NZ762230B2 - Oro-Nasal Patient Interface - Google Patents
Oro-Nasal Patient Interface Download PDFInfo
- Publication number
- NZ762230B2 NZ762230B2 NZ762230A NZ76223014A NZ762230B2 NZ 762230 B2 NZ762230 B2 NZ 762230B2 NZ 762230 A NZ762230 A NZ 762230A NZ 76223014 A NZ76223014 A NZ 76223014A NZ 762230 B2 NZ762230 B2 NZ 762230B2
- Authority
- NZ
- New Zealand
- Prior art keywords
- nasal
- patient
- cushion
- oral
- plenum chamber
- Prior art date
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Abstract
Disclosed is a CPAP facial mask for assisting with sleep apnoea or other breathing obstruction conditions. The patient interface system provides breathable gas to a patient, with a cushion assembly, including a nasal cushion having a concave shape between sides to receive and seal against the patient’s nose and a nasal opening configured to direct breathable gas to the patient’s nares in use. A nasal plenum chamber and the nasal cushion form a nasal gas chamber and an oral cushion contacts and seal against the patient’s face surrounding the patient’s mouth, the oral cushion including an oral opening configured to direct breathable gas to the patient’s mouth in use. An oral plenum chamber and the oral cushion forming an oral gas chamber, the nasal gas chamber and the oral gas chamber being pneumatically connected within the cushion assembly, where the nasal cushion, the nasal plenum chamber, the oral plenum chamber, and the oral cushion are formed from one piece of silicone. The cushion assembly also has an anti-asphyxiation valve and a positioning and stabilizing structure including a pair of upper side straps, a pair of lower side straps, and a rear portion, the pair of upper side straps and the pair of lower side straps extending from the rear portion. An unitary plate member is removably connected to the cushion assembly, the unitary plate member including a connection port configured to be connected to an air delivery tube, the connection port being configured to receive breathable gas from the air delivery tube and direct breathable gas into the cushion assembly for breathing by the patient during use, the unitary plate member including an upper portion and a lower portion, each of the upper side straps being removably connected to the upper portion of the unitary plate member, each of the lower side straps being removably connected to the lower portion of the unitary plate member, and the upper portion of the unitary plate member contacting the nasal plenum chamber to support the nasal cushion against the patient’s face in use. t’s nose and a nasal opening configured to direct breathable gas to the patient’s nares in use. A nasal plenum chamber and the nasal cushion form a nasal gas chamber and an oral cushion contacts and seal against the patient’s face surrounding the patient’s mouth, the oral cushion including an oral opening configured to direct breathable gas to the patient’s mouth in use. An oral plenum chamber and the oral cushion forming an oral gas chamber, the nasal gas chamber and the oral gas chamber being pneumatically connected within the cushion assembly, where the nasal cushion, the nasal plenum chamber, the oral plenum chamber, and the oral cushion are formed from one piece of silicone. The cushion assembly also has an anti-asphyxiation valve and a positioning and stabilizing structure including a pair of upper side straps, a pair of lower side straps, and a rear portion, the pair of upper side straps and the pair of lower side straps extending from the rear portion. An unitary plate member is removably connected to the cushion assembly, the unitary plate member including a connection port configured to be connected to an air delivery tube, the connection port being configured to receive breathable gas from the air delivery tube and direct breathable gas into the cushion assembly for breathing by the patient during use, the unitary plate member including an upper portion and a lower portion, each of the upper side straps being removably connected to the upper portion of the unitary plate member, each of the lower side straps being removably connected to the lower portion of the unitary plate member, and the upper portion of the unitary plate member contacting the nasal plenum chamber to support the nasal cushion against the patient’s face in use.
Description
(12) Granted patent specificaon (19) NZ (11) 762230 (13) B2
(47) Publicaon date: 2022.01.28
(54) Oro-Nasal Paent Interface
(51) Internaonal Patent Classificaon(s):
A61M 16/06 A61M 16/08
(22) Filing date: (73) Owner(s):
2014.05.14 ResMed Pty Ltd
ORO-NASAL PATIENT INTERFACE
1 CROSS-REFERENCE TO RELATED APPLICATIONS
This application claims the benefit of U.S. Provisional Application No.
61/823,353, filed May 14, 2013, and U.S. Provisional Application No.
61/954,201, filed March 18, 2014, each of which is incorporated by reference
herein in its entirety.
2 BACKGROUND OF THE TECHNOLOGY
2.1 FIELD OF THE TECHNOLOGY
The present technology relates to one or more of the diagnosis, treatment and
amelioration of respiratory disorders, and to procedures to prevent respiratory
disorders. In particular, the present technology relates to medical devices, and
their use for treating respiratory disorders and for preventing respiratory disorders.
2.2 DESCRIPTION OF THE RELATED ART
The respiratory system of the body facilitates gas exchange. The nose and mouth
form the entrance to the airways of a patient.
The airways consist of a series of branching tubes, which become narrower,
shorter and more numerous as they penetrate deeper into the lung. The prime
function of the lung is gas exchange, allowing oxygen to move from the air into
the venous blood and carbon dioxide to move out. The trachea divides into right
and left main bronchi, which further divide eventually into terminal bronchioles.
The bronchi make up the conducting airways, and do not take part in gas
exchange. Further divisions of the airways lead to the respiratory bronchioles, and
eventually to the alveoli. The alveolated region of the lung is where the gas
exchange takes place, and is referred to as the respiratory zone. See West,
Respiratory Physiology- the essentials.
A range of respiratory disorders exist.
2344980
Obstructive Sleep Apnoea (OSA), a form of Sleep Disordered Breathing (SDB), is
characterized by occlusion of the upper air passage during sleep. It results from a
combination of an abnormally small upper airway and the normal loss of muscle
tone in the region of the tongue, soft palate and posterior oropharyngeal wall
during sleep. The condition causes the affected patient to stop breathing for
periods typically of 30 to 120 seconds duration, sometimes 200 to 300 times per
night. It often causes excessive daytime somnolence, and it may cause
cardiovascular disease and brain damage. The syndrome is a common disorder,
particularly in middle aged overweight males, although a person affected may
have no awareness of the problem. See US Patent 4,944,310 (Sullivan).
Cheyne-Stokes Respiration (CSR) is a disorder of a patient's respiratory controller
in which there are rhythmic alternating periods of waxing and waning ventilation,
causing repetitive de-oxygenation and re-oxygenation of the arterial blood. It is
possible that CSR is harmful because of the repetitive hypoxia. In some patients
CSR is associated with repetitive arousal from sleep, which causes severe sleep
disruption, increased sympathetic activity, and increased afterload. See US Patent
6,532,959 (Berthon-Jones).
Obesity Hyperventilation Syndrome (OHS) is defined as the combination of
severe obesity and awake chronic hypercapnia, in the absence of other known
causes for hypoventilation. Symptoms include dyspnea, morning headache and
excessive daytime sleepiness.
Chronic Obstructive Pulmonary Disease (COPD) encompasses any of a group of
lower airway diseases that have certain characteristics in common. These include
increased resistance to air movement, extended expiratory phase of respiration,
and loss of the normal elasticity of the lung. Examples of COPD are emphysema
and chronic bronchitis. COPD is caused by chronic tobacco smoking (primary risk
factor), occupational exposures, air pollution and genetic factors. Symptoms
include: dyspnea on exertion, chronic cough and sputum production.
Neuromuscular Disease (NMD) is a broad term that encompasses many
diseases and ailments that impair the functioning of the muscles either directly via
intrinsic muscle pathology, or indirectly via nerve pathology. Some NMD patients
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are characterised by progressive muscular impairment leading to loss of
ambulation, being wheelchair-bound, swallowing difficulties, respiratory muscle
weakness and, eventually, death from respiratory failure. Neuromuscular disorders
can be divided into rapidly progressive and slowly progressive: (i) Rapidly
progressive disorders: Characterised by muscle impairment that worsens over
months and results in death within a few years (e.g. Amyotrophic lateral sclerosis
(ALS) and Duchenne muscular dystrophy (DMD) in teenagers); (ii) Variable or
slowly progressive disorders: Characterised by muscle impairment that worsens
over years and only mildly reduces life expectancy (e.g. Limb girdle,
Facioscapulohumeral and Myotonic muscular dystrophy). Symptoms of
respiratory failure in NMD include: increasing generalised weakness, dysphagia,
dyspnea on exertion and at rest, fatigue, sleepiness, morning headache, and
difficulties with concentration and mood changes.
Chest wall disorders are a group of thoracic deformities that result in
inefficient coupling between the respiratory muscles and the thoracic cage. The
disorders are usually characterised by a restrictive defect and share the potential of
long term hypercapnic respiratory failure. Scoliosis and/or kyphoscoliosis may
cause severe respiratory failure. Symptoms of respiratory failure include: dyspnea
on exertion, peripheral oedema, orthopnoea, repeated chest infections, morning
headaches, fatigue, poor sleep quality and loss of appetite.
Otherwise healthy individuals may take advantage of systems and devices to
prevent respiratory disorders from arising.
2.2.1 Systems
One known product used for treating sleep disordered breathing is the S9
Sleep Therapy System, manufactured by ResMed.
2.2.2 Therapy
Nasal Continuous Positive Airway Pressure (CPAP) therapy has been used to
treat Obstructive Sleep Apnea (OSA). The hypothesis is that continuous positive
airway pressure acts as a pneumatic splint and may prevent upper airway
occlusion by pushing the soft palate and tongue forward and away from the
posterior oropharyngeal wall.
2344980
Non-invasive ventilation (NIV) has been used to treat OHS, COPD, MD and
Chest Wall disorders.
2.2.3 Patient Interface
The application of a supply of air at positive pressure to the entrance of the
airways of a patient is facilitated by the use of a patient interface, such as a nasal
mask, full-face mask or nasal pillows. A range of patient interface devices are
known, however a number of them suffer from being one or more of obtrusive,
aesthetically undesirable, poorly fitting, difficult to use and uncomfortable
especially when worn for long periods of time or when a patient is unfamiliar with
a system. Masks designed solely for aviators, as part of personal protection
equipment or for the administration of anaesthetics may be tolerable for their
original application, but nevertheless be undesirably uncomfortable to be worn for
extended periods, for example, while sleeping.
Traditional oro-nasal masks include full face masks or ResMed LIBERTY
full-face mask. Due to their size and bulk, they may less comfortable and more
intrusive than other masks due to physiological reasons including claustrophobia
or clithrophobia. Oro-nasal masks are typically bulky and heavy and can interfere
with patient comfort and prevent wearing of eyeglasses.
2.2.3.1 Seal-forming portion
Patient interfaces typically include a seal-forming portion.
One type of seal-forming portion extends around the periphery of the patient
interface, and is intended to seal against the user's face when force is applied to
the patient interface with the seal-forming portion in confronting engagement with
the user's face. The seal-forming portion may consist of an air or fluid filled
cushion, or a moulded or formed surface of a resilient seal element made of an
elastomer such as a rubber. With this type of seal-forming portion, if the fit is not
adequate, there will be gaps between the seal-forming portion and the face, and
additional force will be required to force the patient interface against the face in
order to achieve a seal.
2344980
Another type of seal-forming portion incorporates a flap seal of thin material
so positioned about the periphery of the mask so as to provide a self-sealing action
against the face of the user when positive pressure is applied within the mask.
Like the previous style of seal forming portion, if the match between the face and
the mask is not good, additional force may be required to effect a seal, or the mask
may leak. Furthermore, if the shape of the seal-forming portion does not match
that of the patient, it may crease or buckle in use, giving rise to leaks.
Another form of seal-forming portion may use adhesive to effect a seal. Some
patients may find it inconvenient to constantly apply and remove an adhesive to
their face.
A range of patient interface seal-forming portion technologies are disclosed in
the following patent applications, assigned to ResMed Limited: WO
1998/004,310; ,513; ,785.
2.2.3.2 Positioning and stabilising
A seal-forming portion of a patient interface used for positive air pressure
therapy is subject to the corresponding force of the air pressure to disrupt a seal.
Thus a variety of techniques have been used to position the seal-forming portion,
and to maintain it in sealing relation with the appropriate portion of the face.
One technique is the use of adhesives. See for example US Patent publication
US 2010/0000534.
Another technique is the use of one or more straps and stabilising harnesses.
Many such harnesses suffer from being one or more of ill-fitting, bulky,
uncomfortable and awkward to use.
2.2.3.3 Vent technologies
Some forms of patient interface systems may include a vent to allow the
washout of exhaled carbon dioxide. Many such vents are noisy. Others may block
in use and provide insufficient washout. Some vents may be disruptive of the
sleep of a bed-partner 1100 of the patient 1000, e.g. through noise or focussed
airflow.
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ResMed Limited has developed a number of improved mask vent
technologies. See ,665; ,381; US 6,581,594; US
Patent Application; US 2009/0050156; US Patent Application 2009/0044808.
Table of noise of prior masks (ISO 17510-2:2007, 10 cmH O pressure at 1m)
Mask name Mask type A-weighted A-weighted Year
sound power sound (approx.)
level dbA pressure dbA
(uncertainty) (uncertainty)
Glue-on (*) nasal 50.9 42.9 1981
ResCare standard (*) nasal 31.5 23.5 1993
ResMed Mirage (*) nasal 29.5 21.5 1998
ResMed UltraMirage nasal 36 (3) 28 (3) 2000
ResMed Mirage Activa nasal 32 (3) 24 (3) 2002
ResMed Mirage Micro nasal 30 (3) 22 (3) 2008
ResMed Mirage SoftGel nasal 29 (3) 22 (3) 2008
ResMed Mirage FX nasal 26 (3) 18 (3) 2010
ResMed Mirage Swift (*) nasal pillows 37 29 2004
ResMed Mirage Swift II nasal pillows 28 (3) 20 (3) 2005
ResMed Mirage Swift LT nasal pillows 25 (3) 17 (3) 2008
ResMed Mirage series I, II (*) full face 31.7 23.7 2000
ResMed UltraMirage full face 35 (3) 27 (3) 2004
ResMed Mirage Quattro full face 26 (3) 18 (3) 2006
ResMed Mirage Quattro FX full face 27 (3) 19 (3) 2008
(* one specimen only, measured using test method specified in ISO3744 in CPAP mode at
10cmH O)
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Sound pressure values of a variety of objects are listed below
Object A-weighted sound pressure dbA Notes
(uncertainty)
Vacuum cleaner: Nilfisk 68 ISO3744 at 1m
Walter Broadly Litter Hog: B+ distance
Grade
Conversational speech 60 1m distance
Average home 50
Quiet library 40
Quiet bedroom at night 30
Background in TV studio 20
2.2.3.4 Nasal pillow technologies
One form of nasal pillow is found in the Adam Circuit manufactured by
Puritan Bennett. Another nasal pillow, or nasal puff is the subject of US Patent
4,782,832 (Trimble et al.), assigned to Puritan-Bennett Corporation.
ResMed Limited has manufactured the following products that incorporate
nasal pillows: SWIFT nasal pillows mask, SWIFT II nasal pillows mask, SWIFT
LT nasal pillows mask, SWIFT FX nasal pillows mask and LIBERTY full-face
mask. The following patent applications, assigned to ResMed Limited, describe
nasal pillows masks: International Patent Application WO2004/073,778
(describing amongst other things aspects of ResMed SWIFT nasal pillows), US
Patent Application 2009/0044808 (describing amongst other things aspects of
ResMed SWIFT LT nasal pillows); International Patent Applications WO
2005/063,328 and ,903 (describing amongst other things aspects of
ResMed LIBERTY full-face mask); International Patent Application WO
2009/052,560 (describing amongst other things aspects of ResMed SWIFT FX
nasal pillows).
3 BRIEF SUMMARY OF THE TECHNOLOGY
The present technology is directed towards providing medical devices used in
the diagnosis, amelioration, treatment, or prevention of respiratory disorders
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having one or more of improved comfort, cost, efficacy, ease of use and
manufacturability.
[30a] Preferred aspects of the invention are set forth in the appended claims.
Particular embodiments are described below in non-limiting terms.
An embodiment of the present technology may be directed to a patient
interface to provide breathable gas to a patient. The patient interface may
comprise: a plenum chamber assembly, comprising: a nasal plenum chamber at
least partly defining a first gas chamber, the nasal plenum chamber structured to
contact the patient’s nose below the bridge of the nose and around the lower
periphery of the nose; an oral plenum chamber at least partly defining a second
gas chamber, the oral plenum chamber structured to seal around the patient’s
mouth; and a decoupling structure at least partly connecting the nasal plenum
chamber and the oral plenum chamber and at least partly defining a flow path
between the nasal plenum chamber and the oral plenum chamber, the decoupling
structure configured to decouple relative movement between the nasal plenum
chamber and the oral plenum chamber; a top plate operatively connected to the
plenum chamber assembly at the nasal plenum chamber, including at least one
connection feature configured to releasably retain a first portion of a positioning
and stabilising structure; and a faceplate operatively connected to the plenum
chamber assembly at the oral plenum chamber, and configured to releasably retain
a second portion of the positioning and stabilising structure, wherein the top plate
and faceplate are more rigid than the plenum chamber assembly.
In examples, (a) said flow path may pneumatically connect the first gas
chamber and the second gas chamber, (b) said top plate and said faceplate may be
releasably attachable to the plenum chamber assembly, (c) said positioning and
stabilising structure may comprise a rigidiser arm assembly having a pair of
rigidiser arms, the rigidiser arm assembly may be connected to the top plate, (d)
each of the pair of rigidiser arms may be permitted to flex in a plane parallel to the
patient’s transverse plane, and each of the pair of rigidiser arms may be structured
to resist flexing in a plane perpendicular to the patient’s transverse plane, resist
twisting, and/or resist stretching, (e) each of the rigidiser arms may have an
ellipsoidal profile to conform with the curvature of a patient’s cheek, (f) said nasal
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plenum chamber may comprise a nasal flange defining a nasal opening, and said
nasal flange may be configured to form a seal with at least the nose of the patient,
(g) said nasal flange may include a recessed portion to receive the tip of the nose
of the patient, (h) said oral plenum chamber may comprise an oral flange defining
an oral opening, and said oral flange may be configured to form a seal with at
least the mouth of the patient, (i) said oral flange may be formed around the entire
perimeter of the oral plenum chamber, or around two opposing sides of the
perimeter of the oral plenum chamber, or the majority of the perimeter of the oral
plenum chamber, (j) said oral plenum chamber may comprise a pair of oral
undercushion portions each disposed on a respective side of said oral plenum
chamber to support said oral flange, (k) said oral plenum chamber may comprise
an oral undercushion portion disposed circumferentially about said oral plenum
chamber and extending radially from each end of the decoupling structure to
support said oral flange, (j) said decoupling structure may connect the nasal flange
and the oral flange, (k) the decoupling structure may comprise an upper surface, a
lower surface, and a connecting surface, the connecting surface having a greater
stiffness than the upper surface and the lower surface, (l) said decoupling structure
may be stiffer at a portion opposite the face of the patient than at a portion
adjacent to the face of the patient, (m) said decoupling structure may have a
stiffness that increases radially from a portion adjacent to the face of the patient to
a portion opposite the face of the patient, (n) a nose-contacting portion of said
nasal flange may be stiffer at a portion that does not contact the nose of the patient
than at a portion of said nasal flange that does not contact the nose of the patient,
(o) said nasal flange may increase in stiffness outwardly from said nasal opening,
(p) said nasal flange may have a varied stiffness around said nasal opening at
predetermined positions, (q) a lower portion of said nasal flange proximal to said
decoupling structure may be concave to seal against the upper lip of the patient,
(r) said nasal flange may comprise a pair of protruding ends extending
symmetrically about the nasal opening, each protruding end configured to seal
against a corresponding alae of the nose of the patient, (s) said nasal plenum
chamber may comprise a pair of nasal undercushion sections, each of the pair of
nasal undercushion sections supporting one of the pair of protruding ends, (t) each
said nasal undercushion section may be disposed on an upper portion of said oral
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plenum chamber, (u) the patient interface may comprise headgear to releasably
secure said patient interface to the patient, said headgear including a pair of upper
straps configured to connect to the nasal plenum chamber and a pair of lower
straps configured to connect to the oral plenum chamber, (v) the top plate may be
permanently connected to the nasal plenum chamber, (w) the top plate may be
removably attachable to a soft connection region of the nasal plenum chamber, (x)
the top plate may be removably attachable to a hard connection region of the nasal
plenum chamber, and/or (y) the top plate and the rigidiser arms may comprise one
piece and the rigidiser arms are flexible relative to the top plate in a plane parallel
to the patient’s transverse plane.
Another embodiment of the present technology may be directed to a patient
interface to provide breathable gas to a patient. The patient interface may
comprise: a nasal cushion to at least partially define a nasal gas chamber; an oral
cushion to at least partially define an oral gas chamber distinct from said nasal gas
chamber; a decoupling structure disposed between said nasal cushion and said oral
cushion; a top plate fixed to the nasal cushion and a pair of upper attachment
features configured to releasably attach a pair of upper side straps of a positioning
and stabilizing structure to the top plate; and a faceplate fixed to the oral cushion
and a pair of lower attachment features configured to releasably attach a pair of
lower side straps of the positioning and stabilizing structure.
In examples, (a) said decoupling structure may be adapted to form a
pneumatic connection between said nasal gas chamber and said oral gas chamber,
(b) the decoupling structure may comprise an upper surface, a lower surface, and a
connecting surface, the connecting surface having a greater stiffness than the
upper surface and the lower surface, (c) said decoupling structure may have a
stiffness that is radially variable about its perimeter such that a portion distal to the
face of the patient is stiffer than a portion proximal to the face of the patient, and
the nasal cushion may be structured to move independently of the oral cushion, (d)
a nose-contacting portion of the nasal cushion may be less stiff than a portion of
the nasal cushion that does not contact the patient’s nose, (e) said decoupling
structure may be structured to support the nasal cushion against the nose of the
patient, (f) said nasal cushion may be stiffer at a portion of said nasal cushion that
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does not contact the nose of the patient than at a nose-contacting portion, (g) said
nasal cushion may comprise a concave portion to seal against the upper lip of the
patient, (h) said nasal cushion may comprise a pair of protruding ends that are
each configured to form a seal between respective alae and nasolabial sulci of the
face of the patient, (i) said nasal cushion may comprise a pair of nasal
undercushion portions each disposed under each respective protruding end to
support each respective protruding end against the face of the patient, (j) said
nasal cushion may comprise a wing on each side of the nasal cushion to seal
against respective alae of the nose of the patient, (k) said oral cushion may
comprise an oral undercushion portion extending radially about said oral cushion
from either side end said of decoupling structure to support said oral cushion
against the face of the patient, (l) said oral cushion may comprise a pair of oral
undercushion portions each disposed on a respective side of said oral cushion to
support said oral cushion against the face of the patient, (m) said nasal cushion
may be shaped to include a recessed portion configured to receive the tip of the
nose of the patient, (n) said nasal cushion may be configured to contact the
inferior periphery of the nose of the patient below the bridge of the nose, (o) said
nasal cushion, said oral cushion, and said decoupling structure may comprise one
piece, (p) the top plate may be permanently connected to the nasal plenum
chamber, (q) the top plate may be removably attachable to a soft connection
region of the nasal plenum chamber, (r) the top plate may be removably attachable
to a hard connection region of the nasal plenum chamber, (s) the top plate and a
rigidiser arm assembly may comprise one piece and a pair of rigidiser arms of the
rigidiser arm assembly are flexible relative to the top plate in a plane parallel to
the patient’s transverse plane, (t) the positioning and stabilising structure may
comprise a rigidiser arm assembly releasably attachable to the top plate at the
upper attachment features, (u) the patient interface may comprising a frame
releasably attachable to the faceplate and the lower attachment features may be
disposed on the frame, (v) each of the lower attachment features may comprise a
mating portion having a mating portion magnet to releasably connect to
corresponding clips of the positioning and stabilising structure and each of the
corresponding clips may include a clip magnet oriented such that when each clip
magnet is magnetically attracted to each mating portion magnet the mating portion
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is joined to the corresponding clip, (w) the patient interface may comprise a top
plate buffer to dampen the connection between the top plate and the rigidiser arm
assembly and a faceplate buffer to dampen the connection between the faceplate
and the frame, and/or (x) the frame may be shaped to join around the periphery of
the faceplate, the frame may comprise catches and the faceplate comprises
cutouts, and engagement between the catches and the cutouts may join the frame
to the faceplate.
