US20130180528A1 - Implanted tongue pulling device, pull plate, pull line, retractor and method - Google Patents

Implanted tongue pulling device, pull plate, pull line, retractor and method Download PDF

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Publication number
US20130180528A1
US20130180528A1 US13/824,287 US201113824287A US2013180528A1 US 20130180528 A1 US20130180528 A1 US 20130180528A1 US 201113824287 A US201113824287 A US 201113824287A US 2013180528 A1 US2013180528 A1 US 2013180528A1
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Prior art keywords
pull
tongue
retractor
pull line
pull plate
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US13/824,287
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English (en)
Inventor
Xing Zhou
Xiangmin Zhang
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Guangzhou Tk Medical Instrument Co Ltd
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Individual
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Assigned to GUANGZHOU T.K MEDICAL INSTRUMENT CO., LTD. reassignment GUANGZHOU T.K MEDICAL INSTRUMENT CO., LTD. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ZHANG, XIANGMIN, ZHOU, XING
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/20—Epiglottis; Larynxes; Tracheae combined with larynxes or for use therewith
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/56—Devices for preventing snoring
    • A61F5/566—Intra-oral devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0404—Buttons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A61B2017/248—Operations for treatment of snoring, e.g. uvulopalatoplasty
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/56—Devices for preventing snoring

Definitions

  • the present invention relates to a tongue pulling device including a pull plate, a pull line, and a retractor, which are implanted into the mandible and the tongue body of a human body, and more particularly to a tongue pulling device including a pull plate, a pull line, and a retractor implanted in the tongue base and/or the tongue dorsum for treating adult obstructive sleep apnea/hypopnea syndrome (OSAHS) and an implantation method.
  • OSAHS adult obstructive sleep apnea/hypopnea syndrome
  • OSAHS is a sleep breathing disorder with clinical features of snoring and apnea caused by upper airway collapse and obstruction during sleep.
  • the major hazard of OSAHS is that frequent sleep apnea and hypopnea result in lowered oxygen saturation levels during sleep for a long term, causing a series of pathologic changes in the human body, thus becoming the cause of various systemic diseases (such as diabetes, hypertension, coronary heart disease, and cerebrovascular accident).
  • systemic diseases such as diabetes, hypertension, coronary heart disease, and cerebrovascular accident.
  • the morbidity of OSAHS is up to 6%-7% among people, and is extremely high among the middle-aged, which seriously affects the health and quality of life. Therefore, it has been listed by the World Health Organization as one of the major diseases that affect the health and quality of life of people.
  • OSAHS As for the pathogenesis of OSAHS, it is generally considered that the main cause is that, pharyngeal muscles for maintaining the upper airway open relax during sleep, resulting in soft tissue collapse and obstruction, and the plane of obstruction is usually located in the palatopharyngeal and glossopharyngeal portions.
  • Methods of Non-Surgical Treatment Mainly Include:
  • CPAP Continuous Positive Airway Pressure
  • a breathing machine capable of continuously generating a positive pressure is closely connected with the nose and face of a patient via a nasal mask, so as to prevent collapse and obstruction of the soft tissues of the airway during sleep.
  • the method is currently preferred for treating OSAHS. Though the method has a good effect, it is difficult for approximately 50% of the patients to adapt to the machine, and they cannot endure the machine due to poor compliance, and cannot sleep when wearing the machine.
  • Oral appliance A device is placed in an oral cavity to move forward the mandible or pull forward the tongue, so as to enlarge the pharyngeal cavity and release the airway obstruction during sleep.
  • the method has many types and produces a certain effect, but most patients cannot adapt to it.
  • the oral appliance leads to irritation and foreign body sensation, causing that the user cannot fall asleep, and may have temporo-mandibular joint injury with long term use.
  • Tongue pulling device International Application PCT/US2005/00139, Jan. 3, 2005 has disclosed a method and a device for relieving upper airway obstructions.
  • the device includes a mouthpiece that is adapted to form a sealed cavity within a patient' mouth. The patient bites the device during sleep, and extends the tongue into the device, so as to form the sealed cavity.
  • a negative pressure generator is connected with the device, which pulls the patient's tongue and/or soft tissues of the upper airway up and away from the posterior pharyngeal wall to open the airway, so as to prevent the occurrence of OSAHS.
  • Methods of Surgical Treatment Mainly Include:
  • Radiofrequency ablation which is also referred to as low-temperature plasma radiofrequency ablation, and is a minimally invasive surgical method.
  • An electrode is penetrated into the soft tissues which cause airway obstruction, such as the soft palate, tonsil, and tongue base, and is electrified to induce tissue coagulation, necrosis, fibrosis, and contraction by heating.
  • the method has a certain therapeutic effect, is effective for a slight case, has a poor long-term efficacy, and is ineffective for serious patients. Since the method causes severe post-surgical responses such as tissue edema and pain and requires multiple surgical operations, it is not easily acceptable to the patients.
  • Soft palate implantation International Application PCT/US2002/007966, Mar. 14, 2002, has disclosed a braided palatal implant for snoring treatment.
  • the braid is implanted into the soft palate to alter the center of gravity of the soft palate when swinging with the air flow and alter the aerodynamic characteristics of the soft palate, so as to increase the critical air flow speed at the soft palate and the pharynx, thereby preventing snoring from occurring.
  • the method fails to prevent OSAHS from occurring, for OSAHS occurs when the soft palate collapses and obstructs the upper airway, so that the method and the adopted implanted instrument cannot be used to treat OSAHS.
  • the risk of OSAHS is increased because the weight at the swinging portion of the soft palate is increased.
  • Tongue reduction surgery An electrosurgical knife or a laser is applied to remove tissues of the tongue body or tongue base portion, so as to achieve a volume reduction effect.
  • the method creates a large wound, and easily hurt important nerves and blood vessels of the tongue, impairing the normal function of the tongue.
  • Tongue advancement surgery including various surgical procedures such as advancement genioplasty and mandibular sagittal split osteotomy.
  • advancement genioplasty and mandibular sagittal split osteotomy have a poor long-term efficacy, and the latter creates a large wound.
  • U.S. Pat. Nos. 7,660,632B2, 6,587,725B1 and 6,251,126B1 introduce a method that uses electrical stimulation of the hypoglossal nerve and the tongue muscles to cause contraction of the tongue muscles when a patient is asleep lying on his/her back, so as to keep the airway behind the tongue. The effectiveness and tolerance of the method needs to be clinically evaluated.
  • the muscular layer of the tongue base portion belongs to soft tissues, the tongue muscles needs to move during speaking and swallowing every day, and different movements of the tongue muscles produce different forces. Since the surgical suture and the anchor are linear objects, they have a small contact area, and impose a cutting effect on the muscular layer of the tongue base portion under long-term alternate tensions, so that the fixing portion displaces, the tension is loosened, and finally the effect of tightening the tongue base portion is lost, failing to enlarge the airway at the glossopharyngeal portion.
  • the single-wire or double-wire tightening mode easily causes movement from the original implantation site. As a result, a wrong portion is tightened, and the tension is loosened, failing to enlarge the airway at the glossopharyngeal portion.
  • the tongue base pulling technology in the prior art does not allow adjustment after surgery, and the forward pulling distance of the tongue base portion and the tension can only be determined during surgical implantation. Since the contraction of scar tissues resulting from surgery varies greatly with different subjects, the forward pulling distance determined during surgery may not be that after recovery. However, if it is required to adjust the forward pulling distance of the tongue base portion, another surgery is needed, creating a new wound, and incurring additional medical expenses.
  • the tongue base pulling method in the prior art for treating OSAHS and snoring still have many defects, and especially it is difficult to control the pulling tension. If the tension is too high, the patient will feel discomfort, and the swallowing and speech functions are affected. If the tension is too low, an effective pulling effect cannot be achieved, resulting in poor efficacy. Therefore, it is necessary to provide a novel technical solution for treating OSAHS, in which the new method should create a wound as small as possible, and the new instrument should be safe, effective, simple, and reliable.
  • Airway collapse, stenosis, and obstruction are usually caused by factors such as tongue hypertrophy, degraded functions of related nerves and muscles of the tongue, and relaxation and collapse of the tongue muscles, and often occur in obese patients, patients with short mandible and middle-aged and elderly patients.
  • the pressure generated by the tension is 1000 g/cm 2 . Accordingly, in order to prevent cutting, the pressure generated by the implant when applying a tension of 3000 g to retract the soft tissues of the tongue base portion needs to be smaller than 1000 g/cm 2 .
  • the movement of the tongue is rather complex, and during speech, swallowing and other activities, the force generated during movement of the tongue may reach 2000 g to 3000 g.
  • the implant that is implanted into the soft tissues of the tongue base portion to produce a pulling effect is a linear object that does not have a large enough stressed area, it easily cuts the soft tissues of the tongue base portion. Firstly, such a cutting effect causes unnecessary injuries. Secondly, after the soft tissues of the tongue base portion are cut, the implant may displace, so that the tension is loosened, and finally the effect of retracting the tongue dorsum portion and/or the tongue base portion is lost, failing to treat OSAHS.
  • the present invention provides a novel technical solution, which achieves the objective of retracting the tongue base portion, avoids the cutting effect on the soft tissues of the tongue base portion that is caused by retracting the tongue dorsum portion and/or the tongue base portion, and allows adjustment of the pulling force after surgery.
  • the specific solution is as follows:
  • An implanted tongue pulling device implanted into the mandible ( 5 ) and the tongue body ( 4 ) of a human body to tighten the tongue dorsum ( 42 ) and/or the tongue base ( 41 ), suitable for treating obstructive sleep apnea/hypopnea syndrome (OSAHS), and including:
  • a pull plate ( 1 ) being a flat implant capable of being implanted under the mucous membrane layer of the tongue body, and including through holes ( 101 ) facilitating growth of fibrous tissues and pull line fixing mechanisms ( 102 );
  • a pull line ( 2 ) being a thread made of a material capable of being implanted into the human body for a long term
  • pull line ( 2 ) has one end connected to the pull plate ( 1 ) and the other end connected to the retractor ( 3 ).
  • a distance between the pull plate ( 1 ) and the retractor ( 3 ) is reduced by 5 mm to 20 mm due to pulling of the pull line ( 2 ); and a pressure generated by a force of the tongue muscles on the pull plate ( 1 ) due to the reduction in the distance between the pull plate ( 1 ) and the retractor ( 3 ) is lower than 7000 g/cm 2 , and is preferably 50 g/cm 2 to 1000 g/cm 2 .
  • the number of the pull line ( 2 ) is at least three, and each of the pull lines ( 2 ) has one end connected to the retractor ( 3 ) and the other end connected to a corresponding one of at least three pull line fixing mechanisms ( 102 ) of the pull plate ( 1 ) that are at different spatial positions, so as to spatially position the pull plate ( 1 ).
  • the number of the pull line ( 2 ) is at least four, and each of the four pull line ( 2 ) has one end connected to the retractor ( 3 ) and the other end connected to a corresponding one of the pull line fixing mechanisms ( 102 ) that are adjacent to four corners of the pull plate ( 1 ), so as to spatially position the pull plate ( 1 ).
