RU2810441C1 - Device for treatment of sensorineural hearing loss using endaural phonoelectrophoresis - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: apparatus for the treatment of sensorineural hearing loss by the method of endaural phonoelectrophoresis contains an ultrasonic frequency oscillation generator, a bandpass filter, an ultrasonic frequency voltage amplifier with a discretely adjustable gain, a power amplifier, the first and second current sensors, the first and second current-to-voltage converters, a switching unit, and an amplitude current detector and amplitude voltage detector, microprocessor, analog-to-digital converter, control panel, piezoelectric emitter, transformer, electrode for electrophoresis, incremental encoder, touch display, controlled current source, polarity switch, second current-to-voltage converter. The piezoelectric emitter is housed in a metal casing. The ultrasound sensor is placed in the housing of the piezoelectric emitter and is mechanically connected to the piezoelectric emitter. The device contains an additional ultrasonic frequency voltage amplifier, an additional amplitude voltage detector, an additional analog-to-digital converter, as well as a button for selecting operating modes, a data input button and a service indicator of the piezoelectric emitter. The ultrasonic emitter is hinged on a flexible bracket with the ability to be fixed in a given position on a fixed base.

EFFECT: increase in the effectiveness of treatment of sensorineural hearing loss and a reduction in rehabilitation time is achieved with automatic control of the power of ultrasonic radiation during the treatment procedures of endaural phonoelectrophoresis and precise positioning of the ultrasound emitter in the patient’s ear canal.

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Description

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

An ultrasonic audio tester device is known for diagnosing various hearing lesions, which contains an ultrasonic frequency oscillation generator and a clock pulse generator connected to an electronic key, a power amplifier and a piezoelectric emitter (see RF patent No. 2252698, IPC A61B5/12, A61B8/00).

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

A device for phonoelectrophoresis is known (and. with. 1003853, IPC A61N1/30), which contains an ultrasound generator and an ultrasonic emitter, a current source and electrodes connected to each other, with one of the electrodes mounted on the ultrasonic emitter and made in the form of a platinum ring, inside which a porous membrane is located, and the current source is equipped with a stabilizer.

The disadvantage of this device is that it cannot be used to treat sensorineural hearing loss. The design is not intended for insertion of the emitter into the ear canal. The known device also has insufficient efficiency in carrying out phonoelectrophoresis, since the zones of radiation and electric current are separated.

The closest to this technical solution is an apparatus for the diagnosis and treatment of sensorineural hearing loss (see RU 2535405, class A61B5/12, 05/17/2017), containing an ultrasonic frequency oscillation generator, a bandpass filter, an ultrasonic frequency voltage amplifier with a discretely adjustable gain, power amplifier, first and second current sensors, first and second current-to-voltage converters, switching unit, amplitude current detector and amplitude voltage detector, the outputs of which are connected to the inputs of the switching unit, the input of the first current-to-voltage converter is connected to the current sensor, the input of the amplitude detector current is connected to the output of the first current-to-voltage converter, the input of the amplitude current detector is connected to the output of the first current-to-voltage converter, a microprocessor, an analog-to-digital converter, a control panel, a piezoelectric emitter, a transformer, the input of which is connected to the output of the first current sensor, the transformer output is connected to piezoelectric emitter, electrode for electrophoresis, connected to the microprocessor and placed on the control panel, an incremental encoder and a touch display, the first current sensor is connected between the output of the power amplifier and the transformer, the control input of the amplifier with discretely adjustable gain and the output of the analog-to-digital converter are connected to the microprocessor, the input of the analog-to-digital converter is connected to the output of the switching unit, the controlled current source is connected to the microprocessor, the polarity switch, the output of the controlled current source is connected to the polarity switch, the second current-to-voltage converter is connected between the output of the second 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 electrode for electrophoresis via a second current sensor.

The disadvantage of this device is the inability to control the ultrasound power level during endaural phonoelectrophoresis treatment procedures, since the effectiveness of treatment for sensorineural hearing loss depends on the presence and maintenance of a given ultrasound power level.

A disadvantage of this device is also the impossibility of accurately positioning the ultrasound emitter in the patient’s ear canal during the treatment procedure, which reduces the effectiveness of treatment for sensorineural hearing loss.

