium interference frequency having a frequency difference of 50 Hz.
In this way, if two types of electrodes are used and the current is set to two types of medium frequencies having different frequencies, it becomes possible to generate an intermediate frequency current of interference in a region where each current intersects, and give a strong stimulus to the region. be able to.

The sixth pharyngeal stimulation method using the pharyngeal stimulation device 90 according to the sixth embodiment of the present invention shown in FIG. 6 uses the fixing portions 4G1a and 4G2a, the first electrode 3G1a of the first electrode group 3G1, and The first electrode 3G2a of the second electrode group 3G2 is fixed to the left and right sides of the living body 19 in the oral cavity 5 of the living body 19, respectively, and the second electrode 3G1b and the second electrode group of the first electrode group 3G1 are fixed. The second electrode 3G2b of 3G2 is fixed to the left side and the right side of the living body 19 of the lower jaw, and the third electrode 3G1c of the first electrode group 3G1 and the third electrode 3G2c of the second electrode group 3G2 are fixed to the neck. The first step of fixing the right side and the left side of the living body 19, the second step of transmitting the electric stimulation current by the transmitter 2, and the electric stimulation current transmitted from the transmitter 2 by the electrode 3 19 throat areas 20 That includes a third step, the. Thus, the first electrode 3G1a, 3G2a applies electrical stimulation to the nasopharyngeal constrictor muscle 21b, and the second electrode 3G1b, 3G2b applies the geniohyoid muscle 21g, the geniohyoid muscle 21h, the maxillohyoid muscle 21i, and the stylohyoid muscle. Electrical stimulation is given to 21j or the digastric muscle 21k, and electrical stimulation is given to the hypopharyngeal constrictor muscle 21d by the third electrodes 3G1c and 3G2c.
According to this method, since electrical stimulation can be applied to the three parts including the nasopharyngeal constrictor muscle 21b and the hypopharyngeal constrictor muscle 21d included in the pharyngeal region 20, the effect of improving the pharyngeal dysfunction caused by the electrical stimulation is further improved. Can be increased.

In this method, the first electrode 3G1a and the second electrode 3G1b of the first electrode group 3G1 arranged on the left side of the living body 19, and the first electrode group 3G1 of the first electrode group 3G1 arranged on the right side of the living body 19 are arranged. For example, a sine wave current having a frequency of 2000 Hz is used for the three electrodes 3G1c, that is, for all the electrodes of the first electrode group 3G1, and the second electrode group 3G2 is disposed on the right side of the living body 19. To the first electrode 3G2a and the second electrode 3G2b of the second electrode group 3G2c of the second electrode group 3G2 disposed on the left side of the living body 19, that is, to all the electrodes of the second electrode group 3G2 For example, it is preferable to use a sine wave current having a frequency of 2050 Hz. Thereby, an electric current can be made into the interference middle frequency of frequency difference 50Hz.
In this way, if the current is set to two medium frequencies having different frequencies using the three groups of electrodes, it becomes possible to generate an intermediate frequency interference current in a region where each current intersects, and give a strong stimulus to the region. be able to.

  The details of the pharyngeal region, the fixed portion, the transmitter, the electrodes, the electrical stimulation current, and the like are as described for the pharyngeal stimulation device.

(Method for assessing the pathological condition of upper respiratory tract disease)
Hereinafter, the pathological condition evaluation method of the upper respiratory tract disease using the pharyngeal stimulation device according to each embodiment of the present invention will be described. Here, examples of the upper respiratory tract disease include dysphagia and sleep apnea syndrome.
This disease state evaluation method is a method for evaluating the disease state of the upper respiratory tract disease by analyzing the data obtained by the pharyngeal stimulation method.
In this method, for example, first, the storage unit 2b of the transmitter 2 records a current value and measures a potential difference between the electrodes 3. Next, the storage unit 2b calculates the impedance of the pharyngeal region 20 portion between the electrodes 3 from the current value and the potential difference. This calculation is repeated for a plurality of current values. The thus obtained impedance profile of the pharyngeal region 20 part of the patient with upper respiratory tract disease is compared with the resistance value profile of the pharyngeal region 20 part of a healthy subject to evaluate the pathological condition of the pharyngeal region 20 part.
In this method, the morphological change of the pharyngeal region 20 can be evaluated by analyzing the temporal change of the current value. In addition, by monitoring the current value when the voltage applied to the electrode 3 is constant, the impedance profile of the pharyngeal region 20 portion of the patient with upper airway disease may be evaluated. Furthermore, a morphological change can be monitored by installing a small electrode 3 at an appropriate position in the oropharynx and measuring the potential of the electrode 3.

  The embodiment of the pharyngeal stimulation device of the present invention has been described above with reference to the drawings. However, the pharyngeal stimulation device of the present invention is not limited to the above example, and the embodiment is appropriately changed. Can be added.