  • Spatial positioning of the pull plate ( 1 ) by using three pull lines ( 2 ) is briefly referred to as a three-line spatial positioning method
  • spatial positioning of the pull plate ( 1 ) by using four pull lines ( 2 ) is briefly referred to as a four-line spatial positioning method, and so on.
  • a pull plate implanted into the tongue body ( 4 ) of a human body to tighten the tongue dorsum ( 42 ) and/or the tongue base ( 41 ), and suitable for treating obstructive sleep apnea/hypopnea syndrome (OSAHS), where the pull plate ( 1 ) is a flat implant capable of being implanted under the mucous membrane layer of the tongue body, and includes through holes ( 101 ) facilitating growth of fibrous tissues and pull line fixing mechanisms ( 102 ).
  • OSAHS obstructive sleep apnea/hypopnea syndrome
  • pull line fixing mechanisms ( 102 ) are through holes for winding, binding or fixing pull lines; catch-slot or concave-convex engagement mechanisms for fixing pull lines; or rivet fastening mechanisms or thread fastening mechanisms capable of fixing pull lines.
  • the area of the pull plate ( 1 ) is larger than 1.0 cm 2 , and is preferably 2.5 cm 2 to 16 cm 2 .
  • the pull plate ( 1 ) includes a frame ( 103 ) and medical films ( 104 ), and the medical films ( 104 ) are wrapped on the frame ( 103 ).
  • the frame ( 103 ) of the pull plate is a mesh formed by braided elastic wires, and the elastic wires ( 103 C) are capable of moving in a gap ( 105 ) between the medical films ( 104 ).
  • a mesh formed by braided elastic wires for example, a braided mesh of elastic metal wires such as shape memory alloy wires, may be adopted.
  • the elastic wires are capable of moving in the gap formed between the two layers of medical film ( 104 ), thereby maintaining good degrees of freedom.
  • the medical films ( 104 ) wrapped on the wire mesh effectively increase the stressed area, thereby avoiding cutting the soft tissues of the tongue base. In this way, it is a desirable structure that not only adapts to the requirements of movement of various muscle groups during the movement of the tongue, but also effectively increases the stressed area to avoid cutting the soft tissues of the tongue base.
  • the pull plate ( 1 ) has a curved surface matching with the shape of the tongue dorsum portion and/or the tongue base portion of the human body, and typical geometrical shapes include a rectangle, a square, a trapezoid, a circle, an ellipse, a V-shape, a U-shape and an H-shape.
  • Main geometric dimensions of the rectangular pull plate ( 1 ) include:
  • a radian R of the curved surface being 10 mm to 120 mm, and preferably 20 mm to 50 mm;
  • a width W of the curved surface being 10 mm to 50 mm, and preferably 15 mm to 30 mm;
  • a height H of the curved surface being 10 mm to 50 mm, and preferably 20 mm to 35 mm;
  • a thickness T of the plate being 0.1 mm to 1 mm, and preferably 0.4 mm to 0.8 mm;
  • a diameter ⁇ of the through hole ( 101 ) being 0.1 mm to 4 mm, and preferably 0.5 mm to 2 mm.
  • Main dimensions of the U-shaped pull plate ( 1 ) include:
  • a radian R of the curved surface being 10 mm to 120 mm, and preferably 20 mm to 50 mm;
  • a width W of the curved surface being 10 mm to 50 mm, and preferably 15 mm to 30 mm;
  • a height H of the curved surface being 10 mm to 50 mm, and preferably 20 mm to 35 mm;
  • a height H 1 being 5 mm to 20 mm, and preferably 5 mm to 15 mm;
  • a clearance C of the curved surface being 6 mm to 15 mm, and preferably 5 mm to 10 mm;
  • a thickness T of the plate being 0.1 mm to 1 mm, and preferably 0.4 mm to 0.8 mm;
  • a diameter ⁇ of the through hole ( 101 ) being 0.1 mm to 4 mm, and preferably 0.5 mm to 3 mm.
  • the pull plate ( 1 ) is made of a material selected from a group consisting of, but not limited to: medical metal materials, including medical grade titanium and titanium alloy, medical grade stainless steel, medical grade titanium-nickel shape memory alloy (Nitinol alloy), Ti—Zr—Ta alloy, and amorphous metal materials; and medical polymer materials, including polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP), medical grade polytetrafluoroethylene, fiber reinforced composite materials and the like.
  • medical metal materials including medical grade titanium and titanium alloy, medical grade stainless steel, medical grade titanium-nickel shape memory alloy (Nitinol alloy), Ti—Zr—Ta alloy, and amorphous metal materials
  • medical polymer materials including polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP), medical grade polytetrafluoroethylene, fiber reinforced composite materials and
  • the pull plate ( 1 ) includes a left-side pull plate ( 109 A) and a right-side pull plate ( 109 B); the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) are assembled together through a mechanical connection mechanism ( 109 E); and a gap ( 109 C) and junctions ( 109 D) are formed between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B).
  • the gap ( 109 C) has a maximum width (H 109 ) of 1 mm to 10 mm, and preferably 2 mm to 5 mm; and the gap ( 109 C) has a length (L 109 ) of 5 mm to 20 mm, and preferably 5 mm to 15 mm.
  • the mechanical connection mechanism ( 109 E) is a mechanical fixing mechanism capable of fixing two metal plates, and is selected from a group consisting of a rivet structure, a concave-convex engagement structure, a thread fixing structure and other mechanical fixing mechanisms.
  • the pull line ( 2 ) includes a draw line ( 201 ) and a sleeve ( 202 );
  • the draw line ( 201 ) is a flexible line made of a high-strength medical material;
  • the sleeve ( 202 ) is a hollow hose made of a flexible medical material; and the sleeve ( 202 ) is mounted over the draw line ( 201 ), and the draw line ( 201 ) is capable of moving axially in the sleeve ( 202 ).
  • the draw line ( 201 ) is a non-absorbable surgical suture.
  • the sleeve ( 202 ) is a multi-layer hollow hose, having an inner layer made of an ultra-smooth material, and an outer layer made of a highly biocompatible material facilitating growth, penetration and bonding of fibrous tissues.
  • Each draw line ( 201 ) of the pull line has a tensile strength of greater than 2000 g, and has a diameter of 0.3 mm to 1.3 mm, and preferably 0.35 mm to 0.6 mm; and the sleeve ( 202 ) has an inner diameter of 0.4 mm to 1.5 mm, and preferably 0.4 mm to 1.0 mm.
  • the material of the pull line ( 2 ) is selected from a group consisting of, but not limited to: metal lines; natural fiber lines; and synthetic fiber lines, including polyester lines, polyamide lines, polypropylene lines and the like.
  • the pull line ( 2 ) is formed by spirally braiding a plurality of wires having a diameter of 0.1 mm to 0.5 mm, the material of which is selected from a group consisting of, but not limited to: titanium and titanium alloy wires, Nitinol titanium wires, synthetic fiber wires and other medical material filaments.
  • the sleeve ( 202 ) of the pull line ( 2 ) is a corrugated tube.
  • the sleeve ( 202 ) of the pull line ( 2 ) is a coil spring tube.
  • the pull line ( 2 ) is a necklace structure formed by the draw line ( 201 ) and the sleeve ( 202 ) constituted by a string of beads ( 203 ).
  • the beads ( 203 ) may be riveted and fixed to the draw line ( 201 ), or may be slidably strung on the draw line ( 201 ).
  • a retractor implanted on the mandible ( 5 ) of a human body to fix a pull line ( 2 ), where the retractor ( 3 ) includes a control switch ( 301 ) capable of adjusting a tension of the pull line ( 2 ), a pull line fixing device ( 302 ) capable of fixing the pull line, and a casing ( 304 ), the control switch ( 301 ) and the pull line fixing device ( 302 ) being mounted in the casing ( 304 ).
  • control switch ( 301 ) of the retractor ( 3 ) is a thread structure or concave-convex engagement structure, and the tension of the pull line ( 2 ) is increased or reduced by adjusting the control switch ( 301 ).
  • the control switch ( 301 ) includes a tightening switch ( 301 C) capable of increasing the tension of the pull line ( 2 ) and a loosening switch ( 301 D) capable of reducing the tension of the pull line ( 2 ).
  • the control switch ( 301 ) includes a ratchet ( 301 B 2 ), the ratchet ( 301 B 2 ) is driven to rotate when the tightening switch ( 301 C) is pressed, and the ratchet ( 301 B 2 ) is released when the loosening switch ( 301 D) is pressed.
  • the control switch ( 301 ) includes a positioning convex step ( 301 A) and a positioning concave groove ( 301 B) engaged with each other, and the positioning convex step ( 301 A) and the positioning concave groove ( 301 B) form a concave-convex engagement structure for positioning.
  • the control switch ( 301 ) includes tooth racks ( 301 B 3 ), when the control switch ( 301 ) is pressed, the positioning convex step ( 301 A) of the control switch is capable of moving longitudinally along the tooth racks ( 301 B 3 ); and when the control switch ( 301 ) released, the positioning convex step ( 301 A) of the control switch is automatically engaged into the positioning concave groove ( 301 B) for the tooth racks ( 301 B 3 ), and the positioning convex step ( 301 A) of the control switch does not move longitudinally along the tooth racks ( 301 B 3 ).
  • the retractor ( 3 ) has a winding-type structure or displacement-type structure for adjusting the tension of the pull line ( 2 ); movement of the pull line ( 2 ) of the winding-type structure is achieved by winding the pull line ( 2 ) onto the bobbin ( 302 L) through rotation of the bobbin ( 302 L); and the displacement-type structure is achieved by rotary movement of a thread structure or reciprocating movement of a concave-convex engagement structure.
  • the retractor ( 3 ) includes an anti-cutting buffer device ( 303 ), the anti-cutting buffer device ( 303 ) is a spring structure, and the anti-cutting buffer device ( 303 ) is disposed inside the casing ( 304 ) and connected to the pull line fixing device ( 302 ); and when the tension of the pull line ( 2 ) is greater than a preset operational driving force of the spring structure or a pressure on the pull plate ( 1 ) is greater than a set value, the spring structure of the anti-cutting buffer device ( 303 ) deforms to automatically buffer the tension of the pull line ( 2 ), so as to prevent the pull plate ( 1 ) from cutting the tongue muscles.
  • the operational driving force of the spring structure of the anti-cutting buffer device ( 303 ) is smaller than 1000 g, or the preset value of the pressure on the pull plate ( 1 ) is smaller than 7000 g/cm 2 , and is preferably 500 g/cm 2 to 1500 g/cm 2 .
  • the retractor ( 3 ) includes a restoring spring ( 305 ), the restoring spring ( 305 ) is a coil spring; and the restoring spring ( 305 ) stores elastic deformation energy when compressed, and releases the stored elastic deformation energy when released.
  • the retractor ( 3 ) includes a protective sheath ( 306 ), the protective sheath ( 306 ) is a hollow hose made of a flexible medical material, and the protective sheath ( 306 ) is mounted in the casing ( 304 ).