Another embodiment of the present technology may be directed to a patient
interface to provide breathable gas to a patient. The patient interface may
comprising: a plenum chamber assembly, comprising: a nasal plenum chamber at
least partly defining an first gas chamber, the nasal plenum chamber is adapted to
seal against the patient below the bridge of the nose and around the inferior
periphery of the patient’s nose; and an oral plenum chamber at least partly
defining a second gas chamber operatively connected to the nasal plenum
chamber; and a unitary plate member having an upper portion releasably
attachable to the nasal plenum chamber and a lower portion releasably attachable
to the oral plenum chamber; wherein the upper portion of the plate member
includes at least one connection feature configured to releasably retain a first
portion of a positioning and stabilising structure having a pair of rigidiser arms,
and the lower portion of the plate member is configured to releasably retain a
second portion of the positioning and stabilising structure.
In examples, (a) the plenum chamber assembly may comprise a decoupling
structure at least partly connecting the nasal plenum chamber and the oral plenum
chamber, the decoupling structure at least partly defining a flow path between the
nasal plenum chamber and the oral plenum chamber, (b) each of the pair of
rigidiser arms may be permitted to flex in a plane parallel to the patient’s
transverse plane, and each of the pair of rigidiser arms may be structured to resist
flexing in a plane perpendicular to the patient’s transverse plane, resist twisting,
and/or resist stretching, (c) each said at least one connection feature may comprise
a hinge to allow a corresponding one of the pair of rigidiser arms to rotate relative
to the rigid top plate upper portion of the unitary plate member in a plane parallel
to the patient’s transverse plane, (d) the first portion of a positioning and
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stabilising structure may include a hook to pivotably connect with the connection
feature of the upper portion of the unitary plate member, (e) said nasal plenum
chamber may comprise a nasal flange defining a nasal opening, and said nasal
flange may be configured to form a seal with at least the nose of the patient, (e)
said nasal flange may include a recessed portion to receive the tip of the nose of
the patient, (f) said oral plenum chamber may comprise an oral flange defining an
oral opening, and said oral flange may be configured to form a seal with at least
the mouth of the patient, (g) said oral flange may be formed around the entire
perimeter of the oral plenum chamber, or around two opposing sides of the
perimeter of the oral plenum chamber, or the majority of the perimeter of the oral
plenum chamber, (f) said oral plenum chamber may comprise a pair of oral
undercushion portions each disposed on a respective side of said oral plenum
chamber to support said oral flange, (g) said oral plenum chamber may comprise
an oral undercushion portion disposed circumferentially about said oral plenum
chamber and extending radially from each end of the decoupling structure to
support said oral flange, (h) said decoupling structure may connect the nasal
flange and the oral flange, (i) said decoupling structure may be stiffer at a portion
opposite the face of the patient than at a portion adjacent to the face of the patient,
(j) said decoupling structure may have a stiffness that increases radially from a
portion adjacent to the face of the patient to a portion opposite the face of the
patient, (k) a nose-contacting portion of said nasal flange may be stiffer at a
portion that does not contact the nose of the patient than at a portion of said nasal
flange that does not contact the nose of the patient, (l) said nasal flange may
increase in stiffness outwardly from said nasal opening, (m) said nasal flange may
have a varied stiffness around said nasal opening at predetermined positions, (n) a
lower portion of said nasal flange proximal to said decoupling structure may be
concave to seal against the upper lip of the patient, (o) said nasal flange may
comprise a pair of protruding ends extending symmetrically about the nasal
opening, each protruding end configured to seal against a corresponding alae of
the nose of the patient, (p) said nasal plenum chamber may comprise a pair of
nasal undercushion sections each corresponding to each protruding end to support
each protruding end, (q) each said nasal undercushion section may be disposed on
an upper portion of said oral plenum chamber, and/or (r) each of said pair of
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rigidiser arms may have an ellipsoidal curvature between the first end and the
second end.
Another embodiment of the present technology may be directed to a cushion
assembly for a patient interface for treatment of sleep disordered breathing of a
patient, comprising: a nasal cushion joined to a nasal plenum chamber, the nasal
cushion structured to seal around the lower periphery of the patient’s nose; an oral
cushion joined to an oral plenum chamber, the oral cushion structured to seal
around the patient’s mouth; a decoupling structure connecting the nasal cushion
and the nasal plenum chamber to the oral cushion and the oral plenum chamber,
the decoupling structure configured to allow the nasal cushion and the nasal
plenum chamber to move relative to the oral cushion and the oral plenum
chamber; a pair of side supports, each of the pair of side supports located on
opposite sides of the nasal cushion and joining respective lateral sides of the nasal
cushion to the oral cushion; a pair of undercushion support walls provided to
support protruding ends positioned posteriorly on the nasal cushion; and a pair of
pockets, each of the pair of pockets located on opposite sides of the nasal cushion,
each of the pair of pockets including an upper surface defined by the nasal cushion
and the nasal plenum chamber, each of the pair of pockets including a lower
surface defined by the oral cushion and the oral plenum chamber, and each of the
pair of pockets including side surfaces defined by the decoupling structure and
respective ones of the pair of side supports, wherein an opening of each of the pair
of pockets is positioned opposite the face of the patient when the patient interface
is donned by the patient.
In examples, (a) each of the pair of side supports may include a notch to
provide a pivot point for relative movement between the nasal cushion and the
oral cushion, (b) the notch of each of the pair of side supports may be open in a
direction opposite the face of the patient when the patient interface is donned by
the patient, (c) the nasal cushion may comprise a pair of stiffened sections, each of
the pair of stiffened sections may be located at opposite lateral sides of the nasal
cushion, and the stiffened sections may be stiffer than the remainder of the nasal
cushion, (d) the pair of stiffened sections may comprise a thickness greater than
other portions of the nasal cushion, (e) the pair of stiffened sections may extend
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internally relative to the nasal cushion and the nasal plenum chamber such that an
external surface of the nasal cushion is not raised, (f) the nasal cushion may
comprises a nasal sling, the nasal sling being formed in-plane with the nasal
cushion, and the nasal sling being structured to contact the patient’s columella, (g)
the nasal cushion and the nasal sling may define a pair of nare ports, each of the
pair of nare ports structured to pneumatically communicate with a respective one
of the patient’s nares, and/or (h) the nasal sling may be structured to prevent the
tip of the patient’s nose from extending into a nasal gas chamber, the nasal gas
chamber defined at least in part by the nasal cushion and the nasal plenum
chamber.
Another embodiment of the present technology is directed to a patient
interface system to provide breathable gas to a patient. The patient interface may
comprise: a cushion assembly, the cushion assembly may comprise: a nasal
cushion to at least partially define a nasal gas chamber; an oral cushion to at least
partially define an oral gas chamber distinct from said nasal gas chamber; and a
decoupling structure disposed between said nasal cushion and said oral cushion; a
positioning and stabilizing structure with a pair of lower side straps; and a pair of
lower attachment features configured to releasably attach a corresponding one of
the pair of lower side straps of the positioning and stabilizing structure to the
cushion assembly, wherein each of the pair of lower attachment features
comprises a thermoplastic elastomer and each of the pair of lower attachment
features has a first magnet embedded therein.
In examples, (a) the patient interface system may comprise: a faceplate fixed
to the oral cushion; and a frame releasably attachable to the faceplate, wherein the
pair of lower attachment features are fixed to the frame, (b) the frame may
comprise a material more rigid than thermoplastic elastomer, (c) the pair of lower
attachment features may be molded onto the frame, (d) the positioning and
stabilizing structure may comprise a pair of clips to attach a corresponding one of
the pair of lower side straps to corresponding one of the pair of lower attachment
features, (e) each of the pair of clips may comprise a second magnet to attach each
of the pair of clips to a corresponding one of the pair of lower attachment features,
(f) each of the pair of clips may comprise a notch and each of the pair of lower
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attachment features may comprise a protrusion, and the protrusion may engage
with the notch when each of the pair of clips are engaged with a corresponding
one of the pair of lower attachment features, (g) each of the pair of lower
attachment features may comprise a flex point, each of the pair of the pair of
lower attachment features structured to flex at said flex point, and/or (h) each of
the pair of lower attachment features may include a region of reduced thickness at
the flex point.
Another embodiment of the present technology is directed to a patient
interface to provide breathable gas to a patient. The patient interface may
comprise: a nasal cushion to at least partially define a nasal gas chamber; an oral
cushion to at least partially define an oral gas chamber distinct from said nasal gas
chamber; a decoupling structure disposed between said nasal cushion and said oral
cushion; a top plate fixed to the nasal cushion; and a rigidiser arm assembly
releasably attachable to the top plate, wherein the rigidiser arm assembly and the
top plate engage at least three points of contact.
In examples, (a) the top plate may comprise a pair of upper attachment
features and the rigidiser arm assembly may comprise a pair of connection
features, each of the pair of connection features may be structured to engage with
a corresponding one of the pair of upper attachment features, (b) the rigidiser arm
assembly may comprise a rib to engage with the top plate when the rigidiser arm
assembly is engaged with the top plate, (c) the patient interface may comprise a
top plate buffer to dampen engagement between the rigidiser arm assembly and
the top plate, the top plate buffer may be positioned on an anterior side of the top
plate to contact a posterior side of the rigidiser arm assembly, (d) the top plate
buffer and the nasal cushion may comprise one piece, the top plate buffer
extending through the top plate from the nasal cushion, (e) the rigidiser arm
assembly may comprise a pair of rigidiser arms, each of the pair of rigidiser arms
may be structured to a receive an upper side strap of a positioning and stabilizing
structure, and/or (f) each of the pair of rigidiser arms may comprise a pad to
cushion the pair of rigidiser arms against the patient’s face.
Another embodiment of the present technology is directed to a patient
interface to provide breathable gas to a patient. The patient interface may
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comprise: a nasal cushion to at least partially define a nasal gas chamber; an oral
cushion to at least partially define an oral gas chamber distinct from said nasal gas
chamber; and a decoupling structure disposed between said nasal cushion and said
oral cushion, wherein the decoupling structure comprises an upper surface joining
the decoupling structure to the nasal cushion, a lower surface joining the
decoupling structure to the oral cushion, and a connecting surface joining the
upper surface and the lower surface, wherein the upper surface and the lower
surface are substantially equal in thickness, and wherein the connecting surface is
thicker than the upper surface and the lower surface.
In examples, (a) the connecting surface may be about twice as thick as the
upper surface and the lower surface, (b) the decoupling structure may be
structured to be flexible such that the upper surface and the lower surface can be
positioned at up to 50° relative to one another, and/or (c) the upper surface and the
lower surface may be about 0.5 mm thick and the connecting surface is about 1.2
mm thick.
Another embodiment of one form of the present technology is a patient
interface that is moulded or otherwise constructed with a clearly defined perimeter
shape which is intended to match that of an intended wearer. The patient interface
system may have a reduced part count compared to currently available patient
interface systems. The patient interface system may provide a visible mouth
region of the patient if the faceplate is semi-transparent or transparent. The patient
interface system is an oro-nasal mask meaning it covers the nasal airways and the
mouth. It may not obstruct the patient’s line of sight, and may be considered
physiologically non-threatening and may increase patient selection of the system
and adherence to therapy. The patient interface system may flex to adapt to
changes in jaw movement and head position throughout the night. The patient
interface system may provide a supply of pressurised air or breathable gas to a
patient’s nasal passages and may prevent or reduce mouth leak by providing an
effective seal with both the patient’s mouth and the patient’s nasal passages.
Another embodiment of one form of the present technology is a patient
interface that may have a reduced skin contact area and less total points of contact
with the face, when compared to most known full face masks. This may allow a
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far reduced headgear tension to be applied, significantly improving patient
comfort. Patient comfort may be further enhanced since the patient is less likely to
feel claustrophobic, particularly with the removal of any mass that is close to the
eyes.
Another embodiment of one form of the present technology is a patient
interface that may be quick and easy to fit by all customer segments including
patient, home medical equipment dealers and clinicians. It may simplify mask
selection for clinicians and dealers due to its superior ease of use (fitting, sealing,
size selection, sometimes remotely) and intuitiveness to assemble and fit allowing
greater success in remote setups done in an unassisted environment without
instruction. The patient interface may have one primary size fitting the majority of
the general adult patient population, and no more than two additional sizes. It is
envisaged that three sizes of the patient interface will fit at least 90% of the
general adult population.
Of course, portions of the aspects may form sub-aspects of the present
technology. Also, various ones of the sub-aspects and/or aspects may be combined
in various manners and also constitute additional aspects or sub-aspects of the
present technology.
Other features of the technology will be apparent from consideration of the
information contained in the following detailed description, abstract, drawings and
claims.
4 BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
The present technology is illustrated by way of example, and not by way of
limitation, in the figures of the accompanying drawings, in which like reference
numerals refer to similar elements including:
4.1 TREATMENT SYSTEMS
Fig. 1a shows a system in accordance with the present technology. A patient
1000 wearing a patient interface 3000, receives a supply of air at positive pressure
from a PAP device 4000. Air from the PAP device is humidified in a humidifier
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5000, and passes along an air circuit 4170 to the patient 1000. A bed partner 1100
is also shown.
Fig. 1b shows a PAP device in use on a patient with a nasal mask.
Fig. 1c shows a PAP device in use on a patient with a full-face mask.
4.2 THERAPY
4.2.1 Respiratory system
Fig. 2a shows an overview of a human respiratory system including the nasal
and oral cavities, the larynx, vocal folds, oesophagus, trachea, bronchus, lung,
alveolar sacs, heart and diaphragm.
Fig. 2b shows a view of a human upper airway including the nasal cavity,
nasal bone, lateral nasal cartilage, greater alar cartilage, nostril, lip superior, lip
inferior, larynx, hard palate, soft palate, oropharynx, tongue, epiglottis, vocal
folds, oesophagus and trachea.
4.2.2 Facial anatomy
Fig. 2c is a front view of a face with several features of surface anatomy
identified including the lip superior, upper vermillion, lower vermillion, lip
inferior, mouth width, endocanthion, a nasal ala, nasolabial sulcus and cheilion.
Fig. 2d is a side view of a head with several features of surface anatomy
identified including glabella, sellion, pronasale, subnasale, lip superior, lip
inferior, supramenton, nasal ridge, otobasion superior and otobasion inferior. Also
indicated are the directions superior & inferior, and anterior & posterior.
Fig. 2e is a further side view of a head. The approximate locations of the
Frankfort horizontal and nasolabial angle are indicated.
Fig. 2f shows a base view of a nose.
Fig. 2g shows a side view of the superficial features of a nose.
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Fig. 2h shows subcutaneal structures of the nose, including lateral cartilage,
septum cartilage, greater alar cartilage, lesser alar cartilage and fibrofatty tissue.
Fig. 2i shows a medial dissection of a nose, approximately several millimeters
from a sagittal plane, amongst other things showing the septum cartilage and
medial crus of greater alar cartilage.
Fig. 2j shows a front view of the bones of a skull including the frontal,
temporal, nasal and zygomatic bones. Nasal concha are indicated, as are the
maxilla, mandible and mental protuberance.
Fig. 2k shows a lateral view of a skull with the outline of the surface of a head,
as well as several muscles. The following bones are shown: frontal, sphenoid,
nasal, zygomatic, maxilla, mandible, parietal, temporal and occipital. The mental
protuberance is indicated. The following muscles are shown: digastricus, masseter
sternocleidomastoid and trapezius.
Fig. 2l shows anterolateral view of the skull and tissue structures.
4.3 PATIENT INTERFACE
Figure 3a shows a perspective view of a patient interface in accordance with
an example of the present technology.
Figure 3b shows a front view of a patient interface in accordance with an
example of the present technology.
Figure 3c shows a rear view of a patient interface in accordance with an
example of the present technology.
Figure 3d shows a top view of a patient interface in accordance with an
example of the present technology.
Figure 3e shows a bottom view of a patient interface in accordance with an
example of the present technology.
Figure 3f shows a side view of a patient interface in accordance with an
example of the present technology.
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Figure 3g shows a perspective view of a patient interface including a air
circuit in accordance with an example of the present technology.
Figure 3h shows a rear view of a patient interface including a air circuit in
accordance with an example of the present technology.
Figure 3i shows a front view of a patient interface including a air circuit in
accordance with an example of the present technology.
Figure 3j shows a top view of a patient interface including a air circuit in
accordance with an example of the present technology.
Figure 3k shows a bottom view of a patient interface including a air circuit in
accordance with an example of the present technology.
Figure 3l shows a side view of a patient interface including a air circuit in
accordance with an example of the present technology.
Figure 3m shows a perspective view of a patient interface including a air
circuit donned on a patient in accordance with an example of the present
technology.
Figure 3n shows a front view of a patient interface including a air circuit
donned on a patient in accordance with an example of the present technology.
Figure 3o shows a side view of a patient interface including a air circuit
donned on a patient in accordance with an example of the present technology.
Figure 3p shows a top view of a patient interface including a air circuit donned
on a patient in accordance with an example of the present technology.
Figure 3q shows a side cross-sectional view of a patient interface according to
an example of the present technology with the patient interface located against the
face of a patient. The patient is shown with a cross-section of the airways.
Figure 3r shows a detailed front perspective view of a portion of a patient
interface according to an example of the present technology. The patient interface
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is shown in dashed lines and the nose, mouth, and chin of the patient are shown in
solid lines.
Figure 3s shows an exploded perspective view of a patient interface in
accordance with an example of the present technology.
Figure 3t shows an exploded front view of a patient interface in accordance
with an example of the present technology.
Figure 3u shows an exploded rear view of a patient interface in accordance
with an example of the present technology.
Figure 4a shows a top view of a nasal cradle cushion of a patient interface in
accordance with an example of the present technology.
Figure 4b shows a bottom cross-sectional view taken through line 4c-4c of
Figure 4a of a nasal cradle cushion of a patient interface in accordance with an
example of the present technology.
Figure 4c shows a side cross-sectional view taken through line 4c-4c of Figure
4a of a nasal cradle cushion of a patient interface in accordance with an example
of the present technology. A patient’s nose is shown in dashed lines.
Figure 5a shows a top view of another nasal cradle cushion of a patient
interface in accordance with another example of the present technology.
Figure 5b shows a bottom cross-sectional view taken through line 5c-5c of
Figure 5a of another nasal cradle cushion of a patient interface in accordance with
another example of the present technology.
Figure 5c shows a side cross-sectional view taken through line 5c-5c of Figure
5a of another nasal cradle cushion of a patient interface in accordance with an
example of the present technology. A patient’s nose is shown in dashed lines.
Figure 6a shows a top view of another nasal cradle cushion of a patient
interface in accordance with another example of the present technology.
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Figure 6b shows a bottom cross-sectional view taken through line 6c-6c of
Figure 6a of another nasal cradle cushion of a patient interface in accordance with
another example of the present technology.
Figure 6c shows a side cross-sectional view taken through line 6c-6c of Figure
6a of another nasal cradle cushion of a patient interface in accordance with
another example of the present technology. A patient’s nose is shown in dashed
lines.
Figure 7a shows a rear perspective view of a plenum chamber assembly of a
patient interface in accordance with an example of the present technology.
Figure 7b shows a side perspective view of a plenum chamber assembly of a
patient interface in accordance with an example of the present technology.
Figure 7c shows a front perspective view of a plenum chamber assembly of a
patient interface in accordance with an example of the present technology.
Figure 7d shows a rear view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology.
Figure 7e shows a front view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology.
Figure 7f shows a top view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology.
Figure 7g shows a bottom view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology.
Figure 7h shows a side view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology.
Figure 8a shows a top view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology and includes
several lines defining various cross-sections.
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Figure 8b shows a side cross-sectional view taken through line 8b-8b of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8c shows a side cross-sectional view taken through line 8c-8c of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8d shows a side cross-sectional view taken through line 8d-8d of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8e shows a side cross-sectional view taken through line 8e-8e of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8f shows a side cross-sectional view taken through line 8f-8f of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8g shows a front cross-sectional view taken through line 8g-8g of
Figure 8a of a plenum chamber assembly of a patient interface in accordance with
an example of the present technology.
Figure 8h shows a front cross-sectional view taken through line 8h-8h of
Figure 8a of a plenum chamber assembly of a patient interface in accordance with
an example of the present technology.
Figure 8i shows a front cross-sectional view taken through line 8i-8i of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8j shows a front perspective cross-sectional view taken through line 8j-
8j of Figure 8a of a plenum chamber assembly of a patient interface in accordance
with an example of the present technology.
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Figure 8k shows a side cross-sectional view taken through line 8k-8k of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 8l shows a side cross-sectional view taken through line 8l-8l of Figure
8a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9a shows a front view of a plenum chamber assembly of a patient
interface in accordance with an example of the present technology and includes
several lines defining various cross-sections.
Figure 9b shows a side cross-sectional view taken through line 9b-9b of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9c shows a side cross-sectional view taken through line 9c-9c of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9d shows a side cross-sectional view taken through line 9d-9d of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9e shows a side cross-sectional view taken through line 9e-9e of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9f shows a side cross-sectional view taken through line 9f-9f of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9g shows a side cross-sectional view taken through line 9g-9g of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
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Figure 9h shows a side cross-sectional view taken through line 9h-9h of Figure
9a of a plenum chamber assembly of a patient interface in accordance with an
example of the present technology.
Figure 9i shows a side cross-sectional view taken through line 9i-9i of Figure
9a of a plenum chamber assembly of a patient interface in accordance with one
form of the present technology.
Figure 10a shows a top view of a nasal cushion of a patient interface in
accordance with an example of the present technology.
Figure 10b shows a top view of a nasal cushion of a patient interface in
accordance with another example of the present technology.
Figure 10c shows a top view of a nasal cushion of a patient interface in
accordance with another example of the present technology.
Figure 10d shows a top view of a nasal cushion of a patient interface in
accordance with another example of the present technology.
Figure 11a shows a cross-section of a nasal cushion taken through line 11a-
11a of Figure 4a according to an example of the present technology.
Figure 11b shows a cross-section of a nasal cushion taken through line 11b, c
of Figure 13 according to an example of the present technology.
Figure 11c shows a cross-section of a nasal cushion taken through line 11b, c
of Figure 13 according to an example of the present technology.
Figure 12a shows a rear view of an oral cushion with an undercushion of an
exemplary seal-forming structure according to the present technology.
Figure 12b shows a rear view of an oral cushion with an undercushion of
another exemplary seal-forming structure according to the present technology.
