RU2535405C1 - Apparatus for diagnosing and treating sensorineural hearing loss - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: apparatus comprises an ultrasonic frequency vibration generator, a pass-band filter, an amplifier with an incremental coefficient, a power amplifier, a current sensor, a current-to-voltage transmitter, a switch unit, an amplitude current detector and an amplitude voltage detector. Besides, an electric transformer is connected to a piezoelectric transmitter; an electrode for electrophoresis is connected to a microprocessor. An increment encoder and a sensor display, a controlled current source and a polarity circuit are arranged in a control panel. The piezoelectric transmitter is arranged in a metal case; the polarity circuit has two outputs, one of which is connected to a body of the piezoelectric transmitter, while the other output is connected through an additional current sensor to the electrode for electrophoresis.

EFFECT: invention provides higher reliability of diagnosing and treating sensorineural hearing loss.

2 cl, 1 dwg

Description

The invention relates to the field of medical equipment. The device for the diagnosis and treatment of sensorineural hearing loss is designed to diagnose and treat various hearing injuries and can be used in hospitals and clinics, as well as in research medical institutions.

A device is known for ultrasonic audiotest for the diagnosis of various hearing injuries, which contains an ultrasonic frequency oscillator and a clock pulse generator connected to an electronic key, a power amplifier and a piezoelectric emitter (see RF patent No. 2252698, IPC АВВ 5/12, А61В 8/00) .

The disadvantage is the lack of a galvanic current source in the device, which does not allow the treatment of sensorineural hearing loss with phonoelectrophoresis.

A device for phonoelectrophoresis (AS 1003853, IPC A61N 1/30) is known, which comprises interconnected ultrasound generator and an ultrasonic emitter, a current source and electrodes, one of the electrodes being mounted on an ultrasonic emitter and made in the form of a platinum ring, inside which is a porous membrane, and the current source is equipped with a stabilizer.

The disadvantage of this device is the impossibility of its use for the treatment of sensorineural hearing loss. The design is not intended to introduce the emitter into the auditory canal. The known device also has insufficient efficiency in conducting phonoelectrophoresis, since the radiation and electric current zones are separated.

Closest to this technical solution is an apparatus for diagnosing and treating sensorineural hearing loss, comprising an ultrasonic frequency oscillation generator, a bandpass filter, a discretely adjustable gain amplifier, a power amplifier, a current sensor and a current to voltage converter, as well as a switching unit and an amplitude current detector and an amplitude voltage detector, the outputs of which are connected to the inputs of the switching unit, the input of the amplitude current detector is connected to the output of the current converter an indicator, a microprocessor connected to a control input of an amplifier with a discretely adjustable gain, an analog-to-digital converter, the input of which is connected to the output of the switching unit, and the output to a microprocessor, a control panel and a piezoelectric emitter (see RU2307587, class A61B 5/12 10.10.2007)

The disadvantage of this ultrasound device for the diagnosis of hearing damage is the inability to use the apparatus for the treatment of sensorineural hearing loss by phonoelectrophoresis and electrophoresis.

The objective of the invention is to increase the reliability of diagnosis and the effectiveness of the treatment of sensorineural hearing loss by automatically monitoring and controlling the power of ultrasonic radiation and the strength of the galvanic current using a microprocessor, as well as due to the convenient design of the ultrasonic emitter.

The specified technical result is achieved by the fact that in the apparatus for diagnosing and treating sensorineural hearing loss, comprising an ultrasonic frequency oscillation generator, a bandpass filter, an amplifier with a discretely adjustable gain, a power amplifier, a current sensor and a current to voltage converter, as well as a switching unit, an amplitude detector current and an amplitude voltage detector, the outputs of which are connected to the inputs of the switching unit, the input of the amplitude current detector is connected to the output of the current converter a microprocessor connected to a control input of an amplifier with a discretely adjustable gain, an analog-to-digital converter, the input of which is connected to the output of the switching unit, and the output to a microprocessor, a control panel and a piezoelectric emitter, according to the invention, further comprises a transformer, the output of which is connected to a piezoelectric emitter, an electrophoresis electrode connected to the microprocessor and placed in the control panel incremental encoder and touch display, adjustable current source and polarity switch, while the output of the controlled current source is connected to the polarity switch, an additional current sensor and an additional current to voltage converter connected between the output of the additional current sensor and the microprocessor, the ultrasonic frequency oscillator is connected to the microprocessor, the piezoelectric emitter is placed in a metal case, the polarity switch has two outputs, one of which is connected to the body of the piezoelectric emitter, and the other the output is connected via an additional current sensor to the electrophoresis electrode, the current sensor is connected between the output of the power amplifier and the input of the transformer, to which the input of the amplitude voltage detector is also connected.