  • the protective sheath ( 306 ) is a multi-layer hollow hose, having an inner layer made of an ultra-smooth material, and an outer layer made of a highly biocompatible material facilitating growth of fibrous tissues.
  • a silica gel plug ( 304 D) in a color similar to the skin color of the human body is disposed on the casing ( 304 ), the silica gel plug ( 304 D) is connected to the casing ( 304 ), and after the silica gel plug ( 304 D) is removed, the tension of the pull line ( 2 ) is adjusted by adjusting the control switch ( 301 ); during sleep, the pull line ( 2 ) is tightened to apply a tension to the pull plate ( 1 ), so as to tighten the tongue dorsum portion and/or the tongue base portion toward the mandible, thereby maintaining the airway at the palatopharyngeal portion open; and in a non-sleep state, the pull line ( 2 ) is loosened to release the pull plate ( 1 ) from the pull line ( 2 ), so as to allow the tongue to move freely, thereby maintaining normal swallowing and speech functions.
  • the retractor ( 3 ) is made of a material selected from a group consisting of, but not limited to: medical metal materials, including medical grade titanium and titanium alloy, medical grade stainless steel, medical grade titanium-nickel shape memory alloy (Nitinol alloy), Ti—Zr—Ta alloy, and amorphous metal materials; and medical polymer materials, including polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP), medical grade polytetrafluoroethylene, fiber reinforced composite materials and the like.
  • medical metal materials including medical grade titanium and titanium alloy, medical grade stainless steel, medical grade titanium-nickel shape memory alloy (Nitinol alloy), Ti—Zr—Ta alloy, and amorphous metal materials
  • medical polymer materials including polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP), medical grade polytetrafluoroethylene, fiber reinforced composite materials and
  • a method for treating obstructive sleep apnea/hypopnea syndrome including:
  • providing an implanted tongue pulling device where the tongue pulling device is implanted into the mandible ( 5 ) and the tongue body ( 4 ) of a human body to tighten the tongue dorsum ( 42 ) and/or the tongue base ( 41 ), is suitable for treating OSAHS, and includes:
  • a pull plate ( 1 ) being a flat implant capable of being implanted under the mucous membrane layer of the tongue body, and including through holes ( 101 ) allowing growth and penetration of fibrous tissues and pull line fixing mechanisms ( 102 );
  • a pull line ( 2 ) being a thread made of a material capable of being implanted into the human body for a long term
  • pull line ( 2 ) has one end connected to the pull plate ( 1 ) and the other end connected to the retractor ( 3 );
  • the implanted tongue pulling device pulls the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) forward by a distance of 5 mm to 20 mm;
  • the implanted tongue pulling device is capable of adjusting the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) by adjusting the control switch ( 301 ) after surgery.
  • the retractor ( 3 ) is fixed to the front portion ( 51 ) of the mandible, and the pull lines ( 2 ) are passed across the bottom portion ( 52 ) of the mandible and connected to the pull plate ( 1 ) that is implanted into the muscular layer under the mucous membrane layer of the tongue base portion and/or the tongue dorsum portion.
  • the retractor ( 3 ) is fixed to the bottom portion ( 52 ) of the mandible, and each of the pull lines ( 2 ) has one end connected to the retractor ( 3 ), and the other end connected to the pull plate ( 1 ) that is implanted into the muscular layer under the mucous membrane layer of the tongue base portion and/or the tongue dorsum portion.
  • the implanted tongue pulling device is capable of adjusting a pulling degree of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) after surgery, characterized in that:
  • the retractor ( 3 ) of the implanted tongue pulling device is mounted on the front surface of the mandible and close to the bottom portion of the mandible so that the control switch ( 301 ) faces upward, and after surgery, the patient pulls apart the lower lip, inserts a screwdriver ( 9 ) into a cross slot of the control switch ( 301 ), and rotates the control switch ( 301 ) to tighten or loosen the pull lines ( 2 ), so as to adjust the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ).
  • the implanted tongue pulling device is capable of adjusting a pulling degree of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) after surgery, characterized in that:
  • the retractor ( 3 ) of the implanted tongue pulling device is mounted on the front surface of the mandible and close to the bottom portion of the mandible so that the control switch ( 301 ) faces downward, and the silica gel plug ( 304 D) on the casing is exposed out of the skin at the bottom portion of the mandible; and when adjustment is needed, the silica gel plug ( 304 D) is removed, and the screwdriver ( 9 ) is used to rotate the control switch ( 301 ) to tighten or loosen the pull lines ( 2 ), so as to adjust the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ).
  • the implanted tongue pulling device is capable of adjusting a pulling degree of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) after surgery, characterized in that:
  • the retractor ( 3 ) of the implanted tongue pulling device is mounted on the front surface of the mandible and close to the bottom portion of the mandible, and the control switch ( 301 ) is divided into a tightening switch ( 301 C) and a loosening switch ( 301 D), and adopts a ratchet ( 301 B 2 ) as an adjustment structure;
  • the tightening switch ( 301 C) is pressed from a position outside the skin of the mandible corresponding to the tightening switch ( 301 C); each time when the tightening switch ( 301 C) is pressed, a positioning convex step ( 301 A) on the tightening switch ( 301 C) pushes the ratchet ( 301 B 2 ) to rotate by one step, so as to drive the pull line fixing device ( 302 ) to move to tighten the pull lines ( 2 ), thereby increasing the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ), and a positioning convex step ( 301 A) on the loosening switch ( 301 D) stops reverse rotation of the ratchet ( 301 B 2 ), so as to prevent loosening of the tightened pull lines ( 2 ); and
  • the loosening switch ( 301 D) in a non-sleep state, the loosening switch ( 301 D) is pressed from a position outside the skin of the mandible corresponding to the loosening switch ( 301 D); and when the loosening switch ( 301 D) is pressed, the ratchet ( 301 B 2 ) is released, the ratchet ( 301 B 2 ) is in a free state, the pull lines ( 2 ) are in a loosened state, and under the movement of the tongue or the action of a restoring spring ( 305 ), the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) is reduced.
  • the implanted tongue pulling device is capable of adjusting a pulling degree of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) after surgery, characterized in that:
  • the retractor ( 3 ) of the implanted tongue pulling device is mounted at the bottom portion of the mandible, and after surgery, by pressing the control switch ( 301 ) from the skin of the bottom portion of the mandible of the patient and at the same time pushing or pulling the control switch ( 301 ), the patient is capable of adjusting the pulling degree of the tongue dorsum portion and/or the tongue base portion being pulled by the pull lines ( 2 ):
  • the control switch ( 301 ) in a non-sleep state, the control switch ( 301 ) is pressed and pushed toward the tongue base portion so that the pull lines ( 2 ) apply a small pulling force to the tongue base portion or are completely in a loosened state, and then the control switch ( 301 ) is released so that the control switch ( 301 ) is automatically positioned and locked, that is, the control switch ( 301 ) is adjusted to an “off” state, and at this time, the tongue base portion is almost unconstrained, and the tongue is capable of moving freely during speaking, swallowing and other activities; and
  • control switch ( 301 ) before sleep, the control switch ( 301 ) is pressed and pulled toward the mandible so that the control switch ( 301 ) is adjusted to an “on” state, and at this time, the pull lines ( 2 ) apply a large pulling force to the tongue base portion, so that the tongue base portion is in an effective retracted state, and the tongue base portion is pulled forward, so as to maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • the implanted tongue pulling device is capable of adjusting a pulling degree of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) after surgery, characterized in that:
  • the retractor ( 3 ) of the implanted tongue pulling device is mounted on the front surface of the mandible and close to the bottom portion of the mandible, and a degree of comfort is set by adjusting the control switch ( 301 ); and the control switch ( 301 ) is adjusted so that the pull lines ( 2 ) maintain a proper tension to maintain the forward pulling distance of the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) at a proper distance, so as to move the tongue dorsum portion ( 42 ) and/or the tongue base portion ( 41 ) forward while ensuring comfort during movement of the tongue, and maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • the tongue pulling device and the implantation method provided in the present invention effectively solve the technical problem that the tongue muscles are easily cut during pulling, and the patient can adjust the tongue pulling device of the present invention after surgery to reduce the pulling force in the non-sleep state and ensure effective pulling during sleep, so as to enlarge the airway at the palatopharyngeal portion, thereby preventing OSAHS.
  • the present invention has the following innovative points:
  • a surgical method for implanting a tongue pulling device with a combined-type pull plate of the present invention mainly includes the following steps:
  • surgical sites such as the tongue and the oral cavity are disinfected under anesthesia according to general requirements of oral cavity, head and neck surgeries.
  • each of two pull lines is fixed to a left-side pull plate ( 109 A), and one end of each of another two pull lines is fixed to a right-side pull plate ( 109 B); then, a surgical knife is used to make incisions of about 3 mm to 6 mm at a position about 10 mm to 15 mm from circumvallate papillae of the tongue and beside two sides of the midline of the tongue, and of about 8 mm transversely cutting the mucous membrane of the tongue, and a moderately curved hemostatic forceps is used to separate the mucous membrane toward the tongue base, so as to form an about 40 mm deep surgical cavity on left and right sides of the midline of the tongue respectively; a special surgical forceps ( 13 ) is used to simultaneously insert the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) into the surgical cavities below the mucous membrane of the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) to be retracted,
  • the pull lines ( 2 ) are drawn to the vicinity of the mandible ( 5 ) by using a guide needle.
  • the contact area between the pull plate ( 1 ) and the retracted portion of the tongue body is increased, so that the pressure generated during pulling is greatly reduced, which not only improves the pulling effect, but also avoids cutting the tongue tissues when the tongue body is retracted, thereby reducing injuries.
  • the combined-type pull plate ( 1 ) formed by the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) continuity of musculus genioglossus and other fibrous tissues to the fibrous tissues under the mucous membrane of the tongue dorsum or the tongue base is maintained to the maximum extent, thereby further enhancing the capability of spatially positioning the pull plate ( 1 ) and improving the effect of retracting the tongue dorsum ( 42 ) and/or the tongue base ( 41 ).
  • the retractor ( 3 ) is conveniently fixed to the mandible ( 5 ), and the pull lines ( 2 ) are fixed to the retractor ( 3 ), so that the pulling degree of the pull lines ( 2 ) can be conveniently adjusted to accurately control the pulling distance and the pulling force, thereby achieving an optimal therapeutic effect.
  • the double-button type retractor ( 3 ) that can be adjusted after surgery not only the doctor can conveniently adjust and fix the pull lines ( 2 ) during surgery, but also woundless adjustment can be achieved after surgery.
  • FIG. 1 is a schematic structural view of a tongue pulling device implanted into the mandible and the tongue body according to the present invention
  • FIG. 2 is a schematic structural view of a tongue pulling device having a rectangular pull plate according to the present invention
  • FIG. 3 is a schematic structural view of a tongue pulling device using two pull plates according to the present invention.
  • FIG. 4 is a schematic structural view of a tongue pulling device having a U-shaped pull plate according to the present invention.
  • FIG. 5 is a schematic structural view of a tongue pulling device having a coating according to the present invention.
  • FIG. 6 is a schematic structural view of a tongue pulling device having an H-shaped pull plate according to the present invention.