Figure 12c shows a rear view of an oral cushion with an undercushion of
another exemplary seal-forming structure according to the present technology.
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Figure 12d shows a rear view of an oral cushion with an undercushion of
another exemplary seal-forming structure according to the present technology.
Figure 13 shows a top view of a nasal cradle cushion of a patient interface in
accordance with an example of the present technology.
Figure 14 shows an exploded side view of a patient interface in accordance
with an example of the present technology.
Figure 15a shows a front view of a seal-forming structure, top plate, and
rigidiser arms in accordance with an example of the present technology.
Figure 15b shows a front view of a seal-forming structure, top plate, and
rigidiser arms in accordance with another example of the present technology.
Figure 15c shows a front view of a seal-forming structure, top plate, and
rigidiser arms in accordance with an example of the present technology.
Figure 15d shows a front view of a seal-forming structure, top plate, and
rigidiser arms in accordance with an example of the present technology.
Figure 15e shows a front view of a seal-forming structure, top plate, and
rigidiser arms in accordance with an example of the present technology.
Figure 16a shows a top perspective view of a seal-forming structure and
plenum chamber according to an example of the present technology.
Figure 16b shows a bottom perspective view of a seal-forming structure and
plenum chamber according to an example of the present technology.
Figure 16c shows a further top perspective view of a seal-forming structure
and plenum chamber according to an example of the present technology.
Figure 16d shows a front view of a seal-forming structure and plenum
chamber according to an example of the present technology.
Figure 16e shows a rear view of a seal-forming structure and plenum chamber
according to an example of the present technology.
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Figure 16f shows a top view of a seal-forming structure and plenum chamber
according to an example of the present technology.
Figure 16g shows a bottom view of a seal-forming structure and plenum
chamber according to an example of the present technology.
Figure 16h shows a side view of a seal-forming structure and plenum chamber
according to an example of the present technology.
Figure 16i shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16i-16i of Figure 16d according to an example
of the present technology.
Figure 16j shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16j-16j of Figure 16f according to an example
of the present technology.
Figure 16k shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16k-16k of Figure 16h according to an
example of the present technology.
Figure 16l shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16l-16l of Figure 16d according to an example
of the present technology.
Figure 16m shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16m-16m of Figure 16g according to an
example of the present technology.
Figure 16n shows a detailed front perspective view of a seal-forming structure
and plenum chamber according to an example of the present technology.
Figure 16o shows a cross-sectional view of a seal-forming structure and
plenum chamber taken through line 16o-16o of Figure 16d according to an
example of the present technology.
Figure 17a shows a perspective view of a patient interface according to an
example of the present technology.
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Figure 17b shows a front view of a patient interface according to an example
of the present technology.
Figure 17c shows a rear view of a patient interface according to an example of
the present technology.
Figure 17d shows a top view of a patient interface according to an example of
the present technology.
Figure 17e shows a bottom view of a patient interface according to an example
of the present technology.
Figure 17f shows a side view of a patient interface according to an example of
the present technology.
Figure 18a shows a perspective view of a seal-forming structure with a top
plate and a faceplate according to an example of the present technology.
Figure 18b shows a front view of a seal-forming structure with a top plate and
a faceplate according to an example of the present technology.
Figure 18c shows a side view of a seal-forming structure with a top plate and a
faceplate according to an example of the present technology.
Figure 18d shows a top view of a seal-forming structure with a top plate and a
faceplate according to an example of the present technology.
Figure 18e shows a rear perspective view of a seal-forming structure with a
top plate and a faceplate according to an example of the present technology.
Figure 18f shows a cross-sectional view taken through line 18f-18f of Figure
18d of a seal-forming structure with a top plate and a faceplate according to an
example of the present technology.
Figure 19a shows a perspective view of a rigidiser arm assembly according to
an example of the present technology.
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Figure 19b shows a front view of a rigidiser arm assembly according to an
example of the present technology.
Figure 19c shows a side view of a rigidiser arm assembly according to an
example of the present technology.
Figure 19d shows a top view of a rigidiser arm assembly according to an
example of the present technology.
Figure 19e shows a rear view of a rigidiser arm assembly according to an
example of the present technology.
Figure 19f shows a top view of a rigidiser arm assembly according to an
example of the present technology.
Figure 19g shows another top view of a rigidiser arm assembly according to
an example of the present technology.
Figure 19h shows a rear view of a rigidiser arm assembly according to an
example of the present technology.
Figure 20a shows a perspective view of a faceplate frame, lower attachment
features, and clips according to an example of the present technology.
Figure 20b shows a front view of a faceplate frame, lower attachment features,
and clips according to an example of the present technology.
Figure 20c shows a rear view of a faceplate frame, lower attachment features,
and clips according to an example of the present technology.
Figure 20d shows a side view of a faceplate frame, lower attachment features,
and clips according to an example of the present technology.
Figure 20e shows a top view of a faceplate frame, lower attachment features,
and clips according to an example of the present technology.
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Figure 20f shows a partially exploded perspective view of a faceplate frame,
lower attachment features, and clips according to an example of the present
technology.
Figure 20g shows another partially exploded perspective view of a faceplate
frame, lower attachment features, and clips according to an example of the present
technology.
Figure 20h shows an exploded perspective view of a faceplate frame, lower
attachment features, and clips according to an example of the present technology.
Figure 20i shows a perspective view of a faceplate frame according to an
example of the present technology.
Figure 20j shows a front view of a faceplate frame according to an example of
the present technology.
Figure 20k shows a rear view of a faceplate frame according to an example of
the present technology.
Figure 20l shows a side view of a faceplate frame according to an example of
the present technology.
Figure 20m shows a top view of a faceplate frame according to an example of
the present technology.
Figure 20n shows a rear view of a faceplate frame according to an example of
the present technology.
Figure 20o shows another partially exploded perspective view of a faceplate
frame, lower attachment features, and clips according to an example of the present
technology.
Figure 20p shows an exploded perspective view of a faceplate frame, lower
attachment features, and clips according to an example of the present technology.
Figure 20q shows a top view of a faceplate frame according to an example of
the present technology.
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Figure 20r shows a top view of a faceplate frame according to an example of
the present technology.
Figure 20s shows a top view of a faceplate frame according to an example of
the present technology.
Figure 21a shows a perspective view of a top plate according to an example of
the present technology.
Figure 21b shows a front view of a top plate according to an example of the
present technology.
Figure 21c shows a rear view of a top plate according to an example of the
present technology.
Figure 21d shows a top view of a top plate according to an example of the
present technology.
Figure 21e shows a side view of a top plate according to an example of the
present technology.
Figure 22a shows a perspective view of a faceplate according to an example of
the present technology.
Figure 22b shows a front view of a faceplate according to an example of the
present technology.
Figure 22c shows a rear view of a faceplate according to an example of the
present technology.
Figure 22d shows a side view of a faceplate according to an example of the
present technology.
Figure 22e shows a top view of a faceplate according to an example of the
present technology.
Figure 23a shows a front perspective view of a lower attachment feature
support according to an example of the present technology.
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Figure 23b shows another front perspective view of a lower attachment feature
support according to an example of the present technology.
Figure 23c shows a rear view of a lower attachment feature support according
to an example of the present technology.
Figure 23d shows a top perspective view of a lower attachment feature support
according to an example of the present technology.
Figure 23e shows a side perspective view of a lower attachment feature
support according to an example of the present technology.
Figure 23f shows another side perspective view of a lower attachment feature
support according to an example of the present technology.
Figure 24a shows a front perspective view of a connector of a lower
attachment feature according to an example of the present technology.
Figure 24b shows another front perspective view of a connector of a lower
attachment feature according to an example of the present technology.
Figure 24c shows a rear view of a connector of a lower attachment feature
according to an example of the present technology.
Figure 24d shows a top perspective view of a connector of a lower attachment
feature according to an example of the present technology.
Figure 24e shows a side perspective view of a connector of a lower attachment
feature according to an example of the present technology.
Figure 24f shows another rear perspective view of a connector of a lower
attachment feature according to an example of the present technology.
Figure 25a shows a front perspective view of a clip according to an example of
the present technology.
Figure 25b shows another front perspective view of a clip according to an
example of the present technology.
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Figure 25c show a rear perspective view of a clip according to an example of
the present technology.
Figure 25d shows a top perspective view of a clip according to an example of
the present technology.
Figure 25e shows a side perspective view of a clip according to an example of
the present technology.
Figure 25f shows another rear perspective view of a clip according to an
example of the present technology.
Figure 25g shows a front perspective view of a clip according to an example
of the present technology.
Figure 25h shows another front perspective view of a clip according to an
example of the present technology.
Figure 25i show a rear perspective view of a clip according to an example of
the present technology.
Figure 25j shows a top perspective view of a clip according to an example of
the present technology.
Figure 25k shows a side perspective view of a clip according to an example of
the present technology.
Figure 25l shows another rear perspective view of a clip according to an
example of the present technology.
Fig. 26a shows a perspective view of a tube decoupling structure according to
an example of the present technology.
Fig. 26b shows a front view of a tube decoupling structure according to an
example of the present technology.
Fig. 26c shows a rear view of a tube decoupling structure according to an
example of the present technology.
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Fig. 26d shows a cross-sectional view of a tube decoupling structure taken
through line 26d-26d of Fig. 26c according to an example of the present
technology.
Figure 27a shows a perspective view of a seal-forming structure with a top
plate and a faceplate according to an example of the present technology.
Figure 27b shows a front view of a seal-forming structure with a top plate and
a faceplate according to an example of the present technology.
Figure 27c shows a side view of a seal-forming structure with a top plate and a
faceplate according to an example of the present technology.
Figure 27d shows a top view of a seal-forming structure with a top plate and a
faceplate according to an example of the present technology.
Figure 27e shows a rear perspective view of a seal-forming structure with a
top plate and a faceplate according to an example of the present technology.
Figure 27f shows a cross-sectional view taken through line 27f-27f of Figure
27d of a seal-forming structure with a top plate and a faceplate according to an
example of the present technology.
Figure 28a shows a perspective view of a top plate according to an example of
the present technology.
Figure 28b shows a front view of a top plate according to an example of the
present technology.
Figure 28c shows a rear view of a top plate according to an example of the
present technology.
Figure 28d shows a top view of a top plate according to an example of the
present technology.
Figure 28e shows a side view of a top plate according to an example of the
present technology.
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Figure 29a shows a perspective view of a patient interface according to an
example of the present technology.
Figure 29b shows a front view of a patient interface according to an example
of the present technology.
Figure 29c shows a rear view of a patient interface according to an example of
the present technology.
Figure 29d shows a top view of a patient interface according to an example of
the present technology.
Figure 29e shows a bottom view of a patient interface according to an example
of the present technology.
Figure 29f shows a side view of a patient interface according to an example of
the present technology.
DETAILED DESCRIPTION OF EXAMPLES OF THE TECHNOLOGY
Before the present technology is described in further detail, it is to be
understood that the technology is not limited to the particular examples described
herein, which may vary. It is also to be understood that the terminology used in
this disclosure is for the purpose of describing only the particular examples
discussed herein, and is not intended to be limiting.
The following description is provided in relation to various examples which
may share one or more common characteristics and/or features. It is to be
understood that one or more features of any one example may be combinable with
one or more features of another example or other examples. In addition, any single
feature or combination of features in any of the examples may constitute a further
example.
.1 TREATMENT SYSTEMS
In one form, the present technology comprises apparatus for treating a
respiratory disorder. In an example, the apparatus comprises a flow generator or
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blower for supplying pressurised respiratory gas, such as air, to the patient 1000
via an air delivery tube leading to a patient interface 3000.
.2 THERAPY
In one form, the present technology comprises a method for treating a
respiratory disorder comprising the step of applying positive pressure to the
entrance of the airways of a patient 1000.
.2.1 Nasal CPAP for OSA
In one form, the present technology comprises a method of treating
Obstructive Sleep Apnea in a patient by applying nasal continuous positive airway
pressure to the patient.
.3 PATIENT INTERFACE
A non-invasive patient interface in accordance with one aspect of the present
technology comprises the following functional aspects: a seal-forming structure, a
plenum chamber, a positioning and stabilising structure and a connection port for
connection to an air circuit. In some forms a functional aspect may be provided by
one or more physical components. In some forms, one physical component may
provide one or more functional aspects. In use the seal-forming structure is
arranged to surround an entrance to the airways of the patient so as to facilitate the
supply of air at positive pressure to the airways.
Figure 3a shows a front perspective view of a patient interface 3000 according
to an example of the present technology. The patent interface 3000 may include a
seal-forming structure 3100, an oral plenum chamber 3200, a nasal plenum
chamber 3202, and components of a positioning and stabilising structure 3300.
.3.1 Plenum Chamber and Seal-Forming Structure
Also shown in Figure 3a, the upper portion of the seal-forming structure 3100
may include a nasal cushion or flange 3112 to seal around the lower portion of the
nose of the patient, particularly around the ala and tip of the nose. This nasal
cushion 3112 may define, at least in part, an upper gas chamber, which will be
discussed in greater detail below.
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Figure 3a also shows that the seal-forming structure 3100 may also include an
oral cushion or flange 3110 to seal around the mouth of the patient. The oral
cushion 3110 may be attached to the oral plenum chamber 3200 around a
perimeter 3210 of the oral plenum chamber 3200.
The rear view in Figure 3c shows the portions of the seal-forming structure
3100 that may contact the face of the patient during use. The nasal cushion 3112
is shown connected to an upper portion of the oral cushion 3110 by a decoupling
structure 3106. The decoupling structure 3106 may be understood to be an
intermediate structure that joins the nasal cushion 3112 and the oral cushion 3110.
The decoupling structure 3106 may allow the nasal cushion 3112 and the oral
cushion 3110 to move relative to one another, while maintaining a pneumatic flow
path therebetween. The nasal cushion 3112 may define a nasal gas chamber 3104
and a nasal gas chamber opening 3103 in the nasal cushion 3112 may receive a
portion of the nose of the patient in use. During therapy, breathable gas may be
provided to the patient from the patient interface 3000 to the nose through the
nasal gas chamber 3104. The oral cushion 3110 may also include an oral gas
chamber 3102 and an oral gas chamber opening 3101 to provide breathable gas to
the patient’s mouth during therapy. Through the oral gas chamber 3102 of the
oral cushion 3110, the faceplate 3204 and the port 3600 can be seen. It should be
understood that when the patient interface 3000 is donned on a patient, the
faceplate 3204, the plenum chamber 3200, the oral cushion 3110, the nasal
cushion 3112, and the decoupling structure 3106 may at least partially, along with
the face of the patient, define the nasal gas chamber 3104 and the oral gas
chamber 3102 through which breathable gas may be provided to the patient at
positive pressure.
In Figure 3d, a protruding end 3114 can be seen on either side of the nasal
cushion 3112. When donned on the patient each protruding end 3114 may be
shaped to extend from the patient interface 3000 so as to seal within the gap
between the respective alae and nasolabial sulci of the patient. Figure 2c, which
depicts superficial features of the face, indicates the location of the alae and the
nasolabial sulci. The details of the seal provided by the protruding ends 3114 will
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be described in greater detail below. The protruding ends 3114 may partially
inflate and/or deform to seal in this area.
Figure 3r shows how the exemplary patient interface 3000 may seal against a
patient, particularly the nose. In this detailed front perspective view, the nose,
mouth, and chin of a patient are shown in solid lines with the nasal cushion 3112
shown against the nose in dashed lines. It should be understood that the nasal
cushion 3112 may be concave in shape to cradle the nose of the patient. The
recessed portion 3116 is shown receiving the tip of the nose and the protruding
end 3114 can be seen sealing in the region of the ala and nasolabial sulcus. The
nasal undercushion support wall 3208 may support the nasal cushion 3112 in the
region of the protruding end 3114 to aid in maintaining the seal in this region, and
may function like an undercushion. The nasal plenum chamber 3202 is also
shown. The oral components of the patient interface 3000 are not shown in this
view for the sake of clarity.
Figure 3d also shows a recessed portion 3116 that may be included on the
nasal cushion 3112. This recessed portion 3116 may comprise an inwardly
shaped section that extends into the nasal gas chamber 3104 to receive the tip of
the nose of the patient when donned by the patient. The recessed portion 3116
may provide enhanced sealing around and under the tip of the nose of the patient
during therapy by allowing the shape of the nasal cushion 3112 to better conform
to the patient’s nose. The recessed portion 3116 will also be described in greater
detail below.
In Figures 3m and 3n it can be seen that the oral cushion 3110 surrounds the
perimeter of the mouth of the patient 1000. The oral gas chamber 3102 may be
formed by the oral cushion 3110 that surrounds the mouth of the patient 1000, the
oral plenum chamber 3200, and the faceplate 3204. In use, the air circuit 4170
may be connected to a PAP device 4000 (not shown in this view) to provide
breathable gas to the patient 1000 via the oral gas chamber 3102 of the patient
interface 3000 through the patient’s mouth.
This view also shows the nasal cushion 3112 surrounding a portion of the
nose, specifically the nose tip, of the patient 1000. The nasal gas chamber 3104 is
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thus formed by the nasal cushion 3112 and the face of the patient. In this example,
breathable gas from the air circuit 4170 may pass through the oral gas chamber
3102, then through the opening defined by the decoupling structure 3106 and into
the nasal gas chamber 3104. The line B-B shown in Figure 3m is intended to
indicate the transition between the nasal bone and the cartilaginous portion of the
nose extending from the bone structure of the nose of the patient 1000. The nasal
cushion 3112 depicted with this exemplary patient interface 3000 is designed to
seal about the periphery of the nose of the patient and below the line B-B with
respect to the nose. In other words, the nasal cushion 3112 may seal below the
bridge of the nose.
The patient interface 3000, according to an example of the present technology,
has a 4896 mm surface area footprint on the face which is less obtrusive than a
conventional full face mask (for example, the ResMed Quattro FX full face mask
has a 7007.89 mm surface area footprint on the face) by about 30%. For some
patients, it may also feel less claustrophobic. Also, the specific areas of reduced
obstruction are important because these areas are found to have significant
beneficial psychological impact on a bed partner when looking at the mask
because it looks less medical and “opens up” the face. From the patient’s
perspective, the exemplary patient interface 3000 is not in, or significantly
reduced from, their field of vision because the nasal cushion 3112 seals below the
bridge of the nose. This allows the patient to wear spectacles when reading a book
or watching television after donning the patient interface 3000 before they fall
asleep. By sealing below the nose bridge, irritation may be avoided in an area that
has thin skin, is pressure sensitive, and/or has high chance of skin breakdown due
to blood flow constriction. Another advantage may be that anthropometric
variations between patients above the nose bridge do not need to be considered
and focus for the mask fit range can be directed towards anthropometric variations
around the upper lip area. Also, unlike some other full face masks, the patient
interface 3000 may not require a forehead support which is required for providing
pressure point relief. This may also avoid the problem of the forehead support
being a source of a pressure point and/or skin break down.
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Anatomically, Figures 2h and 2i may be referenced for an indication as to the
location of the transitional region between the nasal bone and the cartilage. Thus,
the exemplary nasal cushion 3112 is intended to seal about the periphery of the
nose of the patient in contact with the softer tissues of the nose, e.g., fatty tissue
and cartilage. By forming a seal with the nose on these softer tissues it may be
possible to avoid irritation of the skin of the patient that would otherwise occur
were the seal to be formed around/over the harder nasal structures, i.e., bone. In
other words, patient discomfort may be minimised by sealing below the bridge of
the nose. Also, locating the seal of the nasal cushion 3112 around this region of
the nose may allow for a better seal to be formed because the nasal tissues and the
nasal cushion 3112 may conform to one another to form the seal. The nasal
cushion 3112 should conform to the nose predominantly.
A sealing feature described above that may be seen in Figure 3m is the
location of the protruding end 3114 against the face of the patient 1000.
Specifically, the protruding end 3114 may be an extended portion of the nasal
cushion 3112 that seals in the region between the nasolabial sulcus and ala. These
anatomical features may be seen in Figure 2c. Depending on the individual facial
structure of the patient, this region may represent a recessed portion 3116 such
that an extension from the nasal cushion 3112 may be necessary to form an
adequate seal about the nose of the patient. The protruding ends 3114, as depicted
in Figure 3m, may advantageously serve this function.
Another sealing feature of the depicted exemplary patient interface 3000 can
be seen in Figure 3p. The nasal cushion 3112 includes, as discussed above, a
recessed portion 3116 to receive the tip of the nose of the patient 1000 when
donned by the patient. Specifically, at the region where the recessed portion 3116
is located, the tip of the nose of the patient 1000 can be seen in dashed lines. This
view also shows how the nasal cushion 3112 may be shaped to seal against the
perimeter of the nose at its underside. In other words, the seal formed by the nasal
cushion 3112 against the nose may be characterized as against an inferior and
peripheral portion of the nose. Thus, it may be understood from this view that the
sealing surface of the nasal cushion 3112, as a whole, may be concave or form a
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pocket to receive the nose and it may further include the recessed portion 3116 to
receive the tip of the nose.
Figure 3q depicts the various points of contact that may be made by the patient
interface 3000 to seal against the face of a patient. The patient interface 3000 is
shown in a side cross-sectional view. Specifically, the nasal cushion 3112, nasal
plenum chamber 3202, oral cushion 3110, and the oral plenum chamber 3200 are
shown in cross-section. Reference may also be made to Figures 2b-f for
description of the relevant anatomical features. The nasal cushion 3112 is shown
sealing against the nose of the patient at the tip. A connection region 3106.2
between the oral cushion 3110 and nasal cushion 3112 is shown sealing against
the lip superior of the patient. It should be noted that connection region 3106.2
may be arranged to seal against the lip superior of the patient in a region that is
below the naris and above the mouth so as not block airflow into the airways. The
connection region 3106.2 may connect the posterior portions of the oral cushion
3110 and the nasal cushion 3112. The connection region 3106.2 may be structured
and positioned to maintain a seal against the lip superior of the patient and below
the naris, while allow for relative movement between structures of the oral gas
chamber 3102 and the nasal gas chamber 3104 (e.g., the oral cushion 3110 and the
nasal cushion 3112, respectively). The connection region 3106.2 may function
cooperatively with the decoupling structure 3106 to facilitate this relative
movement as well.
The nasal gas chamber 3104 may be seen defined, at least in part, by the nasal
cushion 3112, nasal plenum chamber 3202, and the patient’s nose to provide a
sealed path for breathable gas to enter the patient’s airways via the naris or nostril.
A gap 3106.1 can also be seen between the oral plenum chamber 3200 and the
nasal plenum chamber 3202. The gap 3106.1 will be discussed in greater detail
below, however, it should be understood that the gap 3106.1 may facilitate, in
part, maintenance of the seals against the nose and mouth in spite of independent
movement of the nasal cushion 3112 and the oral cushion 3110. It may be
advantageous to maintain the seal of the nasal cushion 3112 against the nose, the
connection region 3106.2 against the lip superior, and the oral cushion 3110
around the mouth while allowing these components to move independently of one
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another and also to accommodate anthropometric variance and a large range of
patients.
As shown in Figure 3q, the oral gas chamber 3102 may be seen defined, at
least in part, by the oral cushion 3110, oral plenum chamber 3200, and the mouth
of the patient to provide a sealed path for breathable gas to enter the patient’s
airways via the mouth. A seal and/or contact at the lip inferior of the patient may
be made by the oral cushion 3110. Although not shown in this view, it should be
understood that the oral undercushion 3120 may support the thinner oral cushion
3110 against the lip inferior when a positioning and stabilising 3300 structure
urges the patient interface 3000 against the face of the patient. In such a situation,
the oral undercushion 3120 would be urged into contact with a corresponding
portion of the oral cushion 3110.