The objectives of the invention are to increase the effectiveness of treatment of sensorineural hearing loss through automatic control of the power of ultrasonic radiation during endaural phonoelectrophoresis treatment procedures, as well as through precise positioning of the ultrasound emitter in the patient’s ear canal.

The technical result is the creation of a controlled concentration of the drug in the parotid depot, due to which the rehabilitation period is reduced and the bone sound conduction thresholds are improved in patients with sensorineural hearing loss.

The specified technical result is achieved in that the device for the treatment of sensorineural hearing loss by the method of endaural phonoelectrophoresis additionally contains an ultrasound sensor located in the body of the piezoelectric emitter and mechanically connected to the piezoelectric emitter, an additional ultrasonic frequency voltage amplifier, an additional amplitude voltage detector, an additional analog-to-digital converter, and the input of an additional ultrasonic frequency voltage amplifier is connected to the output of the ultrasonic sensor, the output of an additional ultrasonic frequency voltage amplifier is connected to the input of an additional amplitude voltage detector, the output of which is connected to the input of an additional analog-to-digital converter, the output of which is connected to the microprocessor, as well as located on the control panel and connected to the microprocessor is a button for selecting operating modes, a data entry button and an indicator of the serviceability of the piezoelectric emitter.

This technical result is achieved by the fact that the ultrasonic emitter is hinged on a flexible bracket that can be fixed in a given position and fixed to a fixed base.

Figure 1 shows a block diagram of an apparatus for the treatment of sensorineural hearing loss using endaural phonoelectrophoresis

Figure 2 shows the design of a device for precise positioning of an ultrasonic emitter during endaural phonoelectrophoresis treatment procedures.

Figure 1 and figure 2 show the following symbols:

1 - ultrasonic frequency oscillation generator;

2 - bandpass filter;

3 - amplifier with discretely adjustable force coefficient;

4 - power amplifier;

5 - first current sensor;

6 - second current sensor

7 - first current-to-voltage converter;

8 - second current to voltage converter

9 - switching unit;

10 - amplitude current detector;

11 - amplitude voltage detector;

12 - microprocessor;

13 - analog-to-digital converter (ADC);

14 - control panel;

15 - piezoelectric emitter;

16 - transformer;

17 - electrode for electrophoresis;

18 - incremental encoder (angular displacement transducer);

19 - display;

20 - controlled current source;

21 - polarity switch;

22 - metal body of the piezoelectric emitter;

23 - ultrasound sensor;

24 - additional ultrasonic frequency oscillation amplifier;

25 - additional amplitude voltage detector;

26 - additional analog-to-digital converter;

27 - button for selecting operating modes;

28- data entry button;

29 - indicator of serviceability of the piezoelectric emitter;

30 - hinge unit;

31- flexible bracket;

32 - fastening unit;

33 - fixed base;

34 - couch;

35 - patient’s head;

36 - auricle.

The operation of the apparatus for diagnosing and treating sensorineural hearing loss is carried out as follows.

From the output of the ultrasonic frequency oscillation generator 1, the ultrasonic signal is supplied to the input of the bandpass filter 2, which suppresses parasitic harmonics and combinational components that arise when modulating the ultrasonic signal. From the output of bandpass filter 2, the modulated ultrasonic signal is fed to the input of an amplifier with a discretely adjustable gain 3.

From the output of the amplifier with a discretely adjustable gain, the modulated 3 ultrasonic signal is supplied to the power amplifier 4, which provides the necessary power to the piezoelectric emitter 15, which converts the electrical signal into mechanical vibrations of ultrasonic frequency.

The first current sensor 5 is connected between the power amplifier 4 and the transformer 16. The first current-to-voltage converter 7 is connected to it, on which the current passing through the transformer 14 is converted into voltage and supplied to the amplitude current detector 10. An amplitude voltage detector is connected to the transformer 16 11. From the outputs of the amplitude detectors of current 10 and voltage 11, through the switching unit 9, the signals are supplied to the analog-to-digital converter 13, where they are converted into a digital code and transmitted to the microprocessor 12. The microprocessor calculates the power supplied to the piezoelectric emitter 15 based on signal levels , proportional to the voltage on the piezoelectric emitter and the current in the emitter. Transformer 16 serves for galvanic isolation between the piezoelectric emitter and its housing 22, used as an electrode for electrophoresis.