  • FIG. 7 is a schematic structural view of a tongue pulling device having a V-shaped pull plate according to the present invention.
  • FIG. 7A is a schematic structural view of pull lines wound on pull line fixing mechanisms of a through-hole type according to the present invention.
  • FIG. 7B is a schematic structural view of pull lines bound on pull line fixing mechanisms of a through-hole type according to the present invention.
  • FIG. 7C is a schematic structural view of pull lines fixed to pull line fixing mechanisms having a concave-convex engagement structure according to the present invention.
  • FIG. 7D is a schematic structural view of pull lines fixed to pull line fixing mechanisms of a rivet type according to the present invention.
  • FIG. 7E is a schematic structural view of pull lines fixed to pull line fixing mechanisms of a thread type according to the present invention.
  • FIG. 8A is a schematic structural view of a pull plate having a composite structure according to the present invention.
  • FIG. 8B is an A-A cross-sectional view of FIG. 8A ;
  • FIG. 9A is a schematic structural view of a pull plate having a wire-braided composite structure according to the present invention.
  • FIG. 9B is a B-B cross-sectional view of FIG. 9A ;
  • FIG. 9C is an enlarged view of part A of FIG. 9A ;
  • FIG. 10A is a schematic structural view of a composite pull line according to the present invention.
  • FIG. 10B is a schematic structural view of a multi-layer composite pull line according to the present invention.
  • FIG. 10C depicts the working principle of the composite pull line of FIG. 10A when being implanted into a human body
  • FIG. 11A is a schematic structural view of a retractor of a bolt adjustment type according to the present invention.
  • FIG. 11B is a schematic structural view of the retractor of FIG. 11A after the position of the pull line fixing device is moved;
  • FIG. 11C is a three-dimensional view showing the top structure of the retractor of FIG. 11A ;
  • FIG. 11D is an exploded view of the retractor of FIG. 11A ;
  • FIG. 11E is a three-dimensional view showing the bottom structure of the retractor of FIG. 11A ;
  • FIG. 12A is a schematic structural view of a retractor of a bolt adjustment type having a sealing top cover according to the present invention
  • FIG. 12B is a schematic structural view of the retractor of FIG. 12A after the position of the pull line fixing device is moved;
  • FIG. 13A is a schematic structural view of a retractor of a bolt adjustment type having an anti-cutting buffer device according to the present invention
  • FIG. 13B is a schematic structural view of the retractor of FIG. 13A after the position of the pull line fixing device is moved;
  • FIG. 13C is a three-dimensional view showing the top structure of the retractor of FIG. 13A ;
  • FIG. 13D is an exploded view of the thread-type retractor of FIG. 13A .
  • FIG. 13E is a three-dimensional view showing the bottom structure of the thread-type retractor of FIG. 13A ;
  • FIG. 14A is a schematic structural view of a retractor of a nut adjustment type according to the present invention.
  • FIG. 14B is a schematic structural view of the retractor of FIG. 14A after the position of the pull line fixing device is moved;
  • FIG. 14C is a three-dimensional view showing the bottom structure of the retractor of FIG. 14A ;
  • FIG. 14D is an exploded view of the retractor of FIG. 14A ;
  • FIG. 14E is a three-dimensional view showing the top structure of the retractor of FIG. 14A ;
  • FIG. 15A is a schematic structural view of a retractor of a nut adjustment type having an anti-cutting buffer device according to the present invention.
  • FIG. 15B is a schematic structural view of the retractor of FIG. 15A after the position of the pull line fixing device is moved;
  • FIG. 15C is a three-dimensional view showing the bottom structure of the retractor of FIG. 15A ;
  • FIG. 15D is an exploded view of the retractor of FIG. 15A ;
  • FIG. 15E is a three-dimensional view showing the top structure of the retractor of FIG. 15A ;
  • FIG. 16A is a schematic structural view of a push-pull type retractor according to the present invention.
  • FIG. 16B is a schematic structural view of the retractor of FIG. 16A after the position of the pull line fixing device is moved;
  • FIG. 16C is a three-dimensional view showing the bottom structure of the retractor of FIG. 16A ;
  • FIG. 16D is an exploded view of the retractor of FIG. 16A ;
  • FIG. 16E is a three-dimensional view showing the top structure of the retractor of FIG. 16A ;
  • FIG. 17A is a schematic structural view of a push-pull type retractor having an anti-cutting buffer device according to the present invention.
  • FIG. 17B is a schematic structural view of the retractor of FIG. 17A after the position of the pull line fixing device is moved;
  • FIG. 17C is a three-dimensional view showing the bottom structure of the retractor of FIG. 17A ;
  • FIG. 17D is an exploded view of the retractor of FIG. 17A ;
  • FIG. 17E is a three-dimensional view showing the top structure of the retractor of FIG. 17A ;
  • FIG. 18A is a schematic structural view of a clutch-type retractor according to the present invention.
  • FIG. 18B is a schematic structural view of the retractor of FIG. 18A in a disassembled state
  • FIG. 18C is an exploded view of the retractor of FIG. 18A ;
  • FIG. 18D is a three-dimensional view showing the side structure of the retractor of FIG. 18A ;
  • FIG. 18E is a three-dimensional view showing the structure of the control switch of the retractor of FIG. 18A ;
  • FIG. 18F is a view depicting the working principle of the retractor of FIG. 18A when the clutch-type retractor is disassembled;
  • FIG. 18G is a view depicting the working principle of the retractor of FIG. 18A when the clutch-type retractor is assembled;
  • FIG. 19A is a schematic structural view of a clutch-type retractor having an anti-cutting buffer device according to the present invention.
  • FIG. 19B is a schematic structural view of the retractor of FIG. 19A in a disassembled state
  • FIG. 19C is an exploded view of the retractor of FIG. 19A ;
  • FIG. 19D is a three-dimensional view showing the side structure of the retractor of FIG. 19A ;
  • FIG. 19E is a three-dimensional view showing the structure of the control switch of the retractor of FIG. 19A ;
  • FIG. 19F is a view depicting the working principle of the retractor of FIG. 19A when the clutch-type retractor is disassembled;
  • FIG. 19G is a view depicting the working principle of the retractor of FIG. 19A when the clutch-type retractor is assembled;
  • FIG. 20A is a schematic structural view of a ratchet-type retractor according to the present invention.
  • FIG. 20B is a schematic structural view of the retractor of FIG. 20A in a disassembled state
  • FIG. 20C is an exploded view of the retractor of FIG. 20A ;
  • FIG. 20D is a three-dimensional view of the retractor of FIG. 20A ;
  • FIG. 21A is a three-dimensional view of a single-switch push-pull type retractor according to the present invention.
  • FIG. 21B is a longitudinal cross-sectional view of FIG. 21A ;
  • FIG. 21C is a transversal cross-sectional view of FIG. 21A ;
  • FIG. 21D is a schematic structural view of the retractor of FIG. 21C after the control switch is pressed;
  • FIG. 21E is a three-dimensional view showing the control switch of FIG. 21A ;
  • FIG. 21F is a three-dimensional view showing positioning tooth racks of FIG. 21A ;
  • FIG. 21G is an exploded view of the retractor of FIG. 21A ;
  • FIG. 21H is an exploded view of a positioning slide block
  • FIG. 21I a mounting view of and a view depicting the working principle of the retractor of FIG. 21A ;
  • FIG. 21K is a mounting view of the retractor of FIG. 21A ;
  • FIG. 22A is a three-dimensional view of a double-button ratchet-type retractor according to the present invention.
  • FIG. 22B is a schematic structural view of the retractor of FIG. 22A ;
  • FIG. 22C is a view depicting the working principle of the retractor of FIG. 22A when the tightening switch pressed;
  • FIG. 22D is a view depicting the working principle of the retractor of FIG. 22A when the loosening switch pressed;
  • FIG. 22E is a longitudinal cross-sectional view of FIG. 22A ;
  • FIG. 22F is a transversal cross-sectional view of FIG. 22A ;
  • FIG. 22G is an exploded view showing the structure of the ratchet and the control switch
  • FIG. 22H is an exploded view showing the structure of the ratchet and the restoring spring
  • FIG. 22I is a three-dimensional view of a button-type retractor that has a protective sheath and can be adjusted after surgery according to the present invention
  • FIG. 22J is a longitudinal cross-sectional view of FIG. 22I ;
  • FIG. 22K is a transversal cross-sectional view of FIG. 22A ;
  • FIG. 22L is a mounting view of a button-type retractor that can be adjusted after surgery in a tongue pulling device according to the present invention
  • FIG. 22M is a mounting view of a button-type retractor that can be adjusted after surgery in a tongue pulling device according to the present invention
  • FIG. 22N is a mounting view of a button-type retractor that can be adjusted after surgery in a tongue pulling device according to the present invention
  • FIG. 22P is a view depicting the working principle
  • FIG. 22Q is a view depicting the working principle
  • FIG. 23A is a schematic structural view of a double-button ratchet thread-type retractor according to the present invention.
  • FIG. 23B is a schematic structural view of the retractor of FIG. 23A ;
  • FIG. 23C is a view depicting the working principle of the retractor of FIG. 23A ;
  • FIG. 23D is a view depicting the working principle of the retractor of FIG. 23A ;
  • FIG. 24A is a schematic structural view of a tongue pulling device in which a retractor of a bolt adjustment type is mounted to the anterior part of the mandible according to the present invention
  • FIG. 24B is a schematic mounting view of the tongue pulling device of FIG. 24A ;
  • FIG. 24C is a view depicting the working principle of adjusting the tongue pulling device of FIG. 24A by using a screwdriver;
  • FIG. 25A is a schematic mounting view of a winding clutch-type tongue pulling device according to the present invention.
  • FIG. 25B is a view depicting the working principle of adjusting the tongue pulling device of FIG. 25A ;
  • FIG. 26A is a schematic mounting view of a double-retractor tongue pulling device according to the present invention.
  • FIG. 26B is a schematic structural view of a double-retractor tongue pulling device according to the present invention.
  • FIG. 27A is a schematic structural view of a combined-type pull plate according to the present invention.
  • FIG. 27B is a side view of FIG. 27A ;
  • FIG. 27C is a left view of FIG. 27A ;
  • FIG. 27D is a right view of FIG. 27A ;
  • FIG. 27E is an E-E cross-sectional view of FIG. 27A ;
  • FIG. 27 E 1 is an enlarged view of part M of FIG. 27E ;
  • FIG. 27F is an F-F cross-sectional view of FIG. 27A ;
  • FIG. 27 F 1 is an enlarged view of part N of FIG. 27E ;
  • FIG. 27G is a three-dimensional schematic structural view of FIG. 27A ;
  • FIG. 27H is a three-dimensional schematic structural view of the back side of FIG. 27G ;
  • FIG. 27I is an exploded view of FIG. 27H ;
  • FIG. 27J is a schematic structural view depicting that the left-side pull plate and right-side pull plate of FIG. 27A are respectively mounted at jaws of a surgical forceps;
  • FIG. 27K is a schematic structural view of combining the left-side pull plate and right-side pull plate by using the special surgical forceps of FIG. 27J ;
  • FIG. 27L is a view depicting the working principle of a tongue pulling device using the combined-type pull plate according to the present invention.