In one form of the present technology, a seal-forming structure 3100 provides
a sealing-forming surface, and may additionally provide a cushioning function.
In an example, a seal-forming structure 3100 in accordance with the present
technology is constructed from a soft, flexible, resilient material such as silicone.
In another example of the present technology, the seal-forming structure 3100,
e.g., the oral cushion 3110, the nasal cushion 3112 and/or their respective
undercushions, may be formed from foam.
In an example, the plenum chamber 3200 has a perimeter 3210 that is shaped
to be complementary to the surface contour of the face of an average person in the
region where a seal will form in use. In use, a marginal edge of the plenum
chamber 3200 is positioned in close proximity to an adjacent surface of the face.
Actual contact with the face is provided by the seal-forming structure 3100. The
seal-forming structure 3100 may extend in use about the entire perimeter 3210 of
the plenum chamber 3200.
Figures 7a-h depict several views of the seal-forming structure 3100 and the
plenum chamber 3200. These views show the seal-forming structure 3100 and the
plenum chamber 3200 without the top plate 3206 and the faceplate 3204, as well
as without any of the associated positioning and stabilising structure 3300.
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Figure 7a shows a rear perspective view of the seal-forming structure 3100
and plenum chamber 3200. The exemplary seal-forming structure 3100 shown in
this view includes the oral cushion 3110 and the nasal cushion 3112. The
connection region 3106.2 can be seen in this view connecting the oral cushion
3110 and the nasal cushion 3112. Also, the location of the decoupling structure
3106 is shown between the oral cushion 3110 and the nasal cushion 3112.
The oral cushion 3110 and the oral plenum chamber 3200 can be seen partially
defining the oral gas chamber 3102. The opening 3101 to the oral gas chamber
3102 defined by the oral cushion 3110 can also be seen.
Also visible in Figure 7a is the nasal plenum chamber 3202 that partly defines
the nasal gas chamber 3104 along with the nasal cushion 3112. This exemplary
nasal cushion 3112 can also be seen, including the protruding ends 3114 at either
side. The recessed portion 3116 that receives the tip of the nose can also be seen.
A nasal undercushion support wall 3208 is shown in this view as well. The nasal
undercushion support wall 3208 is associated with a respective protruding end
3114 and may provide support for the protruding end 3114 as it seals against the
ala and nasolabial sulcus of the patient.
Figure 7b shows a side perspective view of the exemplary seal-forming
structure 3100 and plenum chamber 3200. Figure 7b depicts similar features to
those shown in Figure 7a. This view, however, also depicts that the connection
region 3106.2 may have a concave shape. In other examples, the connection
region 3106.2 may have a non-concave shape. By forming the connection region
3106.2 with a concave shape, the oral cushion 3110 may be able to better seal
around the mouth of the patient and the nasal cushion may be able to better seal
around and under the nose of the patient. Alternatively, a fully convex cushion
may also function similarly. In this view, a portion of the perimeter 3210 of the
oral plenum chamber 3200 can also be seen. Also, the location of the decoupling
structure 3106 is indicated.
Figure 7b shows the nasal undercushion support wall 3208 associated with the
respective protruding end 3114 of the nasal cushion 3112. The nasal undercushion
support wall 3208 extends out to beyond the perimeter of the nasal plenum
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chamber 3202. Such a configuration may allow the nasal undercushion support
wall 3208 to provide sufficient support for the protruding end 3114 to seal against
the patient’s face. The bottom half of the nasal undercushion support wall 3208
may act as a hinge or pivot point for the decoupling structure 3106. The top half
of the nasal undercushion support wall 3208 may help locate the top plate 3206.
Figure 7c shows a front perspective view of the exemplary seal-forming
structure 3100 and plenum chamber 3200. This view depicts particularly well the
anterior portion of the nasal plenum chamber 3202 as well as the nasal
undercushion support wall 3208 that supports the protruding ends 3114 of the
nasal cushion 3112.
Figure 7d shows a rear view of the exemplary seal-forming structure 3100 and
plenum chamber 3200. This view shows features similar to those shown in Figure
7a. On either side of the nasal cushion 3112 a portion of each nasal undercushion
support wall 3208 can be seen. Also, this view shows how the connection region
3106.2 may connect the oral cushion 3110 to the nasal cushion 3112. Also, the
location of the decoupling structure 3106 is indicated.
Figure 7e shows a front view of the exemplary seal-forming structure 3100
and plenum chamber 3200. This view shows especially well the oral cushion
3110 disposed about the perimeter 3210 of the oral plenum chamber 3200.
Further, the oral gas chamber 3102 can be seen defined by the oral cushion 3110
and the oral plenum chamber 3200. Also, this view shows the anterior portion of
the decoupling structure 3106 that connects the nasal cushion 3112 to the oral
cushion 3110. Nasal undercushion support walls 3208 can be seen on either side
of the nasal cushion 3112. From this view, the oral undercushion 3120 is also
visible. This view also shows that the oral undercushion 3120 may terminate at a
tapered region 3122 near either side of the nasal cushion 3112. Thus, there may
be no undercushion at the connection region 3106.2 (not shown in this view)
between the oral cushion 3110 and the nasal cushion 3112. Advantageously, this
may allow greater flexibility in the connection region 3106.2 such that the seal
against the lip superior that is shown in Figure 3q may be easily maintained
despite movement of the oral and nasal cushions 3110, 3112.
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Figures 12a-d show further exemplary arrangements of the oral undercushion
3120 in accordance with the present technology. These Figures show the oral
cushion 3110 and the opening 3101 to the oral gas chamber 3102 with various
configurations of the oral undercushion 3120 shown in stippling. For the sake of
simplicity additional features associated with the seal-forming structure 3100 have
been omitted from these drawings.
Figure 12a depicts an example of the oral cushion 3110 where the oral
undercushion 3120 surrounds the entire perimeter of the oral cushion 3110.
Figure 12b depicts an example of the oral cushion 3110 where there are two
portions of oral undercushion 3120, one on either side of the oral cushion. Figure
12c depicts an example where the oral undercushion 3120 surrounds the entire
perimeter of the oral cushion 3110 with the exception of a portion near an upper
region of the oral cushion 3110. Figure 12d depicts a similar example to Figure
12c, however the portion of the oral cushion 3110 where there is no oral
undercushion 3120 is at a lower region of the oral cushion 3110.
Figure 7f shows a top view of the exemplary seal-forming structure 3100 and
plenum chamber 3200. This view shows nasal cushion 3112 with its protruding
ends 3114 and recessed portion 3116, as well as the nasal gas chamber 3104
defined, in part, by the nasal cushion 3112. This view also partly shows the
pneumatic connection between the oral gas chamber 3102 and the nasal gas
chamber 3104 that is defined by the decoupling structure 3106.
Figure 7g shows a bottom view of the exemplary seal-forming structure 3100
and plenum chamber 3200. This view shows oral cushion 3110 attached to the
oral plenum chamber 3200. Also, the protruding ends 3114 of the nasal cushion
3112 can be seen.
Figure 8a shows another top view of the exemplary seal-forming structure
3100 and plenum chamber 3200. This view also shows a number of cross-section
lines to indicate the cross-sections depicted in subsequent drawings, Figures 8b-8l.
This view is similar to Figure 7f and similar components are therefore depicted.
However, to avoid confusion, reference numerals and lead lines have been
excluded.
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Figures 8b-d show cross-sectional views of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8b, 8c, 8d,-8b, 8c, 8d.
The nasal cushion 3112 can be seen connected to the oral cushion 3110 by the
connection region 3106.2. The oral gas chamber 3102 can be seen defined, in
part, by the oral plenum chamber 3200 and the oral cushion 3110. The nasal gas
chamber 3104 can be seen defined, in part, by the nasal plenum chamber 3202 and
the nasal cushion 3112. The protruding end 3114 and the recessed portion 3116
of the nasal cushion 3112 are also shown. This view also shows how the
connection region 3106.2 in one example of the technology may not include an
undercushion, while the oral cushion 3110 may include an oral undercushion 3120
and a nasal undercushion support wall 3208 (not shown in these views) to support
the protruding end 3114. The gap 3106.1 formed by the hinge-like arrangement
of the oral plenum chamber 3200, nasal plenum chamber 3202, and the
decoupling structure 3106 can also be seen. In another example of the present
technology, the oral undercushion 3120 may include two discontinuous side
portions that are present on either side of the oral cushion 3110, but there would
be no oral undercushion portion at the connection region 3106.2 or at the lower
central portion of the oral cushion 3110. Alternatively, as shown in Figure 7e, the
oral undercushion 3120 may terminate near the nasal cushion 3112 at tapered
regions 3122 on either side thereof.
Figures 8b and 8c also show angles α and β, respectively, being swept out with
respect to the connection region 3106.2. Figure 8b shows that α is the angle from
the nasal cushion 3112 to a lower portion of the oral cushion 3110. Angle α may
be in the range of about 80° to about 180° and in one example of the technology α
may be about 142°. Figure 8c shows that β is the angle from the nasal cushion
3112 to an upper portion of the oral cushion 3110. Angle β may be in the range of
about 80° to about 170° and in one example of the technology β may be about
120°. The cushions 3110, 3112 and plenum chambers 3200, 3202 may be formed
as one-piece.
Figure 8e shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8e-8e. Again in this
view, it can be seen that the oral cushion 3110 includes an oral undercushion
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3120. The connection region 3106.2 is shown without an undercushion in
accordance with this example of the technology. The gap 3106.1 formed by the
hinge-like arrangement of the oral plenum chamber 3200, nasal plenum chamber
3202, and the decoupling structure 3106 can also be seen. Also, the side portion
3106.3 of the decoupling structure 3106 can be seen.
Figure 8f shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8f-8f. This view shows
features similar to the example depicted in Figure 8e. However, this view also
shows a portion of the nasal undercushion support wall 3208 positioned to support
the protruding end 3114 of the nasal cushion 3112. Here, the side portion 3106.3
of the decoupling structure 3106 can be seen proximal to the nasal undercushion
support wall 3208.
Figure 8g shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8g-8g. Figure 8g again
shows similar features to Figures 8e and 8f. This view, however, also more
clearly shows the nasal undercushion support wall 3208 positioned under the
protruding end 3114 of the nasal cushion 3112.
Figure 8h shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8h-8h. This view also
shows features similar to those depicted in Figure 8g. In this view each
protruding end 3114 can be seen with a respective nasal undercushion support
wall 3208 positioned thereunder.
Figure 8i shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8i-8i. This view also
shows features similar to those depicted in Figure 8h.
Figure 8j shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8j-8j. This view also
shows features similar to those depicted in Figure 8f.
Figure 8k shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8k-8k. This view also
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shows features similar to those depicted in Figure 8d. Figure 8k also shows
particularly well that in this depicted example of the technology that the
connection region 3106 may have a concave shape to fit against the upper lip of
the patient.
Figure 8l shows another cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 8l-8l. This view also
shows features similar to those depicted in Figure 8d.
Figure 9a shows another front view of the exemplary seal-forming structure
3100 and plenum chamber 3200. This view also shows a number of cross-section
lines to indicate the cross-sections depicted in subsequent drawings, Figures 9b-9i.
This view is similar to Figure 7e and similar components are therefore depicted.
However, to avoid confusion, reference numerals and lead lines have been
excluded.
Figure 9b shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9b-9b. Figure 9b also
depicts similar features to those shown in Figures 8b-d.
Figure 9c shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9c-9c. This view
shows particularly well a cross-section of the nasal undercushion support wall
3208 that may be included to support the protruding end 3114 of the nasal cushion
3112.
Figure 9d shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9d-9d. The cross-
sectional view shown here is taken at an angle such that no portion of the nasal
cushion 3112 is shown. This view also depicts particularly well the oral
undercushion 3120 of the oral cushion 3110. In the example shown in this view,
the tapered end 3122 of the oral undercushion 3120 can be seen as well.
Figure 9e shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9e-9e. Figure 9e is
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taken along a similar cross-section to Figure 9d and, therefore, depicts similar
features.
Figure 9f shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9f-9f. This view
depicts particularly well the oral cushion 3110 and the oral undercushion 3120 and
how these two cushions 3110, 3120 may share a similar profile to seal against the
face of the patient.
Figure 9g shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9g-9g. Figure 9g is
taken along a similar cross-section to Figure 9f and, therefore, depicts similar
features.
Figure 9h shows a cross-sectional view of the exemplary seal-forming
structure 3100 and plenum chamber 3200 taken along line 9h-9h. Figure 9h
depicts features similar to those shown in Figure 9c, including the cross-section of
the nasal undercushion support wall 3208.
Figure 9i shows a cross-sectional view of the exemplary seal-forming structure
3100 and plenum chamber 3200 taken along line 9i-9i. Figure 9i depicts features
similar to those shown in Figure 9b.
Figures 16a to 16o show several views of another seal-forming structure 3100
and plenum chamber 3200, according to an example of the present technology.
The seal-forming structure 3100 and the plenum chamber 3200 according to
this example includes pockets 3208.1 on either side of the nasal cushion 3112 near
the side portions 3106.3 and under the protruding ends 3114. Figures 16a, 16d,
16i, 16k, and 16m-o.The pockets 3208.1 may be defined, at least in part, by the
decoupling structure 3106, the undercushion support walls 3208, the side portions
3106.3, the nasal plenum chamber 3202, and the side supports 3207. The pockets
3208.1 may be open in an anterior direction of the seal-forming structure 3100 and
the plenum chamber 3200. The pockets 3208.1 may also provide resistance to
deformation of the nasal cushion 3112 in every direction. The pockets 3208.1 may
provide compression resistance for the nasal cushion 3112. This compression
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resistance may help to reduce leak at the corners of nose area where the pockets
3208.1 may support the nasal cushion 3112 and/or the protruding ends 3114 when
the nasal cushion 3112 is in contact the patient’s nose. According to an example
of the present technology, it may be advantageous for the nasal cushion 3112 to
deform at regions other than at the protruding ends 3114 that may be supported by
the pockets 3208.1. The pockets 3208.1 and the decoupling structure 3106 may
help to resist deformation of the nasal cushion 3112 or may help to allow
deformation to occur in targeted areas.
The side supports 3207 shown in the examples depicted by Figures 16a to 16o
may be integrally formed with the seal-forming structure 3100 and the plenum
chamber 3200. Thus, in the example where the seal-forming structure 3100 and
the plenum chamber 3200 are formed from silicone, the side supports 3207 would
likewise be formed of silicone. The side supports 3207 may serve a stiffening
purpose to improve the seal between the seal-forming structure and the patient's
face. For example, the side supports 3207 may help to support the nasal cushion
3112, at its sides, against the patient’s alae and/or the side supports may help to
support the protruding ends 3114 against the region of the patient’s face where the
alae join near the nasolabial sulci. The side supports 3207 may also control
deformation of the nasal cushion 3112, so that certain areas of the nasal cushion
deform before others. The side supports 3207 may also control the extent of
deformation in certain areas of the nasal cushion 3112. The side supports 3207
may facilitate controlled deformation of the nasal cushion 3112 because the side
supports 3207 may allow bending when compressed due to contact with the
patient’s face. The side supports 3207 may also strengthen the sides of the nasal
cushion 3112 to decouple a compression force of the face against the nasal
cushion 3112 to prevent the nasal cushion 3112 from collapsing into the
decoupling structure 3106.
The side supports 3207 may each include a notch 3209. The notches 3209 of
the side supports 3207 may provide a pivot point between the nasal cushion 3112
and the oral cushion 3110. The pockets 3208.1 may also serve to control the
location of the pivot point.
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The side supports 3207 may also provide attachment points for the top plate
3206. The top plate 3206 may be integrally and/or chemically bonded with the
seal-forming structure 3100 and the plenum chamber 3200. In an example, the
silicone of the seal-forming structure 3100 and the plenum chamber 3200 may be
formed and/or molded around the top plate 3206. No mechanical interlock may be
necessary, according to an example of the present technology, between the top
plate 3206 and the seal-forming structure 3100 and the plenum chamber 3200.
Alternatively, there may be no chemical and/or integral bond, such that a
mechanical interlock between the top plate 3206 and the seal-forming structure
3100 and the plenum chamber 3200 would be necessary. The top plate 3206 may
also define, at least in part, the pivot point between the nasal cushion 3112 and the
oral cushion 3110.
It may also be desirable to strengthen or stiffen the nasal cushion 3112 to
provide localized support so as to reduce or control deformation in particular
regions of the nasal cushion relative other regions. Examples of stiffening may
include increasing the relative thickness of the nasal cushion 3112 that are desired
to be strengthened. Alternatively, reinforcement ribs or other reinforcement
structures may be formed on the nasal cushion 3112 to provide the desired level
and position of localized support.
Figures 16i, 16k-m, and 16o show that the nasal cushion 3112 may also
include thickened nasal cushion sections 3124 at the sides. The thickened nasal
cushion sections 3124 may be thickened portions of the nasal cushion 3112 that
extend in an internal direction of the nasal cushion and generally into the nasal gas
chamber 3104. These thickened nasal cushion sections 3124 may provide
additional support for the nasal cushion 3112 when it is in sealing engagement
with the nose and the face of the patient. The thickened nasal cushion sections
3124 may be located on opposite sides of the nasal cushion 3112 in a position
such that they are proximal to the patient’s nasolabial sulcus when the seal-
forming structure engages the patient’s face. The thickened nasal cushion sections
3124 may also help to seal around the alae of the patient’s nose by preventing
collapse of the nasal cushion 3112 due to sealing forces. The thickened nasal
cushion sections 3124 may be formed integrally with the nasal cushion 3112.
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Also, the thickened nasal cushion sections 3124 may be located on the nasal
cushion 3112 such that when the seal-forming structure engages the patient’s nose
and face the thickened nasal cushion sections 3124 may be, at least partially,
urged against respective undercushion support walls 3208. The thickened nasal
cushion sections 3124 may have a constant thickness throughout that is greater
than the thickness of the remainder of the nasal cushion 3112. Alternatively, the
thickened nasal cushion sections 3124 may have a thickness that is variable across
its area.
In alternative examples of the present technology, the thickened nasal cushion
sections 3124 not be provided and other structures may be provided to increase
stiffness in these regions. For examples, ribs or other reinforcing structures may
be provided to the nasal cushion 3112 in the regions where the thickened nasal
cushion sections 3124 are shown to accomplish the function of stiffening the nasal
cushion 3112 in these areas.
Figure 16k also shows an example of the present technology where the oral
plenum chamber 3200 includes thickened oral plenum chamber sections 3212.
These thickened oral plenum chamber sections 3212 may provide additional
support for the oral plenum chamber 3200 to help resist collapsing of the oral
plenum chamber.
Also, Figures 16j and 16k show cross-sectional views through the seal-
forming structure 3100 and the plenum chamber 3200. These views show that the
connection region 3106.2 may be thicker in the examples depicted in these views
relative to the connection region shown in Figures 8a to 8l and 9a to 9l. The
thickness of the connection region 3106.2 shown in Figures 16j and 16k may also
be consistent along its width and height. Tube torque from the air circuit 4170
may cause the oral cushion 3110 to pull on the nasal cushion 3112 via decoupling
structure 3106 and extend the connection region 3106.2 in a generally vertical
direction. Extension of the connection region 3106.2 may cause disruption of the
seal of the nasal cushion 3112. By thickening the connection 3106.2 and making
the thickness consistent throughout, this extension of the connection region 3106.2
may be resisted and disruption of the seal at the nasal cushion 3112 may be
prevented and/or reduced.
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Figures 16b, 16c, 16e, 16f, 16j, and 16o show views of the nasal cushion 3112
that include a nasal sling 3119 that divides the opening 3103 to the nasal gas
chamber 3104 into nare ports 3105. The nasal sling 3119 may seal along the
columella of the patient’s nose (see Fig. 2f) so that each nare may be sealed
individually. Alternatively, the nasal sling 3119 may provide columella relief by
contacting the patient’s columella without forming a seal. Also, the nasal sling
3119 may prevent the tip of the patient’s nose from extending through the nasal
cushion 3112 and into the nasal gas chamber 3104. The nasal sling 3119 may also
provide support for the nasal cushion 3112 to prevent deformation of the nasal
cushion 3112 in the direction of the longitudinal axis of the nasal sling 3119.
The seal-forming structure 3100 may include a compliant region. The
compliant region is not shown in these examples. Description and depiction of
further examples of the compliant region is provided in PCT Application No.
. The compliant region may be relatively soft, flexible,
and/or compliant relative to other portions of the seal-forming structure 3100. The
compliant region’s relative flexibility may be advantageous in that it may help to
relieve discomfort to the patient in the regions of the tip of the nose and the
septum. The compliant region may be relatively thin as compared to other
portions of the seal-forming structure 3100 and, as such, may function like a
mechanical spring to maintain an effective seal at the tip of the nose by wrapping
against and/or contacting the tip of the nose. The compliant region may be located
on the seal-forming structure 3100 at the upper apex where the seal-forming
structure 3100 transitions to the plenum chambers 3200, 3202. The compliant
region may be located on the seal-forming structure 3100 above the recessed
portion 3116. The compliant region may also blend into the recessed portion 3116.
The compliant region may also be located substantially centrally on the seal-
forming structure 3100 in horizontal direction. The seal-forming structure 3100
may have a thickness at the compliant region that is about 0.35mm according to
an example of the present technology and may be one of the thinnest regions of
the seal-forming structure 3100.
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.3.1.1 Exemplary Nasal Cushions
Figures 4a-c, 5a-c, and 6a-c depict various examples of the nasal cushion 3112
in accordance with the present technology.
Figure 4a shows a top view of an exemplary nasal cushion 3112. The
protruding ends 3114 can be seen at either side of the nasal cushion 3112. The
nasal gas chamber 3104 and the opening 3103 thereto can also be seen. The
opening 3103 to the nasal gas chamber 3104 may generally have a rectangular,
lozenge or trapezoidal shape that may be curved at its respective minor and major
sides 3104.2. When placed against the nose of the patient the curved minor sides
3104.2 of the nasal opening 3103 will be proximal to the respective alae of the
nose. Also in this example, one of a pair of major sides, specifically a distal side
3104.1 of the nasal opening 3103, will be distal to the upper lip of the patient and
near the tip of the nose, while another of the pair of major sides, a proximal side
3104.3, will be proximal to the upper lip of the patient. The recessed portion 3116
that is shaped to receive the tip of the nose is also shown.
Figure 4b shows a bottom view of the exemplary nasal cushion 3112 sectioned
along line 4c-4c of Figure 4a. This view also shows the nasal gas chamber 3104
and its associated opening 3103.