The technical result to which the invention is directed is also that the piezoelectric emitter is made in the form of a replaceable assembly.

Figure 1 presents a structural diagram of an apparatus for the diagnosis and treatment of sensorineural hearing loss.

Figure 1 shows the following notation:

1 - oscillator of ultrasonic frequency;

2 - band-pass filter;

3 - amplifier with a discretely adjustable power factor;

4 - power amplifier;

5 - current sensor;

6 - current to voltage converter;

7 - switching unit;

8 - amplitude current detector;

9 - amplitude voltage detector;

10 - microprocessor;

11 - analog-to-digital Converter (ADC);

12 - control panel;

13 - a piezoelectric emitter;

14 - transformer;

15 - electrode for electrophoresis;

16 - incremental encoder (angular displacement transducer);

17 - touch display;

18 - controlled current source;

19 - polarity switch;

20 - additional current sensor;

21 - additional current to voltage converter;

22 - the body of the piezoelectric emitter.

The apparatus for diagnosing and treating sensorineural hearing loss includes an ultrasonic frequency oscillation generator 1 connected through a bandpass filter 2 to an amplifier with a discretely adjustable gain 3, the output of which is connected through a power amplifier 4 and a current sensor 5 to a transformer 14, the output of which is connected to a piezoelectric emitter 13 A current to voltage converter 6 is connected to the current sensor 5. The apparatus includes a control panel 12 with an incremental encoder (angular displacement transducer) 16 and touch m display 17, as well as an amplitude current detector 8 and an amplitude voltage detector 9, respectively connected to a current to voltage converter 6 and an output of a current sensor 5. The outputs of these amplitude detectors are connected to the input through a switching unit 7 and an analog-to-digital converter (ADC) 11 microprocessor 10, the first output of which is connected to an ultrasonic frequency oscillation generator 1, the second output is connected to a control input of an amplifier with a discretely adjustable gain 3, and the third output is connected to a sensor On the display 17, the fourth output is connected to a controlled current source 18, and the fifth output is connected to a polarity switch 19. An incremental encoder located on the control panel 12, as well as an additional current to voltage converter 21 are connected to the inputs of the microprocessor 10. One of the outputs of the polarity switch 19 is connected to the housing with a piezoelectric emitter 22, the other output is connected to an additional current sensor 20, the output of which is connected to the electrode for electrophoresis 15.

The operation of the apparatus for the diagnosis and treatment of sensorineural hearing loss is as follows.

From the output of the ultrasonic frequency oscillation generator 1, the modulated ultrasonic signal is fed to the input of the bandpass filter 2, which suppresses spurious harmonics and combination components that occur when the ultrasonic signal is modulated. From the output of the bandpass filter, the modulated ultrasonic signal is fed to the input of the amplifier with a discretely adjustable gain 3.

From the output of the amplifier with a discretely adjustable gain, the modulated 3 ultrasonic signal is fed to a power amplifier 4, which provides the necessary power on the piezoelectric emitter 13, which converts the electrical signal into mechanical vibrations of the ultrasonic frequency.

A current sensor 5 is connected between the power amplifier 4 and the transformer 14. A current-to-voltage converter 6 is connected to it, at which the current passing through the transformer 14 is converted to voltage and supplied to the amplitude current detector 8. An amplitude voltage detector 9 is connected to the transformer 14. From the outputs of the amplitude detectors 8 and 9, the voltages are supplied to the ADC 11 through the switching unit 7, where they are converted into a digital code and transmitted to the microprocessor 10.

The microprocessor provides software control of the amplifier with a discretely adjustable gain 3 via the I ₂ C serial interface, calculates the power level at the emitter by measuring voltages proportional to the level of the output voltage and emitter current from the corresponding voltage and current detectors. A table of values of rated powers corresponding to each level in the range of 0-30 dB is stored in the microprocessor.

The calculation of the current power on the emitter is carried out according to the following formula:

, $$P=U_{\mathrm{one}}\left(U_{\mathrm{AT}SX}\right)\cdot U_2\left(I_H\right)\cdot K\left(\mathrm{one}\right)$$

,

Where

- значение выходного напряжения на излучателе; $$U_{\mathrm{one}}\left(U_{\mathrm{AT}SX}\right)=\left[U_{\mathrm{one}}^{\text{'}\text{'}}-U_{\mathrm{one}}\left(0\right)-U_{\mathrm{one}}\left(t^{\circ }\right)\right]$$

- the value of the output voltage at the emitter;

- значение напряжения, пропорциональное уровню выходного тока излучателя. $$U_2\left(I_H\right)=\left[U_2^{\text{'}\text{'}}-U_2\left(0\right)-U_2\left(t^{\circ }\right)\right]$$

- voltage value proportional to the level of the output current of the emitter.