  According to the pharyngeal stimulation device of the present invention, since the method of applying electrical stimulation to the pharyngeal region of the patient can be made less invasive and the patient's discomfort can be reduced, the patient's QOL can be increased, and The treatment for the patient can be easily performed for a long time, and the effect of treating the pharyngeal dysfunction caused by electrical stimulation can be enhanced. Furthermore, rehabilitation from pharyngeal dysfunction caused by cerebral infarction or the like can be made efficient.

DESCRIPTION OF SYMBOLS 1 Pharyngeal stimulator which concerns on 1st embodiment 2 Transmitter 2a Control part 2b Memory | storage part 2c Display part 2d Operation part 3 Electrode 3a Electrode 3b Electrode 3G1 1st electrode group 3G1a 1st electrode 3G1b 2nd electrode 3G1c 3rd electrode 3G2 Second electrode group 3G2a First electrode 3G2b Second electrode 3G2c Third electrode 4 Fixed part 4a Fixed part 4b Fixed part 4c Dental row mounting part 4d Back tooth mounting part 4e Insert tooth 4G1a Fixed part of first electrode of first electrode group 4G1b Fixing part of the second electrode of the first electrode group 4G1c Fixing part of the third electrode of the first electrode group 4G2a Fixing part of the first electrode of the second electrode group 4G2b Fixing part of the second electrode of the second electrode group Fixed part 4G2c Fixed part of the third electrode of the second electrode group 5 Oral cavity 6 Jaw 6b Mandible 7 Gum 8 Tooth 8b Mandibular second molar 8d Mandibular third molar 8f Side incisor 9 Communication device 9b Memory part 9c Display part 9d Operation part 10 Implant member 11 Member 19 Living body 20 Pharyngeal region 21a Palatopharyngeal muscle 21b Nasopharyngeal contraction muscle 21c Oropharyngeal contraction muscle 21d Hyopharyngeal contraction muscle 21e Palatoglossus muscle 21f Palatal levator muscular muscle 21g 21h Geniohyoid muscle 21i Mandibular hyoid muscle 21j Stingoid hyoid muscle 21k Digastric muscle 21m Pharyngeal cap 21n Soft palate 50 Pharyngeal stimulation device according to the second embodiment of the present invention 60 Pharyngeal stimulation according to the third embodiment of the present invention Device 70 Pharyngeal stimulator according to the fourth embodiment of the present invention 80 Pharyngeal stimulator according to the fifth embodiment of the present invention 90 Pharyngeal stimulator according to the sixth embodiment of the present invention

Claims (12)

A pharyngeal stimulation device for applying electrical stimulation to the pharyngeal region, comprising: a transmitter that transmits electrical stimulation current; and an electrode that transmits the electrical stimulation current transmitted from the transmitter to a pharyngeal region of a living body. And
A device having a fixing part for fixing the electrode in the oral cavity of the living body.   The apparatus according to claim 1, wherein the fixing unit fixes the electrode between the upper second molar and the palatopharyngeal muscle or between the lower second molar and the palatopharyngeal muscle. .   The apparatus according to claim 1, wherein the fixing part includes a dentition attaching part for attaching to at least a part of the upper and lower jaw teeth and gums.   The apparatus according to claim 1, wherein the fixing part includes an posterior tooth mounting part to be mounted on the upper second molar, the lower second molar, the upper third molar, or the lower third molar. .   The apparatus according to claim 1, wherein the fixing unit includes an incisor attached to a portion of the upper second molar, the lower second molar, the upper third molar, or the lower third molar. .   The pharyngeal region is selected from the group consisting of nasopharyngeal constrictor muscles, oropharyngeal constrictor muscles, hypopharyngeal constrictor muscles, palatopharyngeal muscles, palatine lingual muscles, palatal levator ani muscles, genioglossus muscles, geniohyoid muscles, soft palate, and epiglottis. The device according to claim 1, wherein the device is at least one muscle or organ to be processed.   The device according to claim 6, characterized in that the pharyngeal region is the nasopharyngeal constrictor, the oropharyngeal constrictor, the hypopharyngeal constrictor, the palatopharyngeal muscle, the soft palate, or the epiglottis. The electrode has two groups of one electrode group consisting of a first electrode and a second electrode,
The first electrode provides electrical stimulation to the nasopharyngeal constrictor, and the second electrode provides electrical stimulation to the hypopharyngeal constrictor;
The apparatus according to claim 1, wherein: The electrode comprises two groups of one electrode group consisting of a first electrode, a second electrode, and a third electrode,
The first electrode provides electrical stimulation to the nasopharyngeal constrictor muscle, and the second electrode provides electrical stimulation to the geniohyoid muscle, geniohyoid muscle, maxillohyoid muscle, stylohyoid muscle, or digastric muscle. The third electrode provides electrical stimulation to the hypopharyngeal constrictor muscle,
The apparatus according to claim 1, wherein:   The apparatus according to claim 1, wherein the waveform of the electrical stimulation current is a rectangular wave or a sine wave.   The device according to claim 8 or 9, wherein the waveform of the electric stimulation current is two medium frequency sine waves having different frequencies.   The apparatus according to claim 1, further comprising a communicator for transmitting information related to the electrical stimulation current to the transmitter.

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