Figure 4c shows a side perspective view of the exemplary nasal cushion 3112
sectioned along line 4c-4c of Figure 4a. This view again shows the nasal gas
chamber 3104 and the opening 3103 thereto. The recessed portion 3116 is also
indicated. Of particular note in this view is the profile of the nasal cushion 3112
along the section line 4c-4c. The nasal cushion 3112 can be seen to curve slightly
upward as it approaches the distal side 3104.1 of the opening 3103 to the nasal gas
chamber 3104 from the recessed portion 3116. Also, it can be seen in this view,
as well as Figure 4b, that the anterior upper portion of the nasal cushion 3112 that
is near the recessed portion 3116 includes a slight dip or concave region at its
center where line 4c-4c passes, such that the nasal cushion 3112 is higher at its
sides than in the middle. This view also shows the outline of a nose in dashed
lines to indicate how the nose of the patient may be located relative to the nasal
cushion 3112. The peak 3118 in the cushion 3112 may be tasked with sealing the
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anterior of the nares. The peak 3118 sits further toward the posterior but
transitions more gradually for creating the balloon effect. The distal side 3104.1
may flick up from the cushion 3112 and may improve the seal at the nose tip
because it makes contact with the nose sooner and causes both a compressive and
pneumatic seal by cradling the nose. The recessed portion 3116 that is shaped to
receive the tip of the nose is also shown.
Figure 5a shows a top view of an exemplary nasal cushion 3112. The
protruding ends 3114 can be seen at either side of the nasal cushion 3112. The
nasal gas chamber 3104 and the opening 3103 thereto can also be seen. The shape
of the opening 3103 to the nasal gas chamber 3104 may also be similar to that
which is shown in Figure 4a. The recessed portion 3116 that is shaped to receive
the tip of the nose is also shown.
Figure 5b shows a bottom view of the exemplary nasal cushion 3112 sectioned
along line 5c-5c of Figure 5a. This view also shows the nasal gas chamber 3104
and its associated nasal opening 3103.
Figure 5c shows a side perspective view of the exemplary nasal cushion 3112
sectioned along line 5c-5c of Figure 5a. This view again shows the nasal gas
chamber 3104 and the opening 3103 thereto. The recessed portion 3116 is also
indicated. Of particular note in this view is the profile of the nasal cushion 3112
along the section line 5c-5c. As contrasted with the profile of the nasal cushion
3112 in Figure 4c, it can be seen in this view that the nasal cushion is sloped
downwardly as it approaches the distal side 3104.1 opening 3103 to the nasal gas
chamber 3104 from the recessed portion 3116. It can also be seen that this
example of the nasal cushion 3112 lacks the dip in the anterior region near the
recessed portion 3116 that can be seen in the example shown in Figures 4b and 4c.
In other words, this example shows that the nasal cushion 3112 may be more
circular/rounder, relative to the example shown in Figure 4c in the region from the
recessed portion 3116 to the distal side 3104.1 of the opening 3103 to the nasal
gas chamber 3104. This view also shows the outline of a nose in dashed lines to
indicate how the nose of the patient may be located relative to the nasal cushion
3112.
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Figure 6a shows a top view of an exemplary nasal cushion 3112. The
protruding ends 3114 can be seen at either side of the nasal cushion 3112. The
nasal gas chamber 3104 and the opening 3103 thereto can also be seen. The shape
of the opening 3103 to the nasal gas chamber 3104 may also be similar to that
which is shown in Figure 4a. In Figures 4a to 4c, the shape is more balloon like
and rounder than the example shown in Figures 6a to 6c.
Figure 6b shows a bottom view of the exemplary nasal cushion 3112 sectioned
along line 6c-6c of Figure 6a. This view also shows the nasal gas chamber 3104
and its associated opening 3103. Additionally, it can be seen in this view that the
nasal cushion 3112 has straight sidewalls 3121, in contrast with the sidewalls that
curve smoothly from the upper surface of the nasal cushions 3112 shown in
Figures 4a-c and 5a-c. The straight sidewalls 3121 may have a defined top edge
and assumed to increase stability and strength of the nasal cushions 3112.
Figure 6c shows a side perspective view of the exemplary nasal cushion 3112
sectioned along line 6c-6c of Figure 6a. This view again shows the nasal gas
chamber 3104 and the opening 3103 thereto. The recessed portion 3116 is also
indicated. Of particular note in this view is the profile of the nasal cushion 3112
along the section line 6c-6c. It can be seen, as in Figure 5c that this example of
the nasal cushion 3112 lacks the dip in the anterior region near the recessed
portion that can be seen in the example shown in Figures 4b and 4c. The straight
sidewalls 3121 of this exemplary nasal cushion 3112 can also be seen in this view.
This view also shows the outline of a nose in dashed lines to indicate how the nose
of the patient may be located relative to the nasal cushion 3112.
Furthermore, it should also be understood that the exemplary nasal cushions
3112 depicted in Figures 4a-4c, 5a-5c, and 6a-6c are shown in substantially
undeformed states. Figures 4c, 5c, and 6c may indicate a small amount of
deformation due to conformation with the shape of the nose shown in dashed
lines. Thus, the nasal cushions 3112 may have the concave shape as shown, when
not deformed.
It should also be understood that the nasal cushion 3112 may have a cross-
section of variable thickness. Thus, the region of the nasal cushion 3112
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proximate to the opening 3103 to the nasal gas chamber 3104 may be thinner than
the region where the nasal cushion 3112 attaches to the nasal plenum chamber
3202. Advantageously, this may afford more comfort for the patient by providing
a thinner and, thus, more compliant region of cushion material at the area where a
large amount of contact is made with the patient’s nose.
Figures 10a-d show further additional nasal cushions 3112 according to further
examples of the present technology. These views depict further variations of the
possible shape of the opening 3103 to the nasal gas chamber 3104.
Figures 11a-c depict various cross-sectional profiles of the nasal cushion 3112
according to examples of the present technology. The region 3112.1 may be
proximal to the opening 3103 to the nasal gas chamber 3104 and the region
3112.3 may be proximal to the connection to the nasal plenum chamber 3202. The
region 3112.2 may be the most elevated region around the upper periphery of the
nasal cushion 3112.
Figure 11a shows a cross-section of a nasal cushion 3112 taken across line
11a-11a of Figure 4a. This cross-section shows a smoothly variable thickness for
the nasal cushion 3112 from region 3112.1 to region 3112.3. Also, the thickness x
may be less than the thickness z.
Figure 11b shows a cross-section of a nasal cushion 3112 taken across line
11b, c-11b, c of Figure 13. This cross-section shows that the region 3112.2 may
abruptly become thicker than the regions 3112.1 and 3112.3. Also, the thickness x
may be less than the thickness z and the thickness y may be greater than x and z.
Figure 11c shows a cross-section of a nasal cushion 3112 taken across line
11b, c-11b, c of Figure 13. Region 3112.2 may be stiffened relative to the other
regions 3112.1 and 3112.3. This cross-section shows that the region 3112.2 may
abruptly become thicker than the regions 3112.1 and 3112.3. Also, the thickness z
may be less than the thickness x and the thickness y may be greater than x and z.
Figure 13 shows a top view of another exemplary nasal cushion 3112
according to the present technology. The opening 3103 to the nasal gas chamber
3104 and the protruding end 3114 are indicated to allow for understanding of the
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orientation of the nasal cushion 3112. Regions of various thicknesses are hatched
differently to better indicate where the stiffness and/or thickness of the nasal
cushion 3112 may vary. Region 3113 may be the thinnest to allow for ready
conformation to the tip of the nose. Region 3113, according to an example of the
present technology, may have a thickness of about 0.35mm. Region 3115 may be
thicker to provide more support for the nasal cushion 3112. Region 3115,
according to an example of the present technology, may have a thickness of about
0.5mm. Region 3117 may be thicker than the other regions to provide maximum
support, resistance to deformation, and ensure an effective seal at the ala of the
patient. Region 3117, according to an example of the present technology, may
have a thickness of about 1mm.
.3.2 Decoupling Structure
The decoupling structure 3106 shown in Figure 3c may provide a connection
between the nasal cushion 3112 and the oral cushion 3110. The decoupling
structure 3106 may also define a pneumatic connection between the oral gas
chamber 3102 and the nasal gas chamber 3104. Thus, during therapy when the
patient is provided with breathable gas at positive pressure the gas may enter the
patient interface via the port 3600 and flow directly into the oral gas chamber
3102 defined at least in part by the plenum chamber 3200, the faceplate 3204, the
oral cushion 3110, and the decoupling structure 3106. The gas may then flow to
the mouth of the patient. The breathable gas may also be provided to the nose of
the patient via the nasal gas chamber opening 3103 and through the nasal gas
chamber 3104 that is defined at least partly by the nasal cushion 3112, the nasal
plenum chamber 3202 and the decoupling structure 3106. To reach the nasal gas
chamber 3104, the gas must flow from the oral gas chamber 3102 and through the
pneumatic pathway defined by the decoupling structure 3106 and then into the
nasal gas chamber 3104. It should be understood, however, that a port may be
provided to the top plate 3206 or the nasal cushion 3112 to receive breathable gas.
In that case, the flow pattern through the patient interface 3000 may simply be
reversed.
As to the decoupling structure 3106 depicted in Figure 3c, this feature may
also allow for the nasal cushion 3112 and the oral cushion 3110 to move
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independently of one another when donned by the patient. When worn by the
patient with a positioning and stabilising structure 3300 (e.g., headgear), as will be
described in greater detail below, the nasal cushion 3112 may be urged against the
face of the patient, particularly the nose, by forces transferred along the rigidiser
arms 3302 to the nasal cushion 3112 via the top plate 3206. Also, the oral cushion
3110 may be urged against the face of the patient, particularly the mouth, by
forces transferred to the faceplate 3204 from headgear straps 3306. Because
different sets of headgear straps 3306 may urge different portions of the patient
interface 3000 (e.g., the nasal cushion 3112 and the oral cushion 3110) against
different portions of the patient’s face (e.g., the nose and the mouth, respectively)
it may be advantageous to allow the nasal cushion 3112 and the oral cushion 3110
to move independently of one another because of the decoupling structure 3106.
The decoupling structure 3106 may be used to connect the oral cushion 3110
and the nasal cushion 3112 to facilitate this independent movement. Allowing
independent movement of the cushions 3110, 3112 may allow for better sealing
against a wider variety of patient facial shapes and it may also aid in maintaining a
seal against the patient’s face in spite of movement in different regions of the face,
movement of the air circuit 4170 or external forces. Moreover, due to the fact that
the patient interface 3000 may seal against two separate regions of the face, the
nose and the mouth, two separate openings must be provided to supply the
breathable gas to the patient. By allowing the sealing structures (e.g., the oral
cushion 3110 and the nasal cushion 3112) to move independently a seal may be
maintained around the nose independently of the seal around the mouth to prevent
undesired leakage and, therefore, pressure loss through one or both openings.
The decoupling structure 3106 may also form part of a wall of the oral plenum
chamber 3200 and the nasal plenum chamber 3202 in an anterior direction. The
decoupling structure 3106 may also be resiliently flexible to allow for relative
movement and/or length extension between the structures that define the oral gas
chamber 3102 and the nasal gas chamber 3104. Thus, the oral plenum chamber
3200 and the nasal plenum chamber 3202 may be extended away from one
another or compressed together, while a pneumatic connection is maintained
between the oral gas chamber 3102 and the nasal gas chamber 3104. Moreover,
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the decoupling structure 3106 may also allow these structures (e.g., the oral
plenum chamber 3200 and the nasal plenum chamber 3202) to be tilted relative to
one another, while a pneumatic connection is maintained between the oral gas
chamber 3102 and the nasal gas chamber 3104 and a seal is maintained with the
patient’s face.
The decoupling structure 3106 may also comprise an upper surface 3106.4, a
connecting surface 3106.5, and a lower surface 3106.6. The connecting surface
3106.5 may be relatively stiffer than the upper surface 3106.4 and the lower
surface 3106.6. The lower surface 3106.6 may be understood to be a separate
surface from the oral cushion 3110. The upper surface 3106.4 may be understood
to be a separate surface from the nasal cushion 3112. The greater stiffness of the
connecting surface 3106.5 may be produced by reinforcement ribs or other
reinforcement structures or by making the connecting surface 3106.5 thicker than
the upper surface 3106.4 and the lower surface 3106.6. According to one example,
the upper surface 3106.4 and the lower surface 3106.6 may each have a thickness
of 0.5 mm and the connecting surface 3106.5 may have a thickness of 1.2 mm.
According to further examples of the present technology, the specific numerical
value of the thicknesses may be varied while maintaining the same ratio of
thickness as between the upper surface 3106.4, the connecting surface 3106.5, and
the lower surface 3106.6.
According to a further example of the present technology, the relative
thicknesses of the upper surface 3106.4, the connecting surface 3106.5, and the
lower surface 3106.6 may be chosen to allow for a desired amount of flexibility of
the decoupling structure 3106. In examples, the decoupling structure 3106 may be
able to flex such that the upper surface 3106.4 and the lower surface 3106.6 are
positioned at up to about 45° to about 50° relative to each other.
Also, according to further examples of the present technology, the angle
between the upper surface 3106.4 and the connecting surface 3106.5 may be
between about 80° and about 140°. According to a still further example of the
present technology, the angle between the upper surface 3106.4 and the
connecting surface 3106.5 may be about 90°. It should be understood that the
angle between the upper surface 3106.4 and the connecting surface 3106.5 may
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vary across the length of the decoupling structure 3106 due to its curved shape. If
the angle between the upper surface 3106.4 and the connecting surface 3106.5 is
greater than 90° in a given example, then it may be easier to stretch or separate the
nasal structures and the oral structures from one another. If the angle between the
upper surface 3106.4 and the connecting surface 3106.5 is less than 90° in a given
example, then it may be easier to compress the nasal structures and the oral
structures toward one another.
According to further examples of the present technology, the angle between
the lower surface 3106.6 and the connecting surface 3106.5 may be between about
80° and about 140°. According to a still further example of the present
technology, the angle between the lower surface 3106.6 and the connecting
surface 3106.5 may be about 90°. If the angle between the lower surface 3106.6
and the connecting surface 3106.5 is greater than 90° in a given example, then it
may be easier to stretch or separate the nasal structures and the oral structures
from one another. If the angle between the lower surface 3106.6 and the
connecting surface 3106.5 is less than 90° in a given example, then it may be
easier to compress the nasal structures and the oral structures toward one another.
Another advantageous feature of this exemplary patient interface 3000 may
also be seen in Figure 3m. This feature is the ability of the nasal cushion 3112
and the oral cushion 3110 to each independently form a seal about respective
anatomical features of the patient. As already discussed, the nasal cushion 3112 is
intended to seal about the nose of the patient and the oral cushion 3110 is intended
to seal about the mouth of the patient. The decoupling structure 3106, shown in
Figure 3c for example, may allow the nasal cushion 3112 and the oral cushion
3110 to move independently and seal independently of one another. By attaching
the pair of upper straps 3310 to the nasal cushion 3112 via the top plate 3206, the
nasal cushion 3112 may be urged against the nose of the patient 1000 when the
patient interface 3000 is donned. Also, the pair of lower straps 3312, by their
connection to the faceplate 3204, may urge the oral cushion 3110 around the
mouth of the patient.
It should be understood that each respective pair of straps, upper 3310 and
lower 3312, represent a separate pair of vectors along which tension forces that
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are directed to retain respective portions of the patient interface 3000 against the
face of the patient. In other words, the upper straps 3310 serve to retain the nasal
cushion 3112 against the nose and the lower straps 3312 serve to retain the oral
cushion 3110 against the mouth. The decoupling structure 3106 allows for a
pneumatic connection between the two cushions 3110, 3112 although these
cushions may be moved independently of one another. Thus, a variety of different
patient head and face shapes may be accommodated by the patient interface 3000.
Also, it should be understood that the ability to form separate seals independently
may allow the patient interface 3000 to maintain these seals in spite of movement
by the patient.
Figure 7h shows a side view of the exemplary seal-forming structure 3100 and
plenum chamber 3200. This view shows the nasal cushion 3112 attached to the
nasal plenum chamber 3202, as well as the protruding end 3114 that is supported
by the nasal undercushion support wall 3208 that is proximal to the side portion
3106.3 of the decoupling structure 3106. The oral plenum chamber 3200 is shown
with the oral cushion 3110 disposed about its perimeter 3210. Also in this view
the decoupling structure 3106 can be seen connecting the oral cushion 3110 to the
nasal cushion 3112. This view shows particularly well the hinge-like arrangement
the nasal plenum chamber 3202 and the nasal cushion 3112 may take with respect
to the oral plenum chamber 3200 and the oral cushion 3110 by virtue of the
connection via the decoupling structure 3106 and the connection region 3106.2
(not shown in this view). It should be understood that this hinge-like arrangement
may allow the nasal plenum chamber 3202 and nasal cushion 3112 to tilt
depending on the forces applied by the face of the patient when the complete
patient interface 3000 is placed on the patient. Thus, the oral plenum chamber
3200 and the nasal plenum chamber 3202 may approach one another in the gap
3106.1
By providing a gap 3106.1 between respective anterior portions of the oral
plenum chamber 3200 and the nasal plenum chamber 3202, as shown in this view,
it may be possible to allow the components of the oral plenum chamber 3200 and
the nasal plenum chamber 3202 to move independently of one another with some
amount of freedom before coming into contact with one another. It should also be
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understood that the ability of the nasal cushion 3112 and the oral cushion 3110 to
move independently of one another while maintaining an effective seal may be
furthered by providing the decoupling structure 3106 with a radially variable
thickness or varied stiffness. Thus, the decoupling structure 3106 may be
thinnest, or least stiff, at the portion that contacts the upper lip of the patient and
its thickness/stiffness may increase radially to the anterior portion of the
decoupling structure 3106. By this arrangement an effective seal against the
upper lip may be maintained while also providing sufficient support and structure
to the cushions 3110, 3112. The decoupling structure 3106 may be thicker at its
vertex at the closed end of the gap 3106.1 compared to regions proximal to the
open end of the gap 3106.1. This variation may prevent distortion and to improve
hinging because the thicker portion of the decoupling structure 3106 at the closed
end of the gap 3106.1 may serve as a pivot point.
Figure 14 shows another example of the present technology in a partially
exploded side view. This example may include the oral and nasal cushions 3110,
3112 and the oral and nasal plenum chambers 3200, 3202 connected by the
decoupling structure 3106 in similar fashion to other examples disclosed herein.
The upper portion or top plate 3206 and the lower portion or faceplate 3204 can
be seen disconnected from the nasal plenum chamber 3202 and the oral plenum
chamber 3200, respectively. Also, the attachment feature 3252 can be seen
connected to the connection feature 3304 of the rigidiser arm 3302, which has
been partially cut off for clarity. This view also shows a middle or connection
portion 3205 that may connect the top plate 3206 and the faceplate 3204 to form a
unitary plate member. The connection portion 3205 may be shaped and
dimensioned to substantially follow the shape of the decoupling structure 3106
such that when the unitary member of the top plate 3206, faceplate 3204, and
connection portion 3205 are attached to the nasal plenum chamber 3202 and the
oral plenum chamber 3200 the connection portion 3205 may be substantially flush
with the decoupling structure 3106. To allow the oral and nasal plenum chambers
3200, 3202 to move relative to one another as described elsewhere herein, it may
be advantageous to form the connection portion 3205 from silicone or any other
suitable material that is soft, flexible, air impermeable, and biocompatible.
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In another example of the present technology, a portion of the decoupling
structure 3106 proximal to the gap 3106.1 may be eliminated such that only the
undercushion support walls 3208 and/or the connection region 3106.2 connect the
oral and nasal plenum chambers 3200, 3202 and the oral and nasal cushions 3110,
3112. In such an example, the connection portion 3205 may also perform a sealing
function to provide a pneumatically sealed connection between the oral gas
chamber 3102 and the nasal gas chamber 3104. In other words, the connection
portion 3205 may effectively replace the eliminated portion of the decoupling
structure 3106 when the unitary member of the top plate 3206, connection portion
3205, and faceplate 3204 are attached to the oral and nasal plenum chambers
3200, 3202. Again, in this example it may be desirable to form the connection
portion 3205 from silicone or any other like material.
.3.3 Top Plate and Faceplate Connection Features, Rigidiser Arms, and
Positioning and Stabilising Structure
On a anterior side of the nasal cushion 3112, which would be opposite the face
of the patient in use, a rigid top plate 3206 may be attached to a nasal plenum
chamber 3202. The top plate 3206 may be made from a rigid material such as
EMS-Grivory Grilamid® TR 90. The top plate 3206 may include at least one
upper attachment feature 3252. In one example, a pair of upper attachment
features 3252 may be disposed at either side of the top plate 3206 to releasably
and rotatably connect respective rigidiser arms 3302 of the positioning and
stabilising structure 3300. UBE America Inc.’s Ubesta® nylon, Hytrel® from
DuPont™, TPE and polypropylene and other flexible polymers and materials are
possible materials for the rigidiser arms 3302. Other materials may also be used
for the rigidiser arms 3302 that are substantially inextensible, while allowing the
rigidiser arms 3302 to flex. The rigidiser arms 3302 may be flexible in a direction
parallel to the patient’s coronal plane (see Fig. 2e), while not being significantly
flexible in other directions. The connection of the rigidiser arms 3302 may be a
hinge such that the connection features 3304 of the rigidiser arms may rotate
about the attachment features 3252 of the top plate 3206. In one example of the
technology, the rigidiser arms 3302 may be rotatable about the hinged upper
attachment features 3252 up to about 90°. In examples, the rigidiser arms 3302
may be rotatable about the hinged upper attachment features 3252 over 180°.
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Rotation may also be provided by a ball and socket connection, living hinge, freed
style gimble or overmolded with silicone, TPE or TPU. At respective opposite
ends of the rigidiser arms 3302, there may be an opening 3308 to receive
respective headgear straps 3306 of the positioning and stabilising structure 3300
to be discussed in greater detail below. Between each end of the rigidiser arm
3302 there may also be a curved portion that is shaped to substantially follow the
curvature of the face of the patient.
Figures 3s-u show further examples of the patient interface 3000 with the
rigidiser arms 3302 exploded to depict an exemplary hinge-like connection
between respective attachment features 3252 and connection features 3304. As
discussed above, it should be understood that the rigidiser arms 3302 may be
rotatable in a plane parallel to the patient’s coronal plane and up to about 90° or,
in another example, over 180°.
On an opposite side of the oral cushion 3110, a faceplate or lower plate 3204
may be attached to the oral plenum chamber 3200. The means of attachment may
include being overmolded, push fit with soft material to hard material, or a
cushion clip to rely on the hoop stress of silicone. The faceplate 3204 may include
a port 3600 that facilitates connection to a air circuit 4170 (not pictured in this
view). Also, the faceplate 3204 may include at least one lower attachment feature
3250 to attach respective headgear straps of the positioning and stabilising
structure 3300 to be discussed in greater detail below. The lower attachment
features 3250 shown in this example may be female clip receiving structures to
receive male clips attached to headgear straps 3306. Alternatively, the
configuration may include male structures to receive female clips.
The exemplary patient interface 3000, shown in a front view in Figure 3b,
includes the top plate 3206 connected to the nasal cushion 3112 and having at
least one upper attachment feature 3252 at either side. A rigidiser arm 3302 is
shown connected to respective upper attachment features 3252 via connection
features 3304. Also in this view, the faceplate 3204 can be seen connected to the
anterior side of the oral plenum chamber 3200. The port 3600 shown on the
faceplate 3204 is circular to pneumatically connect to a air circuit 4170 (e.g., via a
tube decoupling structure 3500 discussed further below). Lower attachment
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features 3252 can also be seen on either side of the faceplate 3204. The
decoupling structure 3106 is shown in this view and side portions 3106.3 of the
decoupling structure can also be seen.