Here:

- напряжение, снимаемое с амплитудного детектора тока 8 (U_ВЫХ); $$U_{\mathrm{one}}^{\text{'}\text{'}}$$

- voltage removed from the amplitude current detector 8 (U _OUT );

и вводимых в программу в качестве константы;U ₁ (0) is the initial bias voltage of the amplitude current detector 8 (U _OUT ) in the absence of output ultrasonic vibrations on the emitter (PAUSE mode), measured at $$t_{oc}^{\circ }={\mathrm{twenty}}^{\circ }C$$

and entered into the program as a constant;

U ₁ (t °) is the bias voltage of the amplitude current detector 8 (U _OUT ) in the PAUSE mode during operation;

- напряжение, снимаемое с амплитудного детектора напряжения 9 (I_H); $$U_2^{\text{'}\text{'}}$$

- voltage removed from the amplitude voltage detector 9 (I _H );

и вводимых в программу в качестве константы;U ₂ (0) is the initial bias voltage of the amplitude voltage detector 9 (I _H ) in the absence of output ultrasonic vibrations on the emitter (PAUSE mode), measured at $$t_{oc}^{\circ }={\mathrm{twenty}}^{\circ }C$$

and entered into the program as a constant;

U ₂ (t °) is the bias voltage of the amplitude voltage detector 9 (I _H ) in the PAUSE mode during operation;

K is the coefficient of proportionality, taking into account the nonlinearity of the characteristics of amplitude detectors when measuring power in the entire dynamic range.

The coefficient K is entered into the microprocessor memory as a constant when setting up the device.

Thus, based on the measured values of current and voltage, the microprocessor generates a gain control signal of the amplifier with a discretely adjustable gain and thus stabilizes the power of the signal supplied to the piezoelectric emitter.

The device for the diagnosis and treatment of sensorineural hearing loss is controlled from the control panel 12, on which the incremental encoder and touch display are located.

During the duty cycle (ultrasonic frequency output to the emitter), codes corresponding to the power level entered by the touch screen are received from the microprocessor to the amplifier with a discretely adjustable gain. However, during operation, the complex resistance of the piezoelectric emitter changes, which leads to a change in the radiation power with the same signal at the output of the device, since the load current changes. Therefore, in the process of operation, adjustment of the output power is required. Its correction is made after calculating the real power at the emitter according to formula (1) by changing the gain of the amplifier with a discretely adjustable gain until the set value is reached. When the load impedance (emitter) changes during the duty cycle, the power is corrected.

During the operating cycle, the microprocessor also performs self-monitoring of the device with the emitter. If there is no current or short circuit in the emitter, the corresponding warnings are displayed.

The analysis of these modes is carried out by measuring the voltages coming from the amplitude detectors 8 and 9.

The introduction of ultrasound to the patient by the operator in the diagnosis of sensorineural hearing loss is carried out by means of a piezoelectric emitter, the surface of which is pressed to the ear or frontal part of the head through a thin film of paraffin oil. The impact of ultrasound is perceived by the patient due to the presence of bone conduction.

With a gradual increase in the intensity of ultrasound, a radiation power value is reached at which the patient begins to perceive ultrasound as an audible signal. This allows us to determine the differential threshold of ultrasound perception and, accordingly, determine the degree of atrophy of the auditory nerve, i.e. diagnose the degree of loss of sensorineural sensitivity.

At the same time, a subthreshold level of ultrasound is not used, and the negative effects of ultrasound on a person are practically eliminated.

The device can also be used to treat sensorineural hearing loss using phonophoresis (FF), phonoelectrophoresis (FEF), and electrophoresis (EF).

FF provides for the local flow of drugs under the influence of ultrasound in combination with its direct effect on the ear tissue.

The quantitative patterns of drug intake into the labyrinth tissue are determined by the functional state of the inner ear, its organ specifics, the composition of the contact medium, the intensity and duration of exposure to ultrasound. The effectiveness of FF depends on the pharmacological properties of the drugs and on their concentration.

FF is advisable to use in cases where the drug is not electrically conductive or its properties are not yet known.

In recent years, in clinical otorhinolaryngology, FEF has been increasingly used - the complex use of ultrasound with drug electrophoresis.