  • FIG. 28A is a schematic structural view of a U-shaped combined-type pull plate according to the present invention.
  • FIG. 28B is a side view of FIG. 28A ;
  • FIG. 28C is a left view of FIG. 28A ;
  • FIG. 28D is a right view of FIG. 28A ;
  • FIG. 28E is a G-G cross-sectional view of FIG. 28A ;
  • FIG. 28 E 1 is an enlarged view of part N of FIG. 28E ;
  • FIG. 28F is an H-H cross-sectional view of FIG. 28A ;
  • FIG. 28G is a three-dimensional schematic structural view of FIG. 28A ;
  • FIG. 28H is a three-dimensional schematic structural view of the back side of FIG. 28G ;
  • FIG. 28I is a schematic structural view of the combined-type pull plate of FIG. 28G mounted with pull lines;
  • FIG. 28J is an exploded view of FIG. 28I ;
  • FIG. 28K is a view depicting the working principle of a tongue pulling device using the U-shaped combined-type pull plate according to the present invention.
  • FIG. 29A is a schematic structural view of a pull line formed by braiding multiple metal wires according to the present invention.
  • FIG. 30A is a schematic structural view of a composite pull line of a continuous corrugated tube type according to the present invention.
  • FIG. 30B is a schematic structural view of a composite pull line of a discontinuous corrugated tube type according to the present invention.
  • FIG. 31A is a schematic structural view of a composite pull line of a continuous spiral tube type according to the present invention.
  • FIG. 31B is a schematic structural view of a composite pull line of a discontinuous spiral tube type according to the present invention.
  • FIG. 32 is a schematic structural view of a pull line of a titanium metal bead type according to the present invention.
  • 109 A left-side pull plate
  • 109 B right-side pull plate
  • 109 C gap between left-side pull plate and the right-side pull plate
  • 109 D junction between the left-side pull plate and the right-side pull plate
  • 109 E mechanical connection mechanism
  • 109 E 1 rivet
  • 109 E 2 rivet base
  • 109 E 3 lock nut for concave-convex engagement
  • 109 E 4 lock screw for concave-convex engagement
  • H 109 maximum width of the gap between left-side pull plate and the right-side pull plate
  • L 109 maximum length of the gap between the left-side pull plate and the right-side pull plate
  • control switch 302 . pull line fixing device, 303 . anti-cutting buffer device, 304 . retractor casing, 305 . restoring spring, 306 . protective sheath
  • 301 A positioning convex step of control switch
  • 301 B positioning concave groove of control switch
  • 301 C tightening switch
  • 301 D loosening switch
  • 301 E spring
  • 301 F adjustment handle
  • 301 G spring positioning post
  • 301 B 1 concave gear
  • wedge-shaped slide block ( 301 A 2 ) on the tightening switch the spring ( 301 E 2 ) on the tightening switch
  • 301 B 2 ratchet
  • 301 B 3 tooth rack
  • this embodiment shows the basic structure of a tongue pulling device of the present invention.
  • the tongue pulling device of the present invention includes a pull plate ( 1 ), a pull line ( 2 ), and a retractor ( 3 ).
  • the pull plate ( 1 ) is a flat implant capable of being implanted under the mucous membrane layer of the tongue base portion and/or the tongue dorsum portion of a human body, and includes through holes ( 101 ) allowing growth and penetration of human tissues and pull line fixing mechanisms ( 102 ).
  • the pull line ( 2 ) is a thread made of a material capable of being implanted into the human body for a long term.
  • the retractor ( 3 ) includes a control switch ( 301 ) capable of adjusting a tension of the pull line ( 2 ), a pull line fixing mechanism ( 302 ), and a casing ( 304 ).
  • the pull line ( 2 ) has one end connected to the pull plate ( 1 ) and the other end connected to the retractor ( 3 ).
  • the pull plate ( 1 ) is implanted into the muscular layer under the mucous membrane layer of the tongue dorsum portion.
  • the retractor ( 3 ) is fixed to the mandible ( 5 ) by using a screw ( 10 ).
  • the pull line fixing mechanisms ( 102 ) are through holes for winding and fixing the pull line ( 2 ).
  • the pull plate ( 1 ) is retracted by using a four-line four-corner spatial positioning method, that is, by using four pull lines ( 2 ), where one end of each of the four pull lines is fixed to a corresponding one of the pull line fixing mechanisms ( 102 ) at four corners of the pull plate ( 1 ), and the other end of each of the four pull lines is passed through the protective sheath ( 306 ) and fixed to the retractor ( 3 ), so as to achieve three-dimensional fixing.
  • a four-line four-corner spatial positioning method that is, by using four pull lines ( 2 ), where one end of each of the four pull lines is fixed to a corresponding one of the pull line fixing mechanisms ( 102 ) at four corners of the pull plate ( 1 ), and the other end of each of the four pull lines is passed through the protective sheath ( 306 ) and fixed to the retractor ( 3 ), so as to achieve three-dimensional fixing.
  • the pull plate ( 1 ) Since the pull plate ( 1 ) has a spatial curved surface matching with the shape of the tongue base portion and/or the tongue dorsum portion, the tongue body is retracted in a surface contact manner, so that the pressure generated by retracting the tongue base portion and/or the tongue dorsum portion is greatly reduced, thereby preventing the pull plate ( 1 ) from cutting the tongue muscles under long-term alternate tensions.
  • the pressure generated by the tension on the pull plate ( 1 ) may be smaller than 1000 g/cm 2 , for example, under a tension of 3000 g, if the pressure generated by the tension on the pull plate ( 1 ) needs to be smaller than 500 g/cm 2 , the area of the pull plate ( 1 ) only needs to be larger than 6 cm 2 , that is, the pull plate ( 1 ) only needs to be a 25 mm ⁇ 25 mm square.
  • the patient can adjust the pulling degree of the tongue pulling device of the present invention to the tongue base portion and/or the tongue dorsum portion under the instruction of the doctor, so as to achieve maximum comfort, as shown in FIG. 22A to FIG. 22Q .
  • the control switch ( 301 ) is pressed from a position outside the skin ( 8 ) of the mandible to loosen the pull lines ( 2 ), so as to increase the length of the pull lines ( 2 ) between the pull plate ( 1 ) and the retractor ( 3 ), so that the pull lines ( 2 ) apply a small pulling force to the tongue base portion and/or the tongue dorsum portion or are completely in a loosened state, and at this time, the movement of the tongue is almost unconstrained, and the tongue is capable of moving freely during speaking, swallowing and other activities, thereby ensuring free movement of the tongue during speaking, swallowing and other activities.
  • the control switch ( 301 ) is pressed from the position outside the skin ( 8 ) of the mandible to tighten the pull lines ( 2 ), so as to reduce the length of the pull lines ( 2 ) between the pull plate ( 1 ) and the retractor ( 3 ), and at this time, the pull line ( 2 ) applies a large pulling force to the tongue base portion and/or the tongue dorsum portion, the tongue base portion and/or the tongue dorsum portion is in an effective retracted state, and the tongue base portion and/or the tongue dorsum portion is pulled forward, so as to maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • a degree of comfort may also be set for the tongue pulling device of the present invention.
  • the control switch ( 301 ) may be adjusted so that the pull line ( 2 ) applies a proper pulling force to the tongue base portion and/or the tongue dorsum portion, so as to move the tongue base portion and/or the tongue dorsum portion forward while ensuring comfort during movement of the tongue, and maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • the pull plate ( 1 ) adopts a rectangular spatial curved plate structure.
  • Main dimensions of the rectangular pull plate ( 1 ) include:
  • a radian R of the curved surface being 10 mm to 120 mm, and preferably 20 mm to 50 mm;
  • a width W of the curved surface being 10 mm to 50 mm, and preferably 15 mm to 30 mm;
  • a height H of the curved surface being 10 mm to 50 mm, and preferably 20 mm to 35 mm;
  • a thickness T of the plate being 0.1 mm to 1 mm, and preferably 0.4 mm to 0.8 mm;
  • a diameter ⁇ of the through hole ( 101 ) being 0.1 mm to 4 mm, and preferably 0.5 mm to 2 mm.
  • Typical dimensions include: 15 mm ⁇ 20 mm, 18 mm ⁇ 25 mm, 20 mm ⁇ 30 mm, 25 mm ⁇ 35 mm, 30 mm ⁇ 35 mm, 35 mm ⁇ 35 mm, 35 mm ⁇ 40 mm, 40 mm ⁇ 40 mm and the like.
  • the pull plate ( 1 ) is made of a material selected from a group consisting of, but not limited to: medical metal materials, medical polymer materials, medical composite materials, metal amorphous materials (also referred to as metallic glass) for medical use, and various modified coating materials. Specific materials are generally selected from a group consisting of:
  • Medical grade PA Medical grade PA, medical grade PC, medical grade PE, medical grade PU, medical grade PP, medical grade polytetrafluoroethylene and other medical polymer materials and fiber reinforced composite materials.
  • the basic principle of this embodiment is similar to that of Embodiment 2 shown in FIG. 2 .
  • the difference lies in that: two the pull plates ( 1 ) are used, which are mounted on left and right sides of the tongue base portion and/or the tongue dorsum portion, and disposed into the muscular layer under the mucous membrane layer, where each of the pull plates ( 1 ) is fixed by using four pull lines ( 2 ), and therefore, a total of eight pull lines are used.
  • the basic principle of this embodiment is similar to that of Embodiment 2 shown in FIG. 2 .
  • the difference lies in that: the pull plate ( 1 ) adopts a U-shaped structure, and the pull plate ( 1 ) of the U-shaped structure is particularly suitable for retracting the tongue dorsum portion and the junction between the tongue dorsum portion and the tongue base.
  • the pulling of the tongue dorsum portion and the junction between the tongue dorsum portion and the tongue base is an effective means for enlarging the palatopharyngeal portion to prevent OSAHS.
  • Main dimensions of the U-shaped pull plate ( 1 ) include:
  • a radian R of the curved surface being 10 mm to 120 mm, and preferably 20 mm to 50 mm;
  • a width W of the curved surface being 10 mm to 50 mm, and preferably 15 mm to 30 mm;
  • a height H of the curved surface being 10 mm to 50 mm, and preferably 20 mm to 35 mm;
  • a height H 1 being 5 mm to 20 mm, and preferably 5 mm to 15 mm;
  • a clearance C of the curved surface being 6 mm to 15 mm, and preferably 5 mm to 10 mm;
  • a thickness T of the plate being 0.1 mm to 1 mm, and preferably 0.4 mm to 0.8 mm;
  • a diameter ⁇ of the through hole ( 101 ) being 0.1 mm to 4 mm, and preferably 0.5 mm to 3 mm.
  • the U-shaped pull plate ( 1 ) is generally made of a medical metal material, particularly, medical grade pure titanium, medical grade titanium alloy, Ti—Zr—Ta alloy, Co—Cr—W alloy, a Ti-based amorphous material, a Zr-based amorphous material, a Fe-based amorphous materials, medical grade stainless steel (such as 316 L), medical grade stainless steel with an amorphous material coating, or the like.