Figure 3c shows a rear view of the exemplary patient interface 3000. In this
view a pair of the rigidiser arms 3302 can be seen extending from and connected
to respective upper attachment features 3252 at respective connection features
3304. An opening 3308 can be seen at each respective opposite end of the
rigidiser arms 3302 for connecting to headgear straps 3306 of the positioning and
stabilising structure 3300. The location of the decoupling structure 3106 is
indicated in this view, along with the connection region 3106.2 of the oral cushion
3110 and the nasal cushion 3112.
Figure 3d shows a top view of a patient interface 3000 in accordance with an
example of the present technology. From this top view, the portion of the nasal
cushion 3112 that contacts the nose of the patient can be seen, as well as the
opening 3103 into the nasal gas chamber 3104. This top view also shows the
connection features 3304 of the rigidiser arms 3302 connected to the upper
attachment features 3252 on either side of the top plate 3206, which cannot be
seen in this particular view. The oral plenum chamber 3200 can also be seen
connected to the faceplate 3204 around the periphery 3210 of the plenum
chamber. The lower attachment features 3250 are shown on either side of the
faceplate 3204. The port 3600 can also be seen on the faceplate 3204.
Figure 3e shows a bottom view of the exemplary patient interface 3000 in
accordance with the present technology. This view shows the oral plenum
chamber 3200 connected about its perimeter 3210 to the faceplate 3204. The
faceplate 3204 can be seen with the lower attachment features 3250 extending
therefrom. The port 3600 on the faceplate 3204 can also be seen. The oral
cushion 3110 and the nasal cushion 3112 are shown in this view, along with the
protruding ends 3114 of the nasal cushion 3112. The rigidiser arms 3302 are
shown as well, however, the connection of the rigidiser arms 3302 to the top plate
3206 is not visible in Figure 3e.
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Figure 3f shows a side view of the exemplary patient interface 3000 according
to the present technology. A rigidiser arm 3302 can be seen extending from the
connection feature 3304, which is attached to the upper attachment feature 3252
of the top plate 3206. Also, Figure 3f depicts the plenum chamber 3200
connected at its perimeter 3210 to the faceplate 3204. On the faceplate 3204, the
lower attachment feature 3250 can be seen, as well as the connection port 3600.
The nasal cushion 3112 and the oral cushion 3110 can also be seen. This view
also depicts the location of the decoupling structure 3106 and one of its side
portions 3106.3. The gap 3106.1 between the nasal plenum chamber 3202 and the
oral plenum chamber 3200 that allows these components to flex or move toward
one another while staying connected is also shown. The gap 3106.1 may be
understood to be the distance between the oral plenum chamber 3200 and the
nasal plenum chamber 3202 and, as such, the gap 3106.1 may define the distance
that these structures are allowed to more toward one another. The gap 3106.1 may
extend laterally between the oral plenum chamber 3200 and the nasal plenum
chamber 3202 and the gap 3106.1 may face in an anterior direction.
Figure 3m shows a further front perspective view of an exemplary patient
interface 3000. This view depicts similar features to those shown in Figure 3g and
also shows the patient interface 3000 donned on a patient 1000. Headgear straps
3306 of the positioning and stabilising structure 3300 are shown releasably
securing the patient interface 3000 to the patient 1000. The headgear straps 3306
are shown with at least one upper strap 3310 connected to a corresponding
rigidiser arm 3302 at its corresponding opening 3308. In the depicted example,
each upper strap 3310 loops through the corresponding opening 3308, which in
this example is an opening in the rigidiser arm 3302. This example also shows at
least one lower strap 3312 connected to the lower attachment feature 3250 by
looping through a portion of a clip 3314 that is releasably attached to the
corresponding lower attachment feature 3250.
Figure 3n depicts another front view of an exemplary patient interface 3000
retained on a patient 1000. The patient interface 3000 in this view can be seen
retained against the face of the patient 1000 by upper straps 3310 and lower straps
3312. The upper straps 3310 are attached to the rigidiser arms 3302 and the lower
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straps 3312 are attached to the lower attachment features 3250 by clips 3314.
Again, it can be seen in this example that the nasal cushion 3112 seals against the
nose of the patient 1000 and the oral cushion 3110 seals against the mouth of the
patient 1000. The decoupling structure 3106 is shown in this view and side
portions 3106.3 of the decoupling structure 3106 can also be seen.
Figure 3o depicts another side view of the patient interface 3000. In this view
the patient interface 3000 is retained against the face of the patient 1000 by the
headgear straps 3306. The upper strap 3310 is connected to the rigidiser arm 3302
to urge the nasal cushion 3112 against the nose and the lower strap 3312 is
connected to the faceplate 3204 to urge the oral cushion 3110 against the mouth of
the patient 1000. In this view the lower strap 3312 can be seen extending below
the ear of the patient 1000 and the upper strap 3310 can be seen extending above
the ear and below the eye of the patient. As discussed above, the rigidiser arms
3302 may be made of a relatively stiff material such as nylon. As such, the
rigidiser arms 3302 may cause irritation to the face of the patient if they rub
against and/or directly contact the face of the patient 1000. Thus, Figure 3o also
depicts a sheath 3316 that may surround the rigidiser arm 3302 to cushion the
rigidiser arm against the face of the patient 1000. This view also depicts the
location of the decoupling structure 3106. The rigidiser arms 3302 may
incorporate or be created with face pads 3305 instead of sheaths being added.
Figure 3p shows another top view of an exemplary patient interface 3000. In
this top view the patient interface 3000 can be seen retained against the face of the
patient 1000 by the headgear straps 3306. The upper straps 3310 can be seen
connected to respective openings 3308 of the rigidiser arms 3302 and the lower
straps 3312 can be seen connected to the lower attachment features 3250 by the
clips 3314.
In an example, the seal-forming structure 3100 of the patient interface 3000 of
the present technology is held in sealing position in use by the positioning and
stabilising structure 3300.
In one form of the present technology, the rigidiser arms 3302 discussed above
may be comprised as a component of the positioning and stabilising structure
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3300. Alternatively, the rigidiser arms 3302 may be comprised as a component of
the patient interface 3000.
The positioning and stabilising structure 3300 may comprise headgear straps
3306. The headgear may include at least upper side straps 3310, lower side straps
3312, and a rear portion. Also, the headgear straps 3306 may comprise a one-
piece composite of soft, flexible material. One layer of the headgear, e.g., an
outer layer that does not contact the skin of the patient when donned, may connect
to tabs of material fixed to respective ends of the upper and lower side straps
3310, 3312. This connection may include a hook-and-loop connection and the
outer layer may comprise the loop material. This connection may allow the side
straps 3310, 3312 to loop through attachment features of the patient interface 3000
to releasably and/or adjustably retain the patient interface to the patient’s head via
the headgear straps 3306. Other connections may include a ladder lock or sliders
that are not hook-and-loop.
By including the rigidiser arms 3302 on the patient interface 3000 and
attaching them to the nasal plenum chamber 3202 by the top plate 3206, it may be
possible to advantageously locate the upper straps 3310 of the positioning and
stabilising structure 3300. To effectively seal the nose of the patient, as described
above, it may be desirable to urge the nasal cushion 3112 in a generally upward
direction against the underside of the nose. The rigidiser arms 3302 may allow for
the proper direction of the tension force vectors generated by the upper straps
3310 of the positioning and stabilising structure 3300 while decoupling these
straps 3310 from the nasal plenum chamber 3202 such that the straps 3310 do not
pass across the eyes of the patient. In other words, sufficiently stiff rigidiser arms
3302 will allow the upper straps 3310 of the positioning and stabilising structure
3300 to effectively pull the nasal cushion 3112 against the nose of the patient
while locating the straps 3310 away from the patient’s face so that the patient may
be more comfortable, wear glasses, see more easily, etc.
Figures 15a-e depict various top plate 3206 and rigidiser arm 3302
connections to the seal-forming structure 3100 according to examples of the
present technology.
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Figure 15a shows the seal-forming structure 3100 in stippling. The rigidiser
arms 3302 and the top plate 3206 are one piece according to the depicted example.
It can be seen that the attachment features 3252 and the connection features 3304
are not shown. Thus, the connection between the top plate 3206 and the rigidiser
arms 3302 may be flexible to allow the rigidiser arms 3302 to deflect due to
tension from a positioning and stabilising structure 3300. Additionally, according
to this example, the top plate 3206 is permanently connected to the seal-forming
structure 3100 in this example.
It should be understood that the top plate 3206 may be joined to the nasal
plenum chamber 3202 and/or the faceplate 3204 may be joined to the oral plenum
chamber 3200 by a permanent connection. A permanent connection may be
facilitated by molding to form a mechanical interlock or the components may be
joined by a chemical bond. A permanent connection may be understood to mean a
connection where disconnecting the components is irreversible such that the
components cannot be returned to their connected state. Disconnection of such a
permanent connection may, for example, entail tearing, damaging, or breaking one
or more of the components such that it cannot reconnected in an operative fashion.
Alternatively, the top plate 3206 may be joined to the nasal plenum chamber
3202 and/or the faceplate 3204 may be joined to the oral plenum chamber 3200 by
a non-permanent connection. A non-permanent connection may comprise a
connection where the components can be detached from one another and
reattached in a manner that is reversible. In other words, the separation of the
components does not necessitate, for example, tearing, damaging, or breaking one
or more of the components such that it cannot reconnected in an operative fashion.
In a non-permanent connection, when detached components are reattached, the
device is returned to an operable state.
Figure 15b shows a similar example to Figure 15a. In this example the top
plate 3206 may be connectable to the seal-forming structure 3100 by a hard to soft
connection at a soft connection region 3130. In other words, the top plate 3206
and the rigidiser arms 3302 are removable.
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Figure 15c shows another variation of the example shown in Figure 15a. In
Figure 15c, this example includes the attachment features 3252 on the top plate
3206 and the connection features 3304 on the rigidiser arms 3302. Thus, the top
plate 3206 is permanently fixed to the seal-forming structure 3100 but the rigidiser
arms 3302 may be rotatable and may be removed from the top plate 3206.
Figure 15d shows an example similar to Figure 15b. In this example there is a
hard to hard connection of the top plate 3206 to a hard connection region 3132.
Figure 15e shows an example that includes the hard to hard connection of the
top plate 3206 to the hard connection region 3132. This example also includes the
attachment features 3252 on the top plate 3206 and the connection features 3304
on the rigidiser arms 3302. Thus, the top plate 3206 is removable from the seal-
forming structure 3100 but the rigidiser arms 3302 may be rotatable and may be
removed or disconnected from the top plate 3206.
Another example of the present technology may include lower attachment
features 3250 that are magnetic and provided to a living hinge, such as examples
described in PCT Application No. . The living hinge allows
for movement of the lower attachment features 3250 in one plane (e.g., a plane
parallel to the patient’s transverse plane) and the direction of movement may be
about an axis. Such an arrangement may provide for more control of the
attachment of the positioning and stabilising structure 3300 to the lower
attachment features 3250 and may provide for more stability for the seal of the
oral cushion 3110 against the patient’s face.
Figures 17a to 17f and 19a to 19h show the components of a rigidiser arm
assembly 3301 according to another example of the present technology. The
rigidiser arm assembly 3301 may be detachable from the top plate 3206. The
connection features 3304 of these examples of the rigidiser arm assembly 3301
may comprise holes shaped to conform to respective ones of the upper attachment
features 3252.
The rigidiser arm assembly 3301 may comprise two components. The
rigidiser arms 3302 and a top plate cover 3303 may be formed in one piece, with
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the connection features 3304 and the openings 3308 being molded thereon as well.
Nylon or Hytrel® may be used to form the rigidiser arms 3302 and the top plate
cover 3303. A pad 3305 may be overmolded onto each rigidiser arm 3302 as well.
The pads 3305 may be formed from a thermoplastic elastomer. The pads 3305
may cushion the patient’s face (e.g., the cheeks) against the rigidiser arms 3302
and prevent marking of the patient’s skin when the patient interface 3000 is worn
for several hours (e.g., during therapy).
The rigidiser arms 3302 may also be formed with an ellipsoidal curvature, as
can be seen in Fig. 19d, for example. Also, the rigidiser arms 3302 may be
structured to be flexible only in a direction parallel to the patient’s coronal plane
(see Fig. 2e), e.g., inwardly and outwardly relative to the patient’s face. In other
words, the rigidiser arms 3302 may be flexible in substantially a single plane that
is parallel to the patient’s transverse plane. This may allow the rigidiser arms 3302
to accommodate various patient face widths. Moreover, the rigidiser arms 3302
may be resistant to stretching along their respective longitudinal axes. The
rigidiser arms 3302 may also be resistant to twisting about their respective
longitudinal axes. Additionally, the rigidiser arms 3302 may also be resistant to
bending upwardly or downwardly, e.g., in the superior or inferior direction,
relative to the patient’s face. The rigidiser arms’ 3302 resistance to deformation in
these directions may be beneficial for stability of the patient interface 3000 when
it is worn by the patient.
According to examples of the present technology, it may be advantageous to
ensure that the rigidiser arm assembly 3301 is secured to the top plate 3206 so as
to minimize relative movement between the top plate 3206 and the rigidiser arm
assembly 3301 when engaged with one another. To ensure that relative movement
between the top plate 3206 and the rigidiser arm assembly 3301 is adequately
controlled, these components may be structured to engage one another at at least
three points. The connection features 3304 may provide two of the points of
contact and another structure positioned on the rigidiser arm assembly 3301
between the connection features 3304 may provide a third point of contact.
Figs. 19d and 19e also show that the rigidiser arm assembly 3301 may include
a rib 3307. When the rigidiser arm assembly 3301 is attached to the top plate
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3206, the rib 3307 may help to reduce relative movement between the nasal
cushion 3112 and the top plate 3206 when engaged with the rigidiser arm
assembly 3301. The rib 3307 may have a cross-sectional profile that is triangular
in shape to guide the rigidiser arm assembly 3301 into engagement with the top
plate 3206. The rib 3307 may also help to reduce flexing and/or twisting between
the rigidiser arm assembly 3301 and the top plate 3206 when they are engaged.
Thus, the rib 3307 and the connection features 3304 may provide the three points
of contact on the rigidiser arm assembly that engage with the top plate 3206.
According to further examples of the present technology, structures other than
the rib 3307 may be provided for a third point of contact, in addition to the
connection features. For example, the top plate 3206 and the rigidiser arm
assembly 3301 may engage at a third point of contact with a rod inserted into a
hole.
Figs. 19f to 19h show another example of the rigidiser arm assembly 3301.
According to this example, a claw 3309 may provided on the posterior side of the
rigidiser arm assembly 3301 near where the top plate cover 3303 meets each of
the rigidiser arms 3302. The claw 3309 may engage with corresponding ones of
the side supports 3207 to secure the rigidiser arm assembly 3301 to the nasal
cushion 3112.
Figs. 29a to 29f show views of another example of the present technology.
These views show features that are similar to those shown in Figs. 17a to 17f.
However, the decoupling structure 3500 is not depicted in Figs. 29a to 29f. It
should be understood though that a decoupling structure 3500 as described
elsewhere herein may be attached at the connection port 3600.
.3.3.1 The Top Plate and the Faceplate
As to the faceplate 3204 and the top plate 3206 described above, it may be
advantageous to choose a material that is relatively more rigid than the nasal
cushion 3112, for example, which may be formed from a flexible material such as
silicone. Choosing a relatively rigid material may provide for an effective anchor
point for the positioning and stabilising structure 3300 (e.g., the rigidiser arms
3302) so that the positioning and stabilising structure 3300 may attach to the seal-
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forming structure 3100 at fixed positions. Were the positioning and stabilising
structure 3300 to be connected directly to the seal-forming structure 3100, which
may be made of a relatively flexible material such as silicone, this arrangement
may cause undesirable deformation of the oral and nasal cushions 3110, 3112
when donned by the patient and tension is applied by the positioning and
stabilising structure 3300. Tension may be particularly applied in the
anterior/posterior directions. Examples of the positioning and stabilising structure
3300 may be made from Breathe-O-Prene™, Soft Edge™, and/or elastic cloth.
Also, by forming the faceplate 3204 and the top plate 3206 from relatively a
rigid material, these components may be shaped to have approximately the same
curvature as the face of the patient, which may in turn ensure a better seal by
properly supporting the seal-forming structure 3100. This may also ensure an
effective seal against the airways of the patient when the positioning and
stabilising structure 3300 generates a tension force vector V substantially parallel
to the Frankfort horizontal as indicated in Figure 3o.
Forming the faceplate 3204 and the top plate 3206 from a relatively rigid
material may also be beneficial in that such a relatively rigid material may prevent
the outer portions of the seal-forming structure 3100 from deforming to the point
that the periphery folds inward to the face. This arrangement may also help to
ensure that sealing pressure is evenly applied over the face of the patient by the
seal-forming structure 3100. The headgear strap 3306 of the positioning and
stabilising structure 3300 may generate tension force vectors to seal the seal-
forming structure 3100 against the patient’s face, however, the faceplate 3204 and
the top plate 3206 may help to spread these sealing forces out over the oral
cushion 3110 and the nasal cushion 3112. By spreading these sealing forces over a
broader area, pressure and/or deformation may not be localized to particular
regions of the oral cushion 3110 and the nasal cushion 3112, for example near
where the headgear straps 3306 are connected.
Additionally, by forming the top plate 3206 from a relatively rigid material
this may prevent undesirable vertical flexing of the rigidiser arms 3302 when the
patient interface 3000 is donned, but still allow pivoting of the rigidiser arms 3302
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in a plane parallel to the patient’s coronal plane. It should be understood that a
small amount of vertical flexing may be tolerable.
Also, by making the faceplate 3204 from a relatively rigid material it may be
easier for the patient to attach the lower straps 3312 of the positioning and
stabilising structure 3100. This is so because the lower attachment features 3250
may be held in a relatively fixed position when the patient interface 3000 is
donned by the patient.
Furthermore, disassembly and assembly of the patient interface 3000 and
positioning and stabilising structure 3300 (e.g., for cleaning purposes) may be
easier for the patient if the positioning and stabilising structure 3300 is not directly
connected to the seal-forming structure 3100.
By providing separate attachment points for the upper straps 3310 and the
lower straps 3312 through the top plate 3206 and the faceplate 3204, respectively,
it may be possible to better control the sealing of the nasal cushion 3112 against
the nose. For example, decoupling the nasal cushion 3112 may allow the upper
straps 3310 to provide targeted pressure upward against the underside of the nose
and/or inward against the face. It may also be possible to control the height of the
nasal cushion 3112 relative to the nose as well as its lateral position (e.g., left vs.
right). Additionally, it may be possible to control the rotation of the nasal cushion
3112 relative to the nose and about an axis parallel to a longitudinal axis of the top
plate 3206. These features may provide these benefits which may not be possible
when all of the straps of a positioning and stabilising structure 3300 are connected
to one common front plate. Thus, the examples disclosed herein may provide for a
more effective and stable seal around the nose of the patient. It should also be
understood that by virtue of the connection of the nasal plenum chamber 3202 to
the oral plenum chamber 3200 by the decoupling structure 3106, the relative
height of the oral cushion 3110 may also be controlled by the upper straps 3310 of
the positioning and stabilising structure 3300.
In examples of the technology various headgear configurations may be used
with the exemplary patient interfaces 3000 described herein. One example of the
technology may utilize headgear similar to that disclosed in US Patent Application
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Publication 2012/0138061. A further variation may include upper straps 3310 that
are shorter than those disclosed in the aforementioned publication by virtue of
their connection to the rigidiser arms 3302.
In further examples of the technology, the positioning and stabilising structure
3300 may include the features disclosed in PCT Application No.
or in US Patent Application Publication No. 2014/0026890.
The positioning and stabilising structure 3300 disclosed in that reference may be
used as the upper straps 3310. The lower straps 3312 may be neoprene
CommonLine headgear straps.
According to a further example of the present technology, one size of the top
plate 3206 and the faceplate 3204 may be used for a variety of sizes of seal-
forming structure 3100 and plenum chamber 3200. This may be advantageous to
reduce the number of parts needed to be produced to manufacture patient
interfaces 3000 to accommodate various patient head/face sizes. Thus, only the
seal-forming structure 3100 and the plenum chamber 3200 may need to be molded
in different sizes according to this example of the technology.
Figs. 18a to 18f, 21a to 21e, 22a to 22e, and 28a to 28e show examples of the
top plate 3206 and the faceplate 3204 according to further examples of the present
technology. Figs. 18a to 18f show the top plate 3206 and the faceplate 3204
attached to the nasal plenum chamber 3202 and the oral plenum chamber 3200,
respectively. According to an example of the present technology, the top plate
3206 and the faceplate 3204 may be formed from a material that is relatively rigid
as compared to silicone. The top plate 3206 and the faceplate 3204 may be joined
to the nasal plenum chamber 3202 and the oral plenum chamber 3200,
respectively, by overmolding the nasal plenum chamber 3202 and the oral plenum
chamber 3200 to the top plate 3206 and the faceplate 3204. The nasal plenum
chamber 3202, the nasal cushion 3112, the oral plenum chamber 3200, the oral
cushion 3110, and the decoupling structure 3106 may be molded as one piece
from silicone.
Figs. 18a, 18b, 18c, and 18f also shows a top plate buffer 3214 and a faceplate
buffer 3215. The top plate buffer 3214 may be formed in one piece with the nasal
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plenum chamber 3202 and may be formed from silicone. When the nasal plenum
chamber 3202 is overmolded onto the top plate 3206 the silicone may pass
through a hole 3217 and into or through core-outs 3216 of the top plate 3206 to
form the top plate buffer 3214, as can be seen in Figs. 21a to 21e. The hole 3217
and the core-outs 3216 together may provide a smooth flow path for the silicone
as it is overmolded onto the top plate 3206. Alternatively, the core-outs 3216 may
not be open to provide a passage for the flow of silicone during overmolding, but
instead the core-outs 3216 may comprise recessed pockets that can be filled with
silicone to form a mechanical interlock and provide cushioning. The top plate
buffer 3214 may be pressed against the posterior side of the top plate cover 3303
when the rigidiser arm assembly 3301 is joined to the top plate 3206. The top
plate buffer 3214 being made of a material that is relatively softer than the top
plate 3206 and the top plate cover 3303, e.g., silicone, may dampen the hard-to-
hard connection to reduce or eliminate rattling of these components.
The top plate buffer 3214 being formed in one piece with the nasal plenum
chamber 3202 and connecting through the hole 3217 in the top plate 3206 may
also provide a retaining function to retain the top plate 3206 in position against the
nasal plenum chamber 3206.
The rib 3307 may also work in conjunction with the top plate buffer 3214 to
provide dampening and/or retention of the engagement between the top plate 3206
and the rigidiser arm assembly 3301. The engagement of the rib 3307 with the top
plate buffer 3215 and the top plate 3206 may provide the dampening and/or
retention and the relative dimensions of these components may be selected to
ensure the desired level of dampening and/or retention.
The faceplate buffer 3215 may extend from the periphery of the oral plenum
chamber 3200 in an anterior direction. The faceplate buffer 3215 may be formed
in one piece with the oral plenum chamber 3200. The faceplate buffer 3215 may
be formed from silicone. The faceplate buffer 3215 may also dampen the hard-to-
hard connection between the faceplate 3204 and the frame 3251 to reduce or
eliminate rattling that may result from the connection.
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Figs. 21a to 21e show the top plate 3206 in isolation and Figs. 22a to 22e
show the faceplate 3204 in isolation.