To monitor the emitted ultrasound power, an ultrasound sensor 23 is used, which has mechanical contact with the piezoelectric emitter 15. The ultrasound sensor 23 converts a small fraction of the ultrasonic power emitted by the piezoelectric emitter 15 into a signal, which is amplified by an additional ultrasonic frequency oscillation amplifier 24 and detected by an additional amplitude voltage detector 25 , with the help of an additional analog-to-digital converter 26 is converted into a digital code, which is supplied to the microprocessor 12. This code is used in the microprocessor 12 to calculate the emitted ultrasonic power, which is compared with a given value. The microprocessor 12 generates a gain control signal for the amplifier with a discretely adjustable gain 3 and thus stabilizes the ultrasonic power emitted by the piezoelectric emitter 15. The microprocessor 12 uses the measured electrical power of ultrasonic vibrations supplied to the piezoelectric emitter 15, the measured emitted ultrasonic power and the previously known transfer coefficient of the radiated ultrasonic power to the ultrasound sensor, calculates the efficiency of the piezoelectric emitter, compares it with acceptable limits and issues a corresponding signal to the serviceability indicator of the piezoelectric emitter 29, located on the control panel 14. The indicator 29 can be made using two LEDs of different colors, for example green and red. If the green LED lights up, the piezoelectric emitter is working. If the piezoelectric emitter is faulty, the red LED lights up. If there is a malfunction signal, the operator decides to send the device for repair. To carry out the electrophoresis function, a controlled current source 20 produces a galvanic current of a given strength. The polarity switch 21 is used to change the polarity of the galvanic current when using medications of different chemical compositions. The first output of the polarity switch 21 is connected to the metal body of the piezoelectric emitter 22, which is used as the first electrode for electrophoresis. The second output of the polarity switch 21 is connected through a sensor 6 to the second electrode for electrophoresis 17. The second current-to-voltage converter 8 provides the ability to automatically monitor and control the galvanic current during electrophoresis using a microprocessor 12.

The device for diagnosing and treating sensorineural hearing loss is controlled from the control panel 14, on which an incremental encoder 18, a touch display 19, a mode selection button 27, a data input button 28 and a serviceability indicator of the piezoelectric emitter 15 are located.

The device can be used to treat sensorineural hearing loss using endaural phonoelectrophoresis, phonophoresis and electrophoresis methods. Therefore, on the control panel 14, for the convenience of working with the device, there is a button for selecting operating modes 27. Setting the parameters of the treatment procedure, such as ultrasound power, current strength and procedure time, is carried out using an incremental encoder 18 with visual control of the set values on the display 19. Incremental encoder ( angular displacement sensor) 18 provides the necessary accuracy and convenience of setting the power of ultrasonic radiation and the strength of galvanic current / The selected parameters of the treatment procedure are confirmed using the data entry button 28.

In recent years, in clinical otorhinolaryngology for the treatment of sensorineural hearing loss and other diseases, endaural phonoelectrophoresis - the combined use of ultrasound and medicinal electrophoresis - has been increasingly used. Phonoelectrophoresis is advisable to use in cases where the drug is dissociating (electrically conductive), such as pyridoxine hydrochloride, thiamine bromide, magnesium sulfate, sodium fluoride, etc. Phonoelectrophoresis involves the local delivery of drugs under the influence of ultrasound with its direct effect on the ear tissue. Quantitative patterns of the flow of drugs into the labyrinth tissue are determined by the functional state of the inner ear, its organ specificity, the composition of the contact medium, the intensity and duration of ultrasound exposure. The effectiveness of phonophoresis depends on the pharmacological properties of drugs and their concentration. Phonophoresis is advisable to use in cases where the drug is not electrically conductive or its properties are not yet known.

The endaural phonoelectrophoresis procedure is carried out as follows: the patient is placed on a couch or placed in a chair. The patient's head is positioned so that the axis of the external auditory canal of the affected ear is in a vertical position. 1.5-2.0 ml of a drug solution heated to 36-37°C is poured into the patient’s ear canal. The ultrasonic emitter, fixed in the device for precise positioning using a flexible bracket 31, which has the ability to be fixed in a given position, and a hinge unit 30, is fixed in the desired position so that the body of the ultrasonic emitter is in the scaphoid fossa of the auricle filled with a solution of the medicinal drug, or is located in proximal third of the external auditory canal.