  • a medical metal material particularly, medical grade pure titanium, medical grade titanium alloy, Ti—Zr—Ta alloy, Co—Cr—W alloy, a Ti-based amorphous material, a Zr-based amorphous material, a Fe-based amorphous materials, medical grade stainless steel (such as 316 L), medical grade stainless steel with an amorphous material coating, or the like.
  • the pull plate ( 1 ) has a coating ( 107 ).
  • the coating ( 107 ) has higher biocompatibility than that of the substrate material.
  • the material of the pull plate ( 1 ) is 316 L stainless steel
  • a pure titanium metal coating may be manufactured on the surface of a 316 L stainless steel substrate by plasma spraying or magnetron sputtering. Since pure titanium metal has higher biocompatibility than that of 316 L stainless steel, the growth and penetration of fibrous tissues of the human body are made easier.
  • the coating ( 107 ) on the surface of the pull plate ( 1 ) may be manufactured into a Ti-based amorphous coating by magnetron sputtering.
  • the Ti-based amorphous coating has excellent biocompatibility, and can form a firm bond with human tissues.
  • the pull plate ( 1 ) adopts an H-shaped structure, that is, the geometrical shape of the pull plate ( 1 ) is similar to an H-shape.
  • the pull plate ( 1 ) includes tiny through holes ( 101 ) facilitating growth of tissues, and the through holes ( 101 ) have a diameter of smaller than 1 mm.
  • the pull plate ( 1 ) further includes pull line fixing mechanisms ( 102 ), and the pull line fixing mechanisms ( 102 ) are through holes having a diameter of 2 mm to 3 mm.
  • the pull plate ( 1 ) is made of a medical polymer material.
  • the pull plate ( 1 ) made of the medical polymer material is lighter, and is more suitable for being implanted into the tongue dorsum portion and/or the tongue base portion.
  • the medical polymer material is generally selected from a group consisting of: materials such as polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP) and medical grade polytetrafluoroethylene, and fiber reinforced composite materials such as fiber reinforced PC, fiber reinforced PE, fiber reinforced PU, fiber reinforced PP and fiber reinforced PA.
  • materials such as polyamide (PA), polycarbonate (PC), polyurethane (PU), polythylene/polythene (PE), polypropylene (PP) and medical grade polytetrafluoroethylene
  • fiber reinforced composite materials such as fiber reinforced PC, fiber reinforced PE, fiber reinforced PU, fiber reinforced PP and fiber reinforced PA.
  • the pull plate ( 1 ) adopts a V-shaped structure, that is, the geometrical shape of the pull plate ( 1 ) is similar to a V-shape.
  • the pull plate ( 1 ) includes tiny through holes ( 101 ) facilitating growth of tissues, and the through holes ( 101 ) have a diameter of smaller than 1 mm.
  • the pull plate ( 1 ) further includes pull line fixing mechanisms ( 102 ), and the pull line fixing mechanisms ( 102 ) are through holes having a diameter of 2 mm to 3 mm. In this embodiment, there are a total of three through holes serving as the pull line fixing mechanisms ( 102 ).
  • the three-line positioning method is adopted, that is, three pull lines ( 2 ) are used to spatially position the pull plate ( 1 ).
  • One of the pull lines ( 2 ) is bound to the through hole that serves as the pull line fixing mechanism ( 102 ) at the top of the V-shaped pull plate ( 1 ), and the other two pull lines ( 2 ) are respectively bound to the two through holes that serve as the pull line fixing mechanisms ( 102 ) at the bottom of the V-shaped pull plate ( 1 ); the other end of each of the three pull lines ( 2 ) is fixed to the retractor ( 3 ), so as to spatially position the pull plate ( 1 ).
  • the pull plate ( 1 ) may be made of a high-strength medical polymer fiber braid.
  • the high-strength polymer fiber braid is, for example, polypropylene fiber braided fabric, which not only has high strength, but also is light in weight, and therefore is suitable for manufacturing the pull plate ( 1 ).
  • the pull plate ( 1 ) is made of the polypropylene fiber braided fabric.
  • the fiber braided fabric has many tiny holes, which may function as the tiny through holes ( 101 ) for facilitating growth of tissues, and it only needs to form through holes as the pull line fixing mechanisms ( 102 ).
  • the pull line fixing mechanisms ( 102 ) may be designed into different specific structures.
  • the most common structure of the pull line fixing mechanisms ( 102 ) is a through hole structure, which not only facilitates winding the pull lines, but also facilitates binding and fixing the pull lines.
  • the pull lines ( 2 ) are wound to the through holes ( 102 ) serving as the pull line fixing mechanisms for two turns and then pulled back.
  • the pull lines ( 2 ) are bound, tied, and fixed to the through holes ( 102 ).
  • one of methods for fixing the pull line ( 2 ) is using a catch-slot or concave-convex engagement mechanism, where one end of the pull line ( 2 ) to be fixed is fixed to a small bump ( 102 A) by riveting, and the small bump ( 102 A) and a small groove ( 102 B) on the pull plate ( 1 ) form a catch-slot or concave-convex engagement mechanism for use as the pull line fixing mechanism ( 102 ).
  • one of methods for fixing the pull line ( 2 ) is using a rivet fastening mechanism, where a small hole is formed on the pull plate, the pull line ( 2 ) is passed through the small hole, and the metal plate is compressed and deformed using a locking pliers, so that the pull line ( 2 ) can be directly riveted to the pull plate ( 1 ).
  • the rivet fastening mechanism ( 102 C) is one of the pull line fixing mechanisms ( 102 ) for fixing the pull lines.
  • one of methods for fixing the pull line ( 2 ) is using a thread fastening mechanism ( 102 D), where the pull line ( 2 ) is fixed to the pull plate ( 1 ) by using the thread fastening mechanism ( 102 D).
  • the pull line fixing mechanisms ( 102 ) of many other different specific structures may also be designed according to the technical solution provided by the present invention.
  • the pull plate ( 1 ) adopts a composite structure having medical films ( 104 ) wrapped on a frame ( 103 ).
  • the pull plate ( 1 ) includes a frame ( 103 ) and medical films ( 104 ), and the medical films ( 104 ) are wrapped on the frame ( 103 ).
  • the frame ( 103 ) may be made of a plate.
  • the material of the frame ( 103 ) includes, but is not limited to, medial metal materials such as titanium and titanium alloy and medical grade stainless steel, amorphous materials, and medical polymer materials (such as PC and PE); the frame ( 103 ) is formed by mechanical processing or wire electro-discharge machining or laser cutting, and hollowing out a plate into a skeleton-like structure.
  • the medical films ( 104 ) are made of a material selected from a group consisting of, but not limited to: a polypropylene fiber braided fabric, a polytetrafluoroethylene film, a polyurethane film and other materials capable of being implanted into the human body for a long term.
  • the formed medical films ( 104 ) are wrapped on the frame ( 103 ).
  • the medical films ( 104 ) may be wrapped on the frame ( 103 ) by thermal bonding, sewing, or chemical adhesive bonding. After the medical films ( 104 ) are wrapped on the frame ( 103 ), through holes ( 101 ) for facilitating growth of tongue tissues and pull line fixing mechanisms ( 102 ) are formed thereon, thereby obtaining the pull plate ( 1 ) having a composite structure of the present invention.
  • the medical films ( 104 ) may also be directly attached to the frame ( 103 ).
  • a special wrapping manner is to bond the medical films ( 104 ) together at the hollow part of the frame ( 103 ) by thermal bonding, sewing, or chemical adhesive bonding, where the bonded part is referred to as a bonded edge ( 106 ).
  • a gap ( 105 ) is formed between the two layers of film.
  • the frame ( 103 ) is capable of moving freely in the gap ( 105 ).
  • Such a composite structure has good adaptability to movement, and can meet the requirements of different movements of the tongue.
  • this embodiment shows a pull plate ( 1 ) having an improved composite structure.
  • the frame ( 103 ) adopts a braided mesh of elastic wires ( 103 C), the medical films ( 104 ) are wrapped on the frame ( 103 ) which is a mesh formed by braided elastic wires, and the elastic wires ( 103 C) are capable of moving in the gap ( 105 ) between the medical films ( 104 ).
  • the elastic wire is selected from a group consisting of, but not limited to: medical grade elastic stainless steel, medical grade titanium-nickel shape memory alloy (Nitinol alloy) wires, Ti—Zr—Ta elastic alloy wires, metallic glass wires and the like, which may also be replaced with elastic polymer material wires such as highly elastic nylon wires.
  • the braiding manner of the elastic wires is characterized in that an upper row of wires is connected to a lower row of wires through a U-shaped node ( 108 ).
  • Such an elastic wire mesh formed by braiding through the U-shaped node ( 108 ) has good adaptability to movement, and can slide within a certain range in the vertical and horizontal directions, that is, move in the Y direction and X direction as shown in FIG. 9C .
  • it is at position 103 A before movement, and may be moved to position 103 B, and may further be moved back to position 103 A.
  • Such a braided wire mesh is used as the frame ( 103 ), which is wrapped by the medical films ( 104 ).
  • the medical films ( 104 ) are bonded together to form a bonded edge ( 106 ) by thermal bonding, sewing, or chemical adhesive bonding.
  • the frame ( 103 ) formed by the elastic wires is freely placed in the gap ( 105 ) formed between the bonded edge ( 106 ) and the two layers of medical film ( 104 ).
  • Through holes ( 101 ) for facilitating growth of tongue tissues and pull line fixing mechanisms ( 102 ) are formed at proper positions on the medical films ( 104 ), thereby obtaining the pull plate ( 1 ) having a wire-braided composite structure of the present invention.
  • such a pull plate ( 1 ) having a wire-braided composite structure has excellent adaptability to movement, and can meet the requirements of different movements of muscle groups in the tongue, thereby improving the comfort when the tongue dorsum portion and/or the tongue base portion is retracted.
  • the pull line ( 2 ) is generally made of a non-absorbable medical thread.
  • the most commonly used is a non-absorbable surgical suture, including, but not limited to, metal lines, natural fiber lines, synthetic fiber lines (such as polyester lines, polyamide lines, and polypropylene lines) and the like.
  • the control switch ( 301 ) Since the tongue pulling device of the present invention can be adjusted after surgery, in the non-sleep state, the control switch ( 301 ) is adjusted to an “off” state, and at this time, the tongue base portion receives a small pulling force or is completely in a loosened state, thereby ensuring free movement of the tongue during speaking, swallowing and other activities; before sleep, the control switch ( 301 ) is adjusted to an “on” state, and at this time, the tongue base portion receives a large pulling force, or the tongue base portion is in an effective retracted state, so as to maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • the pull line ( 2 ) has a relative movement in the soft tissues of the tongue.
  • the present invention particularly provides a pull line having a composite structure.
  • Such a pull line ( 2 ) having a composite structure includes a draw line ( 201 ) and a protective sheath ( 202 ).
  • the draw line ( 201 ) is a flexible line made of a high-strength medical material, and is generally made of a non-absorbable surgical suture.