The upper attachment features 3252 of the top plate 3206 may connect the
rigidiser arm assembly 3301 at the connection features 3304, as shown in Figs.
17a to 17f. The upper attachment features 3252 of these examples may comprise
rigid pockets and/or undercuts that engage with respective connection features
3304 to attach the rigidiser arm assembly 3301.
The faceplate 3204 may also include a cutout 3213 on each side to connect a
frame 3251 to the faceplate. Each cutout 3213 may extend laterally from the
faceplate 3204. The cutouts 3213 may facilitate a hard-to-hard connection (e.g.,
between two relatively rigid components) between the faceplate 3204 and the
frame 3251. The hard-to-hard connection may take the form of a snap-fit and may
produce an audible click when the frame 3251 is attached to the faceplate 3204.
Also, the connection port 3600 can be seen formed in the faceplate 3204. In Figs.
17a to 17f, the frame 3251 can be seen attached around the faceplate 3204.
Figs. 28a to 28e show another example of the top plate 3206 similar to the
views shown in Figs. 21a to 21e. However, the example shown in Figs. 28a to 28e
shows that a recess 3219 may be provided to each core-out 3216 on a posterior
side thereof. The recess 3219 may provide more depth for the flow of silicone
during the molding of the seal-forming structure 3100 and plenum chamber 3200
to the top plate 3206. The recess 3219 may be hemispherical and, as such, may
also provide for more surface area for the attachment of silicone to the top plate
3206, which according to an example of the present technology, may be a self-
adhesive liquid silicone rubber (LSR).
Figs. 27a to 27f show another example of the present technology. In these
views the seal-forming structure 3100 is shown with the faceplate 3204 and the
top plate 3204. The example shown in these views is similar to the example
shown in Figs. 18a to 18f in that the seal-forming structure 3100 may be formed
from silicone and may be overmolded to the top plate 3206 and the faceplate 3204
to join these components. Figs. 27a to 27f depict an alternative example in that the
top plate 3206 may be nearly completely embedded in the seal-forming structure
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3100. In other words, the seal-forming structure 3100, when overmolded to the
top plate 3206, may completely surround the top plate 3206 such that a minimal
amount of the top plate 3206 is exposed. Additionally, an extension 3218 may be
formed to extend from the top plate 3206 and may be formed in one-piece with
the seal-forming structure 3100. The extension 3218 may serve cushioning and/or
dampening functions similar to the top plate buffer 3214 when the rigidiser arm
assembly 3301 is joined to the top plate 3206. Also, the extension 3218 may be
formed with a barb shape and thus may serve a retaining function.
In a further alternative example, the extension 3218 may be formed in one
piece with the top plate 3206. In this example, the barb shape of the extension
3218 may serve the retaining function but due to being made from the same,
relatively rigid material of the top plate 3206 it may not serve the cushioning
and/or dampening functions. As such, the overmolded silicone of the seal-forming
structure 3100 that substantially surrounds the top plate 3206 may serve the
cushioning and/or dampening functions.
Figs. 20a to 20s, 23a to 23f, 24a to 24f, and 25a to 25f show several views of
the frame 3251 with clips 3314 and lower attachment features 3250, in addition to
view of their respective subcomponents.
The frame 3251 may also include a catch 3253 on each side to engage with
respective ones of the cutouts 3213 to facilitate attachment to the faceplate 3204.
The engagement of the catches 3253 with the cutouts 3213 may generate a hoop
stress in the frame 3251 that holds the frame onto the faceplate 3204. The lower
attachment features 3250 may also be formed on the frame 3251. As shown in Fig.
20f, for example, the lower attachment features 3250 may each include a mating
surface 3254 to which each of the clips 3314 is joined. Fig. 20g shows that each
mating surface 3254 may be on a mating portion 3255 of the lower attachment
features 3252. Each lower attachment feature 3250 may include a wing portion
3257 to join the frame 3251 to each of the mating portions 3255.
The wing portions 3257 may be joined to the frame 3251 by overmolding the
wing portions 3257 onto frame extensions 3259 of the frame such that a
mechanical interlock is formed. The frame extensions 3259 may then extend into
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respective recesses 3258 of the wing portions 3257. The mating portions 3255
may also be joined to the wing portions 3257 by simultaneous overmolding such
that a mechanical interlock is also formed between the wing portions 3257 and the
mating portions 3255. Thus, mating portion extensions 3256 may also extend into
the recesses 3258 of the wing portions 3257.
The wing portions 3257 may be formed from thermoplastic elastomer. The
wing portions 3257 may also be flexible such that the lower attachment features
3250 function as living hinges. In other words, the lower attachment features 3250
may be able to move in an anterior/posterior direction due to their flexibility so
that the tension of the straps 3306 causes them to flex and retain the patient
interface 3000 on the patient when donned. The mating portions 3255 may also be
formed from a thermoplastic elastomer.
The clip 3314 may include a bar 3315 around which the lower strap 3312 is
looped to attach the clip 3314 to the lower strap 3312.
To join the clips 3314 to the lower attachment features 3250 a magnetic
connection may be provided. A clip magnet 3260 may be provided to each of the
clips 3314 in a clip pocket 3317 and a mating portion magnet 3261 may be
provided to each of the mating portions 3255 of the lower attachment features
3250 within a mating portion pocket 3262. The poles of each clip magnet 3260
and each mating portion magnet 3261 may be aligned such that a magnetic
attraction is generated between these magnets to draw and retain the clips 3314 to
the lower attachment features 3250. Further examples of these attachment
arrangements are disclosed in PCT Application No. , which
is incorporated herein by reference in its entirety.
The mating portions 3255 of these examples may also include a guide surface
3263 and a protrusion 3264 to position the clip 3314 as it is attached. Also, each
of the clips 3314 may include a receiving surface 3319 to engage with a respective
guide surface 3263 and a notch 3318 to engage with a respective protrusion 3264.
When the clips 3314 are attached to respective mating portions 3255 of the lower
attachment features 3250, the engagement of the notch 3318 and the protrusion
3264 may prevent rotation of the clip 3314 relative to the mating portion 3255 of
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the lower attachment feature 3250. This may help ensure that the direction of the
tension force vectors of the lower straps 3312 become and remain properly
aligned when the patient interface 3000 is donned by the patient.
The guide surface 3263 may have a curved profile. The guide surface 3263
may also be shaped to form an overhang. The receiving surface 3319 may be
shaped to correspond to the shape of the guide surface 3263. The shape of the
guide surface 3263 may also have a guiding and/or retaining function. The curved
profile and slope of the guide surface 3263 may allow the receiving surface 3319
to slide along the guide surface 3263 and into position such that the protrusion
3264 engages with the notch 3318. This may be advantageous because it may be
difficult for the patient to align the clips 3314 with the lower attachment features
3250 when the patient interface 3000 is being donned. Also, the patient may be in
a darkened environment, may have limited tactile ability, and/or may have limited
vision to align the clips 3314 with the lower attachment features 3250. Thus,
structuring the guide surface 3263 such that it guides the receiving surface 3315
and, therefore, the clip 3314 into place may be helpful to ensure a proper and
secure fit of the patient interface 3000.
Fig. 20n shows a rear view of frame 3251 and lower attachment features 3250.
According to this example, each of the lower attachment features 3250 may
comprise a flex point which is depicted as a reduced thickness section 3266 in this
view. The lower attachment features 3250, when subjected to tension by the lower
side straps 3312 of the positioning and stabilizing structure 3300, may be
deformed and flex in a posterior direction at the flex point. The lower attachment
features may comprise thermoplastic elastomer.
Figs. 20q to 20s show further examples of the present technology with a top
view of the frame 3251 and the lower attachment features 3250. Fig. 20q shows a
notch 3265 at the flex point on an anterior side of each of the lower attachment
features 3250. The notch 3265 shown in Fig. 20q may allow the lower attachment
feature 3250 to flex through the notch 3265 in an anterior direction. Fig. 20r
shows a notch 3265 at the flex point on a posterior side of each of the lower
attachment features 3250. The notch 3265 shown in Fig. 20r may allow the lower
attachment feature 3250 to flex through the notch 3265 in a posterior direction. It
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should be understood that according to a further example of the present
technology a notch 3265 may be provided on the posterior and anterior side of
each lower attachment feature 3250.
Fig. 20s shows another top view of the frame 3251 and lower attachment
features 3250 according to an example of the present technology. According to
this example, the flex point may comprise a reduced thickness section 3266 that
reduces the thickness of the lower attachment features 3250 from the posterior and
anterior sides to allow the lower attachment features to flex in both directions.
Figs. 20o and 20p show exploded views depicting features similar to Figs. 20g
and 20h. However, Figs. 20o and 20p also depict mating portion magnet receivers
3267. Each of the mating portion magnet receivers 3267 may be structured to
receive a corresponding mating portion magnet 3261. Figs. 23g to 23m also depict
the mating portion magnet receivers 3267.
Figs. 20p and 25g to 25l also show that the clips 3314 may include a clip
magnet receiver 3321 and a clip magnet cover 3320 to secure the clip magnet
3260 within the clip 3314. The clip magnet cover 3320 may secure the clip
magnet 3260 in the clip magnet receiver 3321 with a snap-fit.
.3.4 Vent, Tube Decoupling structure(s), Connection Port, and Anti-asphyxia
Valve
In one form, the patient interface 3000 includes a vent 3400 constructed and
arranged to allow for the washout of exhaled carbon dioxide.
One form of vent 3400 in accordance with the present technology comprises a
plurality of holes, for example, about 20 to about 80 holes, or about 40 to about 60
holes, or about 45 to about 55 holes. More than 80 holes is also envisaged.
In an example, the vent 3400 is located in the plenum chamber 3200.
Alternatively, the vent 3400 is located in a tube decoupling structure 3500, e.g. a
swivel 3510.
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In another example of the present technology the vent 3400 may be located on
the top plate 3206 and/or the faceplate 3204. In such an example, the tube
decoupling structure 3500 may not include a vent.
The vent 3400 may be laser cut or made from a mesh material or a linear
array. The vent 3400 may also be made from a material or textile of interlacing
plastic fibers. The material of the interlacing plastic fibers is a thermoplastic
polymer including polycarbonate, nylon, polyethylene and preferably
polypropylene. Specifically, the textile may be SEFAR material Tetex Mono 05-
1010-K 080 woven polypropylene material. The textile is typically provided in the
form of a roll or ribbon. The weave of the textile is preferably a satin weave.
However, other weaves are envisaged including plain weave, plain reverse dutch
weave and twill weave. The voids or holes defined by the weave of fibers through
the textile do not necessarily have a uniform dimension since there is some
variation between the positioning, spacing and compression of the fibers in the
weave of the textile. The voids are preferably not straight through holes but rather
define a tortuous air flow path between adjacent fibers through the thickness of
the textile. A tortuous air flow path significantly diffuses the air flow and thereby
reduces noise. If the voids are straight through holes, then the fibers of the textile
may be arranged in the form of a mesh grid.
In one example, the airflow rate of the vent portion of the textile is first
measured by an airflow meter. A determination is made on whether there is a
difference between the measured airflow rate and a desired airflow rate. If the
airflow rate through the vent portion exceeds a predetermined range, the amount
of porosity of the vent portion is selectively reduced. The desired predetermined
range is about 42 to about 59 litres per minute at 20cm H2O pressure, preferably,
about 47 to about 53 litres per minute at 20cm H2O pressure. For example, the
airflow rate through the SEFAR material Tetex Mono 05K 080 woven
polypropylene material may be about 37 to about 64 litres at 20cm H2O pressure,
preferably, about 42 to about 58 litres at 20cm H2O pressure. The variance over
the length of the SEFAR textile may be sinusoidal over the length of the textile
ribbon. Different areas of the SEFAR textile when first received from a textile
manufacturer exhibit different air flow rates. After the porosity has been reduced,
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the airflow rate is measured again for verification to confirm it is now within the
predetermined range. The average diameter of the opening of the voids is
preferably less than 0.1mm, and preferably provide a total open area of
approximately 1% to 10% of the superficial area of the vent. For example, the
total open area may be 22mm2 where the superficial area of the vent is 240mm2.
If the desired air flow rate exists in the textile, optionally, the holes in a
peripheral edge region of a desired vent portion are occluded. The peripheral edge
region of the vent portion is overmolded to the top plate 3206 and/or the faceplate
3204. Since the holes that existed at the peripheral edge region have been
occluded, the airflow rate of the vent portion should not differ after overmolding.
In some examples, the airflow rate may be measured after the vent portion is
cut from the textile, and also the vents may be measured after being overmolded
to the top plate 3206 and/or the faceplate 3204. This enables the airflow rate to be
known and determined to be within the desired predetermined range after each
step. This may prevent wastage so that the part may be discarded as soon as it is
known that it is not within the desired predetermined range.
The porosity of the vent portion can be reduced by several ways, including:
heat staking, plastic deformation by compression, ultrasonic welding, applying a
sealant (e.g. hot melt adhesive) and applying a thin film. Preferably, heat staking
by a staking punch is used to reduce porosity due to increased precision, greater
certainty of occlusion of holes in the textile, manufacturing speed, good visual
appeal after heat staking, and no additional material is required. Some material
shrinkage occurs when heating a thermoplastic which is accounted for by having
excess material surrounding the specific physical dimension for the shape of the
vent. The porosity of the vent portion is reduced by partially occluding or by fully
occluding holes in the vent portion.
Any area or region of the vent portion may be selected to reduce porosity.
Preferably, the porosity of a continuous peripheral edge region of the vent portion
is reduced. This provides good visual appeal because this is adjacent to or at the
location where the vent portion is overmolded to the top plate 3206 and/or the
faceplate 3204. Any visual differences between the continuous peripheral edge
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region and the rest of the vent portion may be less noticeable to the human eye at
this location since it may appear to be a defined edge of the top plate 3206 and/or
the faceplate 3204 for receiving the vent 3400. Alternatively, the area for porosity
reduction may be in the form of a character/letter or logo in a central region of the
vent portion to enhance visual impact and improve brand awareness.
Sound caused by exhaled carbon dioxide passing through the vent 3400 is
minimised because of greater air diffusion as it passes through the textile, in
particular, for nasal pillows when a patient exhales out of their nose and the
carbon dioxide flows out through the vent. Diffusion of the exhaled carbon
dioxide avoids direct or focused airflow to a bed partner or the patient depending
on vent orientation and sleeping position.
The vent of the patient interface is easy to clean. A mild cleaning solution or
soapy water can be used for cleaning the vent. Hot water can also be used to flow
through the vent for cleaning. The vent can be hand washed and rinsed without
disassembly from the top plate 3206 and/or the faceplate 3204 because it may be
permanently connected, for example, overmolded, to the top plate 3206 and/or the
faceplate 3204. Less detachable parts for the patient interface avoids the
possibility of losing individual parts and also reduces cleaning time by not having
to detach and re-attach each part from each other. Since the vent is formed with
plastic fibers, durability of the vent is maintained even after repeated cleaning in
contrast to a vent made from another less durable material, for example, a cloth
textile.
The vent is quiet. Sound energy generated by exhaled carbon dioxide is spread
evenly. Vibrations caused by the exhaled carbon dioxide coming in contact with
the top plate 3206 and/or the faceplate 3204 may produce vibrations in the top
plate 3206 and/or the faceplate 3204. Such vibrations may be dampened by the
vent.
In one form the patient interface 3000 includes at least one tube decoupling
structure 3500, for example a swivel or a ball and socket. The tube decoupling
structure 3500 may also include an elbow feature. The tube decoupling structure
3500 may be divided between the hose and mouth.
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A connection port 3600 may allow for connection to the air circuit 4170. The
air circuit 4170 may include a short tube connected to a longer tube. Examples of
the tubes may include the tube features disclosed in PCT Application No.
. A rotatable adapter may also be included to connect the
short tube and long tube.
In one form, the patient interface 3000 includes an anti-asphyxia valve 3800.
Figure 3g shows another front perspective view of an exemplary patient
interface 3000 according to the present technology. This view depicts features
similar to those shown in Figure 3a, however, this view also includes features to
connect the patient interface 3000 to a PAP device 4000. These additionally
depicted features include at least one vent 3400 disposed radially about the port
3600. In the example depicted, the vent 3400 comprises a plurality of vent holes
around the port 3600. The features of the vent 3400 will be discussed in greater
detail below. Also shown in this view is a tube decoupling structure 3500 to
connect the air circuit 4170 to the port 3600 on the faceplate 3204 of the patient
interface 3000. The tube decoupling structure 3500 may be an elbow and it may
include a swivel 3510 to allow the tube decoupling structure 3500 and the air
circuit 4170 to rotate relative to the patient interface 3000 about the port 3600.
The tube decoupling structure 3500 in this view also includes an anti-asphyxiation
valve 3800 that will be described in greater detail below. Also, Figure 3g shows
that the air circuit 4170 may include a cuff 4172 to attach the air circuit to the
decoupling structure 3500.
Figure 3h depicts features of the exemplary patient interface 3000 in a rear
view, similar to Figure 3c. Figure 3h, however, also shows that the patient
interface 3000 may include a vent 3400 in the form of a plurality of vent holes
disposed radially about the port 3600. The cuff 4172 and the air circuit 4170 can
also be seen. The location of the decoupling structure 3106 is indicated in this
view, along with the connection region 3106.2 of the oral cushion 3110 and the
nasal cushion 3112.
Figure 3i shows a front view of an exemplary patient interface 3000, similar to
Figure 3b. Also shown in Figure 3i, is the tube decoupling structure 3500
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attached to the port 3600 on the faceplate 3204 of the patient interface 3000. This
view also shows the vent 3400 in the form of a plurality of vent holes disposed
radially about the port 3600. The anti-asphyxiation valve 3800 can also be seen
on the tube decoupling structure 3500. The cuff 4172 and the air circuit 4170 can
also be seen connected to the tube decoupling structure 3500. The decoupling
structure 3106 is shown in this view and side portions 3106.3 of the decoupling
structure 3106 can also be seen.
Figure 3j shows a top view of an exemplary patient interface 3000 with
features similar to those shown in Figure 3d. Figure 3d additionally depicts the
vent 3400 in the form of a plurality of vent holes disposed around the port 3600.
Extending from the port 3600 is the tube decoupling structure 3500 with the anti-
asphyxia valve 3800 disposed thereon.
Figure 3k shows a bottom view of an exemplary patient interface 3000. This
view is similar to Figure 3e and thus depicts similar features. Additionally, this
view depicts the vent 3400 comprising a plurality of vent holes disposed radially
about the port 3600. The tube decoupling structure 3500 is shown extending from
the port 3600. The cuff 4172 and air circuit 4170 can be seen as well.
Figure 3l shows a side view of an exemplary patient interface 3000 that is
similar to the view shown in Figure 3f. Accordingly, Figure 3l depicts features
similar to those shown in Figure 3f. However, Figure 3l also shows the vent 3400
including a plurality of vent holes disposed radially about the port 3600. The tube
decoupling structure 3500 is shown connected to the port 3600 at one end and
connected to the air circuit 4170 via the cuff 4172 at the other end. This view also
depicts the location of the decoupling structure 3106 and one of its side portions
3106.3. The gap 3106.1 between the nasal plenum chamber 3202 and the oral
plenum chamber 3200 that allows these components to flex or move toward one
another is also shown.
According to the examples shown in Figs. 17a to 17f and Figs. 26a to 26d, the
decoupling structure 3500 may be joined to the faceplate 3204 and the connection
port 3600. In these examples, the vent 3400 may be formed on the tube
decoupling structure 3500. In these examples, the tube decoupling structure 3500
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may comprise an elbow that is rotatable at the connection with the connection port
3600. The decoupling structure 3500 may also include a swivel 3510 to connect to
a air circuit 4170. The decoupling structure 3500 may include a baffle 3520 to
separate the flow path of pressurized gas from the PAP device 4000 from the flow
path of exhaled gas (e.g., CO ) from the patient that exits through the vent 3400.
By separating these flow paths, the baffle 3520 may improve washout of exhaled
gas (e.g., CO ). The tube decoupling structure 3500 may also include a quick
release mechanism 3530 that allows the patient to easily attach and detach the
tube decoupling structure 3500 to and from the connection port 3600 on the
faceplate 3204.The quick release mechanism 3530 may also be structured to
provide a snap-fit connection between the connection port 3600 and the tube
decoupling structure 3500 and engagement may result in an audible click that
ensures the patient that the connection has been made. The tube decoupling
structure 3500 may also include an anti-asphyxiation valve 3800.
.4 GLOSSARY
In certain forms of the present technology, one or more of the following
definitions may apply. In other forms of the present technology, alternative
definitions may apply.
.4.1 General
Air: Air will be taken to include breathable gases, for example air with
supplemental oxygen.
Continuous Positive Airway Pressure (CPAP): CPAP treatment will be taken
to mean the application of a supply of air or breathable gas to the entrance to the
airways at a pressure that is continuously positive with respect to atmosphere, and
preferably approximately constant through a respiratory cycle of a patient. In
some forms, the pressure at the entrance to the airways will vary by a few
centimeters of water within a single respiratory cycle, for example being higher
during inhalation and lower during exhalation. In some forms, the pressure at the
entrance to the airways will be slightly higher during exhalation, and slightly
lower during inhalation. In some forms, the pressure will vary between different
respiratory cycles of the patient, for example being increased in response to
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detection of indications of partial upper airway obstruction, and decreased in the
absence of indications of partial upper airway obstruction.
.4.2 Aspects of PAP devices
Air circuit: A conduit or tube constructed and arranged in use to deliver a
supply of air or breathable gas between a PAP device and a patient interface. In
particular, the air circuit may be in fluid connection with the outlet of the
pneumatic block and the patient interface. The air circuit may be referred to as air
delivery tube. In some cases there may be separate limbs of the circuit for
inhalation and exhalation. In other cases a single limb is used.
APAP: Automatic Positive Airway Pressure.
Blower or flow generator: A device that delivers a flow of air at a pressure
above ambient pressure.
Controller: A device, or portion of a device that adjusts an output based on an
input. For example one form of controller has a variable that is under control- the
control variable- that constitutes the input to the device. The output of the device
is a function of the current value of the control variable, and a set point for the
variable. A servo-ventilator may include a controller that has ventilation as an
input, a target ventilation as the set point, and level of pressure support as an
output. Other forms of input may be one or more of oxygen saturation (SaO2),
partial pressure of carbon dioxide (PCO2), movement, a signal from a
photoplethysmogram, and peak flow. The set point of the controller may be one or
more of fixed, variable or learned. For example, the set point in a ventilator may
be a long term average of the measured ventilation of a patient. Another ventilator
may have a ventilation set point that changes with time. A pressure controller may
be configured to control a blower or pump to deliver air at a particular pressure.
Therapy: Therapy in the present context may be one or more of positive
pressure therapy, oxygen therapy, carbon dioxide therapy, control of dead space,
and the administration of a drug.
Positive Airway Pressure (PAP) device: A device for providing a supply of air
at positive pressure to the airways.
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.4.3 Anatomy of the face
Ala: The external outer wall or "wing" of each nostril (plural: alae)
Alar angle: The angle defined between the ala, from an inferior view.
Alare: The most lateral point on the nasal ala.
Alar curvature (or alar crest) point: The most posterior point in the curved
base line of each ala, found in the crease formed by the union of the ala with the
cheek.
Auricula or Pinna: The whole external visible part of the ear.
(nose) Bony framework: The bony framework of the nose comprises the nasal
bones, the frontal process of the maxillae and the nasal part of the frontal bone.