Automatic control of the power of ultrasonic radiation during treatment procedures of endaural phonoelectrophoresis and precise positioning of the ultrasound emitter in the auricle ensure the achievement of a technical result, namely the creation of a controlled concentration of the drug in the parotid depot, thereby reducing rehabilitation time and improving bone conduction thresholds in patients with sensorineural hearing loss.

The body of the piezoelectric emitter 22 serves as one of the electrodes of the electrophoresis current circuit. Electrode for electrophoresis 17 (lead plate with an area of 6×7 cm ² , wrapped in a napkin soaked in saline solution) is located on the mastoid process of the opposite ear.

Using the control panel, the parameters of the phonoelectrophoresis treatment process are set and the data entry button gives a command to start the procedure. The remaining procedure time is displayed on the display. At the end of the procedure, sound and light signals are given using sound and light signaling elements that are not shown in Figure 1.

The invention makes it possible to create a universal and reliable device that makes it possible to increase the effectiveness of treatment of sensorineural hearing loss using the method of endaural phonoelectrophoresis.

An ATMEGA 2560 microprocessor on an Arduino MEGA2560 board can be used as a microprocessor in the apparatus for the diagnosis and treatment of sensorineural hearing loss, and a 360×480 TFT Display can be used as a display.

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

Current sensor AD 8065, analog-to-digital converter type AD 7818, amplifier with discretely variable gain AD8400, controlled current source AD 7376 and polarity switch ADG 433 from ANALOG DEVICES.

Clinical example.

Patient K., 47 years old, complained of hearing loss and high-frequency noise in the right ear. After pure tone threshold audiometry, the patient was diagnosed with acute right-sided degree II sensorineural hearing loss. The patient underwent a course of 10 procedures of endaural phonoelectrophoresis with dexamethasone. A developed apparatus was used, the procedure was carried out according to the method described above. During repeated audiometry, bone conduction thresholds increased by 10 dB at all frequencies.

Claims (1)

An apparatus for the treatment of sensorineural hearing loss using the method of endaural phonoelectrophoresis, containing an ultrasonic frequency oscillation generator, a bandpass filter, an ultrasonic frequency voltage amplifier with a discretely adjustable gain, a power amplifier, the first and second current sensors, the first and second current-to-voltage converters, a switching unit, and an amplitude detector current and amplitude voltage detector, the outputs of which are connected to the inputs of the switching unit, the input of the first current-to-voltage converter is connected to the current sensor, the input of the amplitude current detector is connected to the output of the first current-to-voltage converter, microprocessor, analog-to-digital converter, control panel, piezoelectric emitter , a transformer, the input of which is connected to the output of the first current sensor, the output of the transformer is connected to a piezoelectric emitter, an electrode for electrophoresis, an incremental encoder and a touch display are connected to the microprocessor and placed on the control panel, the first current sensor is connected between the output of the power amplifier and the transformer, control input amplifier with discretely adjustable gain and the output of the analog-to-digital converter are connected to the microprocessor, the input of the analog-to-digital converter is connected to the output of the switching unit, a controlled current source connected to the microprocessor, a polarity switch, the output of the controlled current source is connected to a polarity switch, the second current converter in voltage is connected between the output of the second current sensor and the microprocessor, the ultrasonic frequency oscillation generator 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 electrode for electrophoresis, characterized in that it additionally contains an ultrasound sensor placed in the body of the piezoelectric emitter and mechanically connected to the piezoelectric emitter, an additional ultrasonic frequency voltage amplifier, an additional amplitude voltage detector, an additional analog-to-digital converter, and the input of the additional ultrasonic frequency voltage amplifier is connected to the output of the ultrasonic sensor, the output of an additional ultrasonic frequency voltage amplifier is connected to the input of an additional amplitude voltage detector, the output of which is connected to the input of an additional analog-to-digital converter, the output of which is connected to the microprocessor, as well as a button for selecting operating modes located on the control panel and connected to the microprocessor , data entry button and service indicator of the piezoelectric emitter, the ultrasonic emitter is hinged on a flexible bracket that can be fixed in a given position and fixed to a fixed base.

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