  • the protective sheath ( 202 ) is a hollow hose made of a flexible medical material. The protective sheath ( 202 ) is sleeved over the draw line ( 201 ), and the draw line ( 201 ) is capable of moving axially in the protective sheath ( 202 ), as shown in FIG. 10A .
  • the protective sheath ( 202 ) is an elastic medical hose, for example, a medical silica gel tube, a medical polyurethane tube, an elastic fiber tube braided by synthetic fibers such as a polypropylene fiber braided tube, or the like.
  • a composite tube having a multi-layer structure has a good effect, for example, a composite tube having an inner layer ( 202 A) being a polyurethane thin wall tube and an outer layer ( 202 B) being an elastic fiber tube braided by synthetic fibers.
  • the outer layer ( 202 ) being an elastic fiber tube braided by synthetic fibers has many tiny holes which facilitate growth and penetration of human tissues so as to enhance the bonding strength.
  • the inner layer ( 202 A) being a polyurethane thin wall tube is smooth and has a small friction resistance, and particularly, is ultra-smooth in the presence of water, facilitating movement of the draw line ( 201 ) in the inner layer ( 202 A), as shown in FIG. 10B .
  • the draw line ( 201 ) is generally made of a non-absorbable medical thread.
  • the most commonly used is a non-absorbable surgical suture, including, but not limited to, metal lines, natural fiber lines, synthetic fiber lines (such as polyester lines, polyamide lines, and polypropylene lines) and the like.
  • the diameter of the draw line ( 201 ) is 0.3 mm to 1.3 mm, and preferably 0.35 mm to 0.6 mm.
  • the inner diameter of the protective sheath ( 202 ) is 0.4 mm to 1.5 mm, and preferably 0.4 mm to 1.0 mm.
  • the pull line ( 2 ) adopts the composite structure of the draw line ( 201 ) and the protective sheath ( 202 ), not only movement of the pull line ( 2 ) in human tissues is ensured, but also attachment and growth of human tissues on the pull line ( 2 ) are facilitated, thereby preventing the pull line ( 2 ) from cutting the tongue tissues during reciprocating movement.
  • the pull line ( 2 ) forms a tunnel in the tongue tissues along the protective sheath ( 202 ), and the draw line ( 201 ) is capable of moving in the protective sheath ( 202 ) at a low friction force; the tongue tissues of the human body are capable of being attached to and growing along the outer wall of the protective sheath ( 202 ), thereby maintaining good bonding strength, as shown in FIG. 10C .
  • this embodiment shows a specific implementation of the thread-type retractor.
  • the retractor ( 3 ) at least includes a control switch ( 301 ) capable of adjusting a tension of the pull line ( 2 ), a pull line fixing mechanism ( 302 ), and a casing ( 304 ).
  • the control switch ( 301 ) of the retractor ( 3 ) adopts a thread-bolt structure, and when the bolt-type control switch ( 301 ) is rotated, the pull line fixing mechanism ( 302 ) moves horizontally along the axial direction of the bolt.
  • the moving distance of the pull line fixing mechanism ( 302 ) is generally 5 mm to 20 mm.
  • the outer diameter of the retractor ( 3 ) is generally 1 mm to 10 mm, and preferably 2 mm to 6 mm.
  • the retractor ( 3 ) of this embodiment includes the control switch ( 301 ), the pull line fixing device ( 302 ), and the retractor casing ( 304 ).
  • the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted in the retractor casing ( 304 ) to form a closed container.
  • Positioning concave grooves ( 302 B) on the pull line fixing device and positioning convex steps ( 304 E) on the retractor casing form a concave-convex engagement, and the pull line fixing device ( 302 ) is capable of moving along the positioning convex steps ( 304 E), but is incapable of rotating.
  • the control switch ( 301 ) is a bolt structure
  • the pull line fixing device ( 302 ) is a nut structure, so that the control switch ( 301 ) and the pull line fixing device ( 302 ) form an adjustable thread-bolt structure.
  • the control switch ( 301 ) is rotated using a screwdriver
  • the bolt of the control switch ( 301 ) is rotated, and the pull line fixing device ( 302 ) is restricted by the positioning convex steps ( 304 E) and cannot rotate, but can only move horizontally along the bolt.
  • the pull line ( 2 ) is fixed to the pull line fixing device ( 302 )
  • the objective of tightening or loosening the pull line ( 2 ) can be achieved.
  • the pull line fixing device ( 302 ) includes thread holes ( 302 A), the positioning concave grooves ( 302 B), and an internal thread ( 302 J).
  • the thread holes ( 302 A) are used for tying the pull line ( 2 ) so as to fix the pull line ( 2 ).
  • the positioning concave grooves ( 302 B) are used for forming a concave-convex engagement with the positioning convex steps ( 304 E) on the retractor casing, so as to prevent rotary movement of the pull line fixing device ( 302 ).
  • the internal thread ( 302 J) is used for being engaged with the bolt of the control switch ( 301 ), so that the pull line fixing device ( 302 ) can move horizontally when the bolt of the control switch ( 301 ) is rotated.
  • the retractor casing ( 304 ) includes thread holes ( 304 A), a seal ring ( 304 B), screw holes ( 304 C), the positioning convex steps ( 304 E) and a main body ( 304 L).
  • the thread holes ( 304 A) are used for the pull line ( 2 ) to pass through.
  • the seal ring ( 304 B) is made of medical grade silica gel, and not only allows the pull line ( 2 ) to pass through, but also has a sealing function to block human tissues from growing and penetrating into the main body ( 304 L).
  • the screw holes ( 304 C) are used for fixing the retractor ( 3 ) to the mandible ( 5 ).
  • the positioning convex steps ( 304 E) and the positioning concave grooves ( 302 B) on the pull line fixing device form a concave-convex engagement, so as to prevent rotary movement of the pull line fixing device ( 302 ).
  • the main body ( 304 L) is used for mounting and fixing the control switch ( 301 ) and serves as a support for bearing the pull line fixing device ( 302 ).
  • a closed space may be formed to block human tissues from growing and penetrating into the main body ( 304 L), thereby ensuring the adjustment function of the control switch ( 301 ).
  • the structure of the retractor ( 3 ) shown in this embodiment is reliable, can conveniently fix the pull line ( 2 ), is easily mounted onto the mandible, can be manufactured into small components, and is conveniently implanted into the human body.
  • this embodiment is a thread-type retractor, which is an improvement to Embodiment 11.
  • the difference lies in that: a top cover ( 304 G) and a top cover seal ring ( 304 B 1 ) are added to the retractor casing ( 304 ).
  • the purpose of adding the top cover ( 304 G) and the top cover seal ring ( 304 B 1 ) is to enhance the sealing performance of the top of the retractor casing ( 304 ), so that good dynamic sealing performance can be maintained when the bolt of the control switch ( 301 ) is rotated, thereby blocking human tissues, tissue fluid or bacteria from entering the retractor casing ( 304 ).
  • this embodiment is an improvement to Embodiment 11.
  • the difference lies in that: an anti-cutting buffer device ( 303 ) is added to the retractor ( 3 ).
  • the anti-cutting buffer device ( 303 ) in this embodiment is four coil springs, where top ends of the four coil springs are connected to a binding plate ( 302 C), and bottom ends of the four coil springs are mounted on spring positioning posts ( 302 D) of the pull line fixing device ( 302 ).
  • the pull line ( 2 ) is bound to the binding plate ( 302 C), and when the pull line ( 2 ) receives an excessive tension, the coil springs of the anti-cutting buffer device ( 303 ) deform, and the springs are compressed to eliminate the excessive tension, so as to prevent the pull plate ( 1 ) from cutting the soft tissues of the tongue.
  • the tension for causing deformation of the coil springs of the anti-cutting buffer device ( 303 ) is generally set to 100 g to 3000 g, and preferably 500 g to 1000 g, which may be set according to the maximum tensions of the tongues of different patients and the contact area between the pull plate ( 1 ) and the tongue base portion.
  • the setting principle is that: under the maximum tension, the maximum pressure generated by the pull plate ( 1 ) is lower than the pressure when the soft tissues are cut, and is generally required to be smaller than 7000 g/cm 2 .
  • the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is generally smaller than 1000 g, or the pressure generated on the pull plate ( 1 ) by the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is smaller than 7000 g/cm 2 , and is preferably 500 g/cm 2 to 1500 g/cm 2 . At this time, not only effective pulling to the tongue base ( 41 ) and/or the tongue dorsum ( 42 ) is maintained, but also injuries caused by cutting the tongue muscles are avoided.
  • this embodiment shows a thread-type retractor ( 3 ), where the control switch ( 301 ) of the thread-type retractor ( 3 ) adopts a nut adjustment manner.
  • the retractor ( 3 ) at least includes a control switch ( 301 ) capable of adjusting a tension of the pull line ( 2 ), a pull line fixing mechanism ( 302 ), and a casing ( 304 ).
  • the control switch ( 301 ) of the retractor ( 3 ) adopts a nut adjustment manner, and when the nut-type control switch ( 301 ) is rotated, the pull line fixing mechanism ( 302 ) moves horizontally along the axial direction of the num.
  • the moving distance of the pull line fixing mechanism ( 302 ) is generally 5 mm to 20 mm.
  • the outer diameter of the retractor ( 3 ) is generally 1 mm to 10 mm, and preferably 2 mm to 6 mm.
  • the retractor ( 3 ) of this embodiment includes the control switch ( 301 ), the pull line fixing device ( 302 ), and the retractor casing ( 304 ).
  • the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted in the retractor casing ( 304 ) to form a closed container.
  • Positioning convex steps ( 302 E) on the pull line fixing device and positioning concave grooves ( 304 F) on the retractor casing form a concave-convex engagement, and the pull line fixing device ( 302 ) is capable of moving along the positioning concave grooves ( 304 F), but is incapable of rotating.
  • the control switch ( 301 ) is a nut structure, and the pull line fixing device ( 302 ) is connected to the control switch ( 301 ) through a concave-convex engagement structure, that is, positioning convex steps ( 302 F) on the pull line fixing device ( 302 ) and a positioning concave groove ( 301 B) on the control switch ( 301 ) form a concave-convex engagement structure.
  • the control switch ( 301 ) When the nut-type control switch ( 301 ) is rotated using a screwdriver, the control switch ( 301 ) rotates, and at the same time moves linearly along the horizontal direction; and the pull line fixing device ( 302 ) is restricted by the positioning concave grooves ( 304 F) on the casing ( 304 ) and cannot rotate, but can only move correspondingly along the horizontal direction under the pulling of the control switch ( 301 ).
  • the pull line ( 2 ) When the pull line ( 2 ) is fixed to the pull line fixing device ( 302 ), the objective of tightening or loosening the pull line ( 2 ) can be achieved.
  • the pull line fixing device ( 302 ) includes thread holes ( 302 A), the positioning convex steps ( 302 E), and the positioning convex steps ( 302 F).
  • the thread holes ( 302 A) are used for the pull line ( 2 ) to pass through so as to tie and fix the pull line ( 2 ).
  • the positioning convex steps ( 302 E) are used for forming a concave-convex engagement with the positioning concave grooves ( 304 F) on the retractor casing, so as to prevent rotary movement of the pull line fixing device ( 302 ).