(nose) Cartilaginous framework: The cartilaginous framework of the nose
comprises the septal, lateral, major and minor cartilages.
Columella: the strip of skin that separates the nares and which runs from the
pronasale to the upper lip.
Columella angle: The angle between the line drawn through the midpoint of
the nostril aperture and a line drawn perpendicular to the Frankfurt horizontal
while intersecting subnasale.
Frankfort horizontal plane: A line extending from the most inferior point of
the orbital margin to the left tragion. The tragion is the deepest point in the notch
superior to the tragus of the auricle.
Glabella: Located on the soft tissue, the most prominent point in the
midsagittal plane of the forehead.
Lateral nasal cartilage: A generally triangular plate of cartilage. Its superior
margin is attached to the nasal bone and frontal process of the maxilla, and its
inferior margin is connected to the major alar cartilage.
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Lip, lower (labrale inferius): A point where the boundary of the vermilion
border of the lower lip and the skin is intersected by the median sagittal plane.
Lip, upper (labrale superius): The point on the upper lip lying in the median
sagittal plane on a line drawn across the boundary of the vermilion border and
skin.
Major alar cartilage: A plate of cartilage lying below the lateral nasal
cartilage. It is curved around the anterior part of the naris. Its posterior end is
connected to the frontal process of the maxilla by a tough fibrous membrane
containing three or four minor cartilages of the ala.
Nares (Nostrils): Approximately ellipsoidal apertures forming the entrance to
the nasal cavity. The singular form of nares is naris (nostril). The nares are
separated by the nasal septum.
Naso-labial sulcus or Naso-labial fold: The skin fold or groove that runs from
each side of the nose to the corners of the mouth, separating the cheeks from the
upper lip.
Naso-labial angle: The angle between the columella and the upper lip, while
intersecting subnasale.
Otobasion inferior: The lowest point of attachment of the auricle to the skin of
the face.
Otobasion superior: The highest point of attachment of the auricle to the skin
of the face.
Pronasale: the most protruded point or tip of the nose, which can be identified
in lateral view of the rest of the portion of the head.
Philtrum: the midline groove that runs from lower border of the nasal septum
to the top of the lip in the upper lip region.
Pogonion: Located on the soft tissue, the most anterior midpoint of the chin.
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Ridge (nasal): The nasal ridge is the midline prominence of the nose,
extending from the Sellion to the Pronasale.
Sagittal plane: A vertical plane that passes from anterior (front) to posterior
(rear) dividing the body into right and left halves.
Sellion: Located on the soft tissue, the most concave point overlying the area
of the frontonasal suture.
Septal cartilage (nasal): The nasal septal cartilage forms part of the septum
and divides the front part of the nasal cavity.
Subalare: The point at the lower margin of the alar base, where the alar base
joins with the skin of the superior (upper) lip.
Subnasal point: Located on the soft tissue, the point at which the columella
merges with the upper lip in the midsagittal plane.
Supramentale: The point of greatest concavity in the midline of the lower lip
between labrale inferius and soft tissue pogonion
.4.4 Anatomy of the skull
Frontal bone: The frontal bone includes a large vertical portion, the squama
frontalis, corresponding to the region known as the forehead.
Mandible: The mandible forms the lower jaw. The mental protuberance is the
bony protuberance of the jaw that forms the chin.
Maxilla: The maxilla forms the upper jaw and is located above the mandible
and below the orbits. The frontal process of the maxilla projects upwards by the
side of the nose, and forms part of its lateral boundary.
Nasal bones: The nasal bones are two small oblong bones, varying in size and
form in different individuals; they are placed side by side at the middle and upper
part of the face, and form, by their junction, the "bridge" of the nose.
Nasion: The intersection of the frontal bone and the two nasal bones, a
depressed area directly between the eyes and superior to the bridge of the nose.
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Occipital bone: The occipital bone is situated at the back and lower part of the
cranium. It includes an oval aperture, the foramen magnum, through which the
cranial cavity communicates with the vertebral canal. The curved plate behind the
foramen magnum is the squama occipitalis.
Parietal bones: The parietal bones are the bones that, when joined together,
form the roof and sides of the cranium.
Temporal bones: The temporal bones are situated on the bases and sides of the
skull, and support that part of the face known as the temple.
Zygomatic bones: The face includes two zygomatic bones, located in the upper
and lateral parts of the face and forming the prominence of the cheek.
.4.5 Anatomy of the respiratory system
Diaphragm: A sheet of muscle that extends across the bottom of the rib cage.
The diaphragm separates the thoracic cavity, containing the heart, lungs and ribs,
from the abdominal cavity. As the diaphragm contracts the volume of the thoracic
cavity increases and air is drawn into the lungs.
Larynx: The larynx, or voice box houses the vocal folds and connects the
inferior part of the pharynx (hypopharynx) with the trachea.
Lungs: The organs of respiration in humans. The conducting zone of the lungs
contains the trachea, the bronchi, the bronchioles, and the terminal bronchioles.
The respiratory zone contains the respiratory bronchioles, the alveolar ducts, and
the alveoli.
Nasal cavity: The nasal cavity (or nasal fossa) is a large air filled space above
and behind the nose in the middle of the face. The nasal cavity is divided in two
by a vertical fin called the nasal septum. On the sides of the nasal cavity are three
horizontal outgrowths called nasal conchae (singular "concha") or turbinates. To
the front of the nasal cavity is the nose, while the back blends, via the choanae,
into the nasopharynx.
Pharynx: The part of the throat situated immediately inferior to (below) the
nasal cavity, and superior to the oesophagus and larynx. The pharynx is
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conventionally divided into three sections: the nasopharynx (epipharynx), the
oropharynx (mesopharynx), and the laryngopharynx (hypopharynx).
.4.6 Materials
Silicone or Silicone Elastomer: A synthetic rubber. In this specification, a
reference to silicone is a reference to liquid silicone rubber (LSR) or a
compression molded silicone rubber (CMSR). One form of commercially
available LSR is SILASTIC (included in the range of products sold under this
trademark), manufactured by Dow Corning. Another manufacturer of LSR is
Wacker. Unless otherwise specified to the contrary, a preferred form of LSR has a
Shore A (or Type A) indentation hardness in the range of about 35 to about 45 as
measured using ASTM D2240.
Polycarbonate: a typically transparent thermoplastic polymer of Bisphenol-A
Carbonate.
.4.7 Aspects of a patient interface
Anti-asphyxia valve (AAV): The component or sub-assembly of a mask system
that, by opening to atmosphere in a failsafe manner, reduces the risk of excessive
CO rebreathing by a patient.
Elbow: A conduit that directs an axis of flow or air to change direction
through an angle. In one form, the angle may be approximately 90 degrees. In
another form, the angle may be less than 90 degrees. The conduit may have an
approximately circular cross-section. In another form the conduit may have an
oval or rectangular cross-section.
Frame: Frame will be taken to mean a mask structure that bears the load of
tension between two or more points of connection with a headgear. A mask frame
may be a non-airtight load bearing structure in the mask. However, some forms of
mask frame may also be air-tight.
Functional dead space: The functional dead space refers to at least one region
within a breathing circuit where a patient’s exhalate may collect such that the
normal flow of gas within the breathing circuit cannot effectively flush the
exhalate from the breathing circuit.
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Headgear: Headgear will be taken to mean a form of positioning and
stabilizing structure designed for use on a head. Preferably the headgear comprises
a collection of one or more struts, ties and stiffeners configured to locate and
retain a patient interface in position on a patient’s face for delivery of respiratory
therapy. Some ties are formed of a soft, flexible, elastic material such as a
laminated composite of foam and fabric.
Membrane: Membrane will be taken to mean a typically thin element that has,
preferably, substantially no resistance to bending, but has resistance to being
stretched.
Plenum chamber: a mask plenum chamber will be taken to a mean portion of a
patient interface having walls enclosing a volume of space, the volume having air
therein pressurized above atmospheric pressure in use. A shell may form part of
the walls of a mask plenum chamber. In one form, a region of the patient's face
forms one of the walls of the plenum chamber.
Seal: The noun form ("a seal") will be taken to mean a structure or barrier that
intentionally resists the flow of air through the interface of two surfaces. The verb
form ("to seal") will be taken to mean to resist a flow of air.
Shell: A shell will preferably be taken to mean a curved structure having
bending, tensile and compressive stiffness, for example, a portion of a mask that
forms a curved structural wall of the mask. Preferably, compared to its overall
dimensions it is relatively thin. In some forms, a shell may be faceted. Preferably
such walls are airtight, although in some forms they may not be airtight.
Stiffener: A stiffener will be taken to mean a structural component designed to
increase the bending resistance of another component in at least one direction.
Strut: A strut will be taken to be a structural component designed to increase
the compression resistance of another component in at least one direction.
Swivel: (noun) A subassembly of components configured to rotate about a
common axis, preferably independently, preferably under low torque. In one form,
the swivel may be constructed to rotate through an angle of at least 360 degrees.
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In another form, the swivel may be constructed to rotate through an angle less
than 360 degrees. When used in the context of an air circuit, the sub-assembly of
components preferably comprises a matched pair of cylindrical conduits.
Preferably there is little or no leak flow of air from the swivel in use.
Tie: A tie will be taken to be a structural component designed to resist tension.
Vent: (noun) the structure that allows a deliberate controlled rate leak of air
from an interior of the mask, or conduit to ambient air, to allow washout of
exhaled carbon dioxide (CO ) and supply of oxygen (O ).
.4.8 Terms used in relation to patient interface
Curvature (of a surface): A region of a surface having a saddle shape, which
curves up in one direction and curves down in a different direction, will be taken
to have a negative curvature. A region of a surface having a dome shape, which
curves the same way in two principle directions, will be taken to have a positive
curvature. A flat surface will be taken to have zero curvature.
Floppy: A quality of a material, structure or composite that is the combination
of features of:
Readily conforming to finger pressure.
Unable to retain its shape when caused to support its own weight.
Not rigid.
Able to be stretched or bent elastically with little effort.
The quality of being floppy may have an associated direction, hence a
particular material, structure or composite may be floppy in a first direction, but
stiff or rigid in a second direction, for example a second direction that is
orthogonal to the first direction.
Resilient: Able to deform substantially elastically, and to release substantially
all of the energy upon unloading, within a relatively short period of time such as 1
second.
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Rigid: Not readily deforming to finger pressure, and/or the tensions or loads
typically encountered when setting up and maintaining a patient interface in
sealing relationship with an entrance to a patient's airways.
Semi-rigid: means being sufficiently rigid to not substantially distort under the
effects of mechanical forces typically applied during positive airway pressure
therapy.
.5 OTHER REMARKS
Unless defined otherwise, all technical and scientific terms used herein have
the same meaning as commonly understood by one of ordinary skill in the art to
which this technology belongs. Although any methods and materials similar or
equivalent to those described herein can also be used in the practice or testing of
the present technology, a limited number of the exemplary methods and materials
are described herein.
It must be noted that as used herein and in the appended claims, the singular
forms "a", "an", and "the" include their plural equivalents, unless the context
clearly dictates otherwise.
Moreover, in interpreting the disclosure, all terms should be interpreted in the
broadest reasonable manner consistent with the context. In particular, the terms
"comprises" and "comprising" should be interpreted as referring to elements,
components, or steps in a non-exclusive manner, indicating that the referenced
elements, components, or steps may be present, or utilized, or combined with
other elements, components, or steps that are not expressly referenced.
Although the technology herein has been described with reference to particular
examples, it is to be understood that these examples are merely illustrative of the
principles and applications of the technology. In some instances, the terminology
and symbols may imply specific details that are not required to practice the
technology. For example, although the terms "first" and "second" may be used,
unless otherwise specified, they are not intended to indicate any order but may be
utilised to distinguish between distinct elements. Furthermore, although process
steps in the methodologies may be described or illustrated in an order, such an
2344980
ordering is not required. Those skilled in the art will recognize that such ordering
may be modified and/or aspects thereof may be conducted concurrently or even
synchronously.
It is therefore to be understood that numerous modifications may be made to
the illustrative examples and that other arrangements may be devised without
departing from the spirit and scope of the technology.
2344980
6 REFERENCE NUMERAL LIST
patient 1000
bed partner 1100
patient interface 3000
seal-forming structure 3100
nasal opening 3101
oral gas chamber 3102
oral opening 3103
nasal gas chamber 3104
distal major side 3104.1
minor side 3104.2
proximal major side 3104.3
nare port 3105
decoupling structure 3106
gap 3106.1
connection region 3106.2
side portion 3106.3
upper surface 3106.4
connecting surface 3106.5
lower surface 3106.6
oral cushion 3110
nasal cushion 3112
region 3112.1
region 3112.2
region 3112.3
region 3113
protruding end 3114
region 3115
recessed portion 3116
region 3117
peak 3118
nasal sling 3119
oral undercushion 3120
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straight sidewalls 3121
tapered region 3122
thickened nasal cushion section 3124
soft connection region 3130
hard connection region 3132
oral plenum chamber 3200
nasal plenum chamber 3202
faceplate 3204
connection portion 3205
top plate 3206
side support 3207
nasal undercushion support wall 3208
pocket 3208.1
notch 3209
perimeter 3210
oral plenum chamber section 3212
cutout 3213
top plate buffer 3214
faceplate buffer 3215
recess 3216
hole 3217
extension 3218
depression 3219
lower attachment feature 3250
frame 3251
upper attachment feature 3252
catch 3253
mating surface 3254
mating portion 3255
mating portion extension 3256
wing portion 3257
recess 3258
frame extension 3259
clip magnet 3260
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mating portion magnet 3261
mating portion pocket 3262
guide surface 3263
protrusion 3264
notch 3265
reduced thickness section 3266
mating portion magnet receiver 3267
positioning and stabilising structure 3300
rigidiser arm assembly 3301
rigidiser arm 3302
top plate cover 3303
connection feature 3304
pad 3305
headgear straps 3306
opening 3308
claw 3309
upper strap 3310
lower strap 3312
clip 3314
bar 3315
sheath 3316
clip pocket 3317
notch 3318
receiving surface 3319
clip magnet cover 3320
clip magnet receiver 3321
vent 3400
tube decoupling structure 3500
swivel 3510
baffle 3520
quick release mechanism 3530
connection port 3600
anti-asphyxiation valve 3800
pap device 4000
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air circuit 4170
cuff 4172
humidifier 5000
2344980
7
Claims (28)
1. A patient interface to provide breathable gas to a patient, comprising: a cushion assembly, comprising: a nasal cushion having a concave shape between a first lateral side and a second lateral side to receive and seal against an inferior periphery of the patient’s nose, the nasal cushion including a nasal opening configured to direct breathable gas to the patient’s nares in use; a nasal plenum chamber and the nasal cushion forming a nasal gas chamber; an oral cushion configured to contact and seal against the patient’s face surrounding the patient’s mouth, the oral cushion including an oral opening configured to direct breathable gas to the patient’s mouth in use; and an oral plenum chamber and the oral cushion forming an oral gas chamber, the nasal gas chamber and the oral gas chamber being pneumatically connected within the cushion assembly, wherein the nasal cushion, the nasal plenum chamber, the oral plenum chamber, and the oral cushion are formed from one piece of silicone; an anti-asphyxiation valve; a positioning and stabilizing structure including a pair of upper side straps, a pair of lower side straps, and a rear portion, the pair of upper side straps and the pair of lower side straps extending from the rear portion; and a unitary plate member removably connected to the cushion assembly, the unitary plate member including a connection port configured to be connected to an air delivery tube, the connection port being configured to receive breathable gas from the air delivery tube and direct breathable gas into the cushion assembly for breathing by the patient during use, the unitary plate member including an upper portion and a lower portion, each of the upper side straps being removably connected to the upper portion of the unitary plate member, each of the lower side straps being removably connected to the lower portion of the unitary plate member, and the upper portion of the unitary plate member contacting the nasal plenum chamber to support the nasal cushion against the patient’s face in use.
2. The patient interface of claim 1, wherein the nasal cushion includes a recessed portion configured to receive the tip of the patient’s nose in use, wherein the nasal cushion includes a pair of peaks, each of the peaks being positioned laterally outward of the recessed portion and configured to extend in a superior direction relative to the patient in use, and wherein the nasal cushion is recessed below the peaks at the recessed portion.
3. The patient interface of claim 1 or claim 2, wherein the oral plenum chamber further comprises a vent configured to allow for washout of exhaled carbon dioxide, the vent having a plurality of holes.
4. The patient interface of any one of claims 1 to 3, wherein the nasal cushion further comprises a pair of protruding ends, each of the protruding ends being positioned on a corresponding lateral side of the nasal cushion and configured to contact and seal against the patient’s face between the respective ala and the respective nasolabial sulcus of the patient.
5. The patient interface of any one of claims 1 to 4, wherein the nasal opening increases in lateral width from an anterior edge to a posterior edge relative to the patient in use.
6. The patient interface of any one of claims 1 to 5, wherein the nasal cushion increases in thickness in a direction that is laterally outward from the nasal opening.
7. The patient interface of any one of claims 1 to 6, wherein a lower portion of the nasal cushion is concave to seal against the upper lip of the patient in use.
8. The patient interface of any one of claims 1 to 7, wherein the positioning and stabilizing structure includes a pair of clips, and wherein the lower portion of the unitary plate member includes a pair of lower attachment features, each of the lower side straps being removably connected to a corresponding one of the clips, each of the lower attachment features comprising a clip receptacle, and each of the clips being removably connected to a corresponding one of the lower attachment features.
9. The patient interface of claim 8, wherein each of the lower side straps includes hook material and loop material to removably connect to a corresponding one of the clips.
10. The patient interface of any one of claims 1 to 9, wherein an anterior side of the nasal plenum chamber includes a depressed region, and wherein the upper portion of the unitary plate member is shaped and dimensioned to complement a lower surface of the depressed region of the nasal plenum chamber when the unitary plate member is removably connected to the cushion assembly.
11. The patient interface of claim 10, wherein the upper portion of the unitary plate member includes a pair of lateral portions that extend farther in a superior direction relative to the patient in use than a medial portion positioned between the lateral portions, wherein and the lateral portions and the medial portion are shaped and dimensioned to be substantially flush with the lower surface of the depressed region when the unitary plate member is removably connected to the cushion assembly.
12. The patient interface of any one of claims 1 to 11, wherein the unitary plate member is constructed from a single piece of material that is relatively more rigid than the silicone of the cushion assembly.
13. The patient interface of any one of claims 1 to 12, wherein the nasal cushion further comprises a nasal sling that divides the nasal opening into a pair of naris ports, each of the naris ports corresponding to one of the patient’s nostrils.
14. The patient interface of any one of claims 1 to 12, wherein the nasal opening is a single opening configured to direct breathable gas to both of the patient’s nares in use.
15. A patient interface to provide breathable gas to a patient, comprising: a cushion assembly, comprising: a nasal plenum chamber including a nasal cushion having a concave shape between a first lateral side and a second lateral side to receive and seal against an inferior periphery of the patient’s nose, the nasal cushion including a nasal opening configured to direct breathable gas to the patient’s nares in use; and an oral plenum chamber including an oral cushion configured to contact and seal against the patient’s face surrounding the patient’s mouth, the oral cushion including an oral opening configured to direct breathable gas to the patient’s mouth in use, wherein the nasal cushion, the nasal plenum chamber, the oral plenum chamber, and the oral cushion are formed from one piece of silicone; an anti-asphyxiation valve; a positioning and stabilizing structure including upper straps, lower straps, and a rear portion, the upper straps and the lower straps extending from the rear portion; and a faceplate having a connection port configured to be connected to an air delivery tube, the connection port being configured to receive breathable gas from the air delivery tube and direct breathable gas into the cushion assembly for breathing by the patient during use, the faceplate being removably connected to a corresponding one of the lower straps; a top plate being removably connected to a corresponding one of the upper straps; a connection portion that joins the top plate and the faceplate to form a unitary structure that is removably connected to the cushion assembly, wherein the top plate contacts the nasal plenum chamber to support the nasal cushion against the patient’s face in use.
16. The patient interface of claim 15, wherein the nasal cushion includes a recessed portion configured to receive the tip of the patient’s nose in use, wherein the nasal cushion includes a pair of peaks, each of the peaks being positioned laterally outward of the recessed portion and configured to extend in a superior direction relative to the patient in use, and wherein the nasal cushion is recessed below the peaks at the recessed portion.
17. The patient interface of claim 15 or claim 16, wherein the oral plenum chamber further comprises a vent configured to allow for washout of exhaled carbon dioxide, the vent having a plurality of holes.
18. The patient interface of any one of claims 15 to 17, wherein the nasal cushion further comprises a pair of protruding ends, each of the protruding ends being positioned on a corresponding lateral side of the nasal cushion and configured to contact and seal against the patient’s face between the respective ala and the respective nasolabial sulcus of the patient.
19. The patient interface of any one of claims 15 to 18, wherein the nasal opening increases in lateral width from an anterior edge to a posterior edge relative to the patient in use.
20. The patient interface of any one of claims 15 to 19, wherein the nasal cushion increases in thickness in a direction that is laterally outward from the nasal opening.
21. The patient interface of any one of claims 15 to 20, wherein a lower portion of the nasal cushion is concave to seal against the upper lip of the patient in use.
22. The patient interface of any one of claims 15 to 21, wherein the positioning and stabilizing structure includes clips, and wherein the faceplate includes lower attachment features, each of the lower straps being removably connected to a corresponding one of the clips, each of the lower attachment features comprising a clip receptacle, and each of the clips being removably connected to a corresponding one of the lower attachment features.
23. The patient interface of claim 22, wherein the lower straps include hook material and loop material to removably connect to a corresponding one of the clips.
24. The patient interface of any one of claims 15 to 23, wherein an anterior side of the nasal plenum chamber includes a depressed region, and wherein the top plate is shaped and dimensioned to complement a lower surface of the depressed region of the nasal plenum chamber when the unitary structure is removably connected to the cushion assembly.
25. The patient interface of claim 24, wherein the top plate includes a pair of lateral portions that extend farther in a superior direction relative to the patient in use than a medial portion positioned between the lateral portions, wherein and the lateral portions and the medial portion are shaped and dimensioned to be substantially flush with the lower surface of the depressed region when the unitary structure is removably connected to the cushion assembly.
26. The patient interface of any one of claims 15 to 25, wherein the unitary structure is constructed from a single piece of material that is relatively more rigid than the silicone of the cushion assembly.
27. The patient interface of any one of claims 15 to 26, wherein the nasal cushion further comprises a nasal sling that divides the nasal opening into a pair of naris ports, each of the naris ports corresponding to one of the patient’s nostrils.
28. The patient interface of any one of claims 15 to 26, wherein the nasal opening is a single opening configured to direct breathable gas to both of the patient’s nares in use.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
NZ780432A NZ780432A (en) | 2013-05-14 | 2014-05-14 | Oro-nasal patient interface |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201361823353P | 2013-05-14 | 2013-05-14 | |
US61/823,353 | 2013-05-14 | ||
US201461954201P | 2014-03-17 | 2014-03-17 | |
US61/954,201 | 2014-03-17 | ||
NZ746688A NZ746688A (en) | 2013-05-14 | 2014-05-14 | Oro-nasal patient interface |
Publications (2)
Publication Number | Publication Date |
---|---|
NZ762230A NZ762230A (en) | 2021-09-24 |
NZ762230B2 true NZ762230B2 (en) | 2022-01-06 |
Family
ID=
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