PEF is advisable to use in cases where the drug is dissociating (electrically conductive), such as pyridoxine hydrochloride, thiamine bromide, magnesium sulfate, sodium fluoride, etc.

The impact of FF and FEF is as follows: the head of a patient in a sitting position is located on the back of the chair so that the external auditory meatus of the exposed ear is in a vertical plane. 1.5-2.0 ml of a drug solution heated to 36-37 ° C is poured into the ear canal. The ultrasonic emitter is immersed in a scaphoid fossa of the auricle filled with a solution, or placed in the proximal third of the external auditory meatus, due to the diameter of the working surface of the ultrasonic emitter. The emitter is held in this position by a special tripod. In the case of an endaural PEF, the body of the piezoelectric emitter serves as a passive electrode. The active electrode (lead plate) 6 × 7 cm ² is located on the mastoid process of the opposite ear. After the procedure, the drug solution is removed on a gauze.

The transformer 14 is used for galvanic isolation between the piezoelectric emitter and its housing 22, used as an electrode when conducting PEF.

Incremental encoder (angular displacement sensor) 16 and provides the necessary accuracy and convenience of setting the power of ultrasonic radiation and the strength of galvanic current.

The touch display 17 provides convenience and visibility of the choice of the FF, FEF and EF modes.

A controlled current source 18 generates a galvanic current of a given force during the FEF and EF procedures.

The polarity switch 19 is used to change the polarity of the galvanic current when using drugs of different chemical composition.

An additional current sensor 20 and an additional converter of current to voltage 21 provide the ability to automatically control and control the galvanic current using a microprocessor, which increases the effectiveness of the treatment of sensorineural hearing loss and ensures the safety of the apparatus.

In the diagnosis and treatment, different frequencies of ultrasonic vibrations are used, for example, a frequency of 100 kHz is used for diagnostics, and frequencies of 1 and 3 MHz are used for treatment, therefore, it is possible to control the switching of the frequency of the oscillation generator of ultrasonic frequency 1 using microprocessor 10.

In the diagnosis and treatment of various diseases, it is necessary to use a piezoelectric emitter 13 tuned to the frequency of the oscillator of ultrasonic frequency. The procedures for FF and FEF procedures also include the use of piezoelectric emitters with different working surface areas. Therefore, it is advisable to perform a piezoelectric emitter in the form of a replaceable unit. This will allow using the device for the treatment of not only sensorineural hearing loss, but also other diseases.

The invention allows to create a universal and reliable device that allows to increase the reliability of diagnosis and the effectiveness of the treatment of sensorineural hearing loss.

As a microprocessor in the apparatus for the diagnosis and treatment of sensorineural hearing loss, a microprocessor of the type TE-STM32F107 and a touch display TE-ULCD35 by STMicroelektronics can be used.

Amplitude detectors can be performed on microcircuits of the TL084 type, and the switching unit on the MPc509 microcircuit from TEXAS INSTRUMENTS.

AD 8065 current sensor, AD 7818 analog-to-digital converter, AD8400 digitally adjustable gain amplifier, AD 7376 controllable current source, and ANALOG DEVICES polarity switch ADG 433.

Claims (2)

1. An apparatus for diagnosing and treating sensorineural hearing loss, comprising an ultrasonic frequency oscillation generator, a bandpass filter, a discretely adjustable gain amplifier, a power amplifier, a current sensor and a current to voltage converter, as well as a switching unit, an amplitude current detector and an amplitude voltage detector, the outputs of which are connected to the inputs of the switching unit, the input of the amplitude current detector is connected to the output of the current to voltage converter, and the microprocessor to the control input of the amplifier with a discretely adjustable gain, an analog-to-digital converter, the input of which is connected to the output of the switching unit, and the output to a microprocessor, a control panel and a piezoelectric emitter, characterized in that it further comprises a transformer, the output of which is connected to a piezoelectric emitter, an electrode for electrophoresis, connected to the microprocessor and placed in the control panel, an incremental encoder and a touch display, a controlled current source and a polarity switch, while the output of the control The supplied current source is connected to the polarity switch, an additional current sensor and an additional current-to-voltage converter connected between the output of the additional current sensor and the microprocessor, the ultrasonic frequency oscillator is connected to the microprocessor, the piezoelectric emitter is placed in a metal case, the polarity switch has two outputs, one of which is connected to the body of the piezoelectric emitter, and the other output is connected to the electric via an additional current sensor a kind for electrophoresis, a current sensor is connected between the output of the power amplifier and the input of the transformer, to which the input of the amplitude voltage detector is also connected. 2. The apparatus according to claim 1, characterized in that the piezoelectric emitter is made in the form of a removable node.