  • the positioning convex steps ( 302 F) are is used for being engaged with the positioning concave groove ( 301 B) of the control switch ( 301 ), so that the pull line fixing device ( 302 ) can move horizontally when the nut-type control switch ( 301 ) is rotated.
  • the retractor casing ( 304 ) includes thread holes ( 304 A), a seal ring ( 304 B), screw holes ( 304 C), the positioning concave grooves ( 304 F), a top cover seal ring ( 304 B 1 ), a top cover ( 304 G), a bottom cover ( 304 H) and a main body ( 304 L).
  • the thread holes ( 304 A) are used for the pull line ( 2 ) to pass through.
  • the seal ring ( 304 B) is made of medical grade silica gel, and not only allows the pull line ( 2 ) to pass through, but also has a sealing function to block human tissues from growing and penetrating into the main body ( 304 L).
  • the screw holes ( 304 C) are used for fixing the retractor ( 3 ) to the mandible ( 5 ).
  • the positioning concave grooves ( 304 F) and the positioning convex steps ( 302 E) of the pull line fixing device form a concave-convex engagement, so as to prevent rotary movement of the pull line fixing device ( 302 ).
  • the top cover ( 304 G) includes a rotary positioning slot ( 304 G 1 ).
  • the rotary positioning slot ( 304 G 1 ) may be elliptical or polygonal, into which a corresponding tool may be inserted in order to rotate the top cover ( 304 G).
  • the top cover seal ring ( 304 B 1 ) is used for sealing purpose to block human tissues from growing and penetrating into the main body ( 304 L).
  • the bottom cover ( 304 H) includes an external thread for being engaged with the internal thread of the main body ( 304 L) to tightly press the seal ring ( 304 B), so as to achieve sealing.
  • the bottom cover ( 304 H) includes elliptical through holes, which may serve as the thread holes ( 304 A) for the pull line ( 2 ) to pass through, and into which a corresponding tool may be inserted in order to rotate the bottom cover ( 304 H), thereby facilitating assembly.
  • the main body ( 304 L) is used for mounting and fixing the control switch ( 301 ) and serves as a support for bearing the pull line fixing device ( 302 ). At the same time, a closed space may be formed to block human tissues from growing and penetrating into the main body ( 304 L), thereby ensuring the adjustment function of the control switch ( 301 ).
  • the retractor ( 3 ) of a nut adjustment type shown in this embodiment has a reliable structure, has good sealing performance, can conveniently fix the pull line ( 2 ), is easily mounted onto the mandible, can be manufactured into small components, and is conveniently implanted into the human body.
  • FIG. 15A to FIG. 15E this embodiment is an improvement to Embodiment 14, where an anti-cutting buffer device ( 303 ) is added.
  • the anti-cutting buffer device ( 303 ) in this embodiment is four coil springs, where top ends of the four coil springs are connected to a binding plate ( 302 C), and bottom ends of the four coil springs are mounted on spring positioning posts ( 302 D) of the pull line fixing device ( 302 ).
  • the pull line ( 2 ) is bound to the binding plate ( 302 C), and when the pull line ( 2 ) receives an excessive tension, the coil springs of the anti-cutting buffer device ( 303 ) deform, and the springs are compressed to eliminate the excessive tension, so as to prevent the pull plate ( 1 ) from cutting the soft tissues of the tongue.
  • the tension for causing deformation of the coil springs of the anti-cutting buffer device ( 303 ) is generally set to 100 g to 3000 g, and preferably 500 g to 1000 g, which may be set according to the maximum tensions of the tongues of different patients and the contact area between the pull plate ( 1 ) and the tongue base portion.
  • the setting principle is that: under the maximum tension, the maximum pressure generated by the pull plate ( 1 ) is lower than the pressure when the soft tissues are cut, and is generally required to be smaller than 7000 g/cm 2 .
  • the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is generally smaller than 1000 g, or the pressure generated on the pull plate ( 1 ) by the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is smaller than 7000 g/cm 2 , and is preferably 500 g/cm 2 to 1500 g/cm 2 . At this time, not only effective pulling to the tongue base ( 41 ) and/or the tongue dorsum ( 42 ) is maintained, but also injuries caused by cutting the tongue muscles are avoided.
  • this embodiment shows a retractor ( 3 ) of a concave-convex engagement type.
  • the control switch ( 301 ) of the retractor ( 3 ) adopts a concave-convex engagement structure, that is, positioning convex steps ( 301 A) on the control switch ( 301 ) and positioning concave grooves ( 304 F) on the inner side of the casing form a concave-convex engagement structure.
  • a special tool is used to press an adjustment handle ( 301 F) of the control switch ( 301 ) centripetally, so that the positioning convex steps ( 301 A) detach from the positioning concave grooves ( 304 F) on the inner side of the casing.
  • the control switch ( 301 ) is pushed/pulled to drive the pull line fixing module ( 302 ) to move.
  • the adjustment handle ( 301 F) is released, so that under the action of the elastic force, the positioning convex steps ( 301 A) on the control switch ( 301 ) are engaged into the positioning concave grooves ( 304 F) on the inner side of the casing, so as to form the concave-convex engagement structure, thereby achieving positioning.
  • the retractor ( 3 ) includes a control switch ( 301 ) capable of adjusting a tension of the pull line ( 2 ), a pull line fixing module ( 302 ), and a casing ( 304 ).
  • the control switch ( 301 ) of the retractor ( 3 ) adopts a push-pull adjustment manner, and when the adjustment handle ( 301 F) of the control switch ( 301 ) is pressed, the positioning convex steps ( 301 A) on the control switch detach from the positioning concave grooves ( 304 F) on the inner side of the casing, and the control switch ( 301 ) can move leftward or rightward, so as to drive the pull line fixing module ( 302 ) to move leftward or rightward to achieve the objective of adjusting the pulling distance.
  • the moving distance of the pull line fixing module ( 302 ) is generally 5 mm to 20 mm.
  • the outer diameter of the retractor ( 3 ) is generally 1 mm to 10 mm, and preferably 2 mm to 6 mm.
  • the control switch ( 301 ) and the pull line fixing device ( 302 ) of the retractor of this embodiment are mounted in the retractor casing ( 304 ), so as to form a closed container.
  • the control switch ( 301 ) includes the positioning convex steps ( 301 A) and the adjustment handle ( 301 F) of the control switch.
  • the adjustment handle ( 301 F) is bent centripetally, so that the positioning convex steps ( 301 A) detach from the positioning concave grooves ( 304 F) on the inner side of the casing. Through pushing or pulling, the position of the control switch ( 301 ) can be adjusted.
  • the control switch ( 301 ) is mounted in the pull line fixing device ( 302 ), and the positioning convex steps ( 301 A) are engaged in positioning concave grooves ( 302 G) of the pull line fixing device, so that the control switch ( 301 ) can drive the pull line fixing device ( 302 ) to move.
  • the pull line fixing device ( 302 ) includes a binding plate ( 302 C) for binding and fixing the pull line ( 2 ).
  • the retractor casing ( 304 ) includes thread holes ( 304 A), a seal ring ( 304 B), screw holes ( 304 C), the positioning concave grooves ( 304 F), a top cover seal ring ( 304 B 1 ), a top cover ( 304 G), a bottom cover ( 304 H) and a main body ( 304 L).
  • the thread holes ( 304 A) are used for the pull line ( 2 ) to pass through.
  • the seal ring ( 304 B) is made of medical grade silica gel, and not only allows the pull line ( 2 ) to pass through, but also has a sealing function to block human tissues from growing and penetrating into the main body ( 304 L).
  • the screw holes ( 304 C) are used for fixing the retractor ( 3 ) to the mandible ( 5 ).
  • the positioning concave grooves ( 304 F) on the inner side of the casing and the positioning convex steps ( 301 A) on the control switch ( 301 ) form the concave-convex engagement structure, so as to achieve positioning during adjustment.
  • the top cover ( 304 G) includes a rotary positioning slot ( 304 G 1 ).
  • the rotary positioning slot ( 304 G 1 ) may be elliptical or polygonal, into which a corresponding tool may be inserted in order to rotate the top cover ( 304 G).
  • the top cover seal ring ( 304 B 1 ) is used for sealing purpose to block human tissues from growing and penetrating into the main body ( 304 L).
  • the bottom cover ( 304 H) includes an external thread for being engaged with the internal thread of the main body ( 304 L) to tightly press the seal ring ( 304 B), so as to achieve sealing.
  • the bottom cover ( 304 H) includes elliptical through holes, which may serve as the thread holes ( 304 A) for the pull line ( 2 ) to pass through, and into which a corresponding tool may be inserted in order to rotate the bottom cover ( 304 H), thereby facilitating assembly.
  • the main body ( 304 L) is used for mounting and fixing the control switch ( 301 ) and serves as a support for bearing the pull line fixing device ( 302 ).
  • the positioning concave grooves ( 304 F) on the inner side of the casing and the positioning convex steps ( 301 A) on the control switch ( 301 ) form the concave-convex engagement structure, so as to achieve positioning during adjustment.
  • the casing ( 304 ) may form a closed space to block human tissues from growing and penetrating into the main body ( 304 L), thereby ensuring the adjustment function of the control switch ( 301 ).
  • this embodiment is an improvement to Embodiment 16.
  • the difference lies in that: an anti-cutting buffer device ( 303 ) is added to the retractor ( 3 ).
  • the anti-cutting buffer device ( 303 ) in this embodiment is a corrugated spring plate, and the pull line ( 2 ) is bound and fixed to the corrugated spring plate.
  • the pull line ( 2 ) receives an excessive tension
  • the corrugated spring plate of the anti-cutting buffer device ( 303 ) deforms, and the spring plate is stretched straight to eliminate the excessive tension, so as to prevent the pull plate ( 1 ) from cutting the soft tissues of the tongue.
  • the tension for causing deformation of the corrugated spring plate of the anti-cutting buffer device ( 303 ) is generally set to 100 g to 3000 g, and preferably 500 g to 1000 g, which may be set according to the maximum tensions of the tongues of different patients and the contact area between the pull plate ( 1 ) and the tongue base portion.
  • the setting principle is that: under the maximum tension, the maximum pressure generated by the pull plate ( 1 ) is lower than the pressure when the soft tissues are cut, and is generally required to be smaller than 7000 g/cm 2 .
  • the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is generally smaller than 1000 g, or the pressure generated on the pull plate ( 1 ) by the elastic force of the spring structure of the anti-cutting buffer device ( 303 ) is smaller than 7000 g/cm 2 , and is preferably 500 g/cm 2 to 1500 g/cm 2 . At this time, not only effective pulling to the tongue base ( 41 ) and/or the tongue dorsum ( 42 ) is maintained, but also injuries caused by cutting the tongue muscles are avoided.
  • the working principle of the control switch ( 301 ) of the retractor ( 3 ) adopts the principle of a clutch, and the pull line ( 2 ) is tightened or loosened by winding, which is specifically as follows:
  • the retractor ( 3 ) of this embodiment includes a control switch ( 301 ), a pull line fixing device ( 302 ), and a retractor casing ( 304 ).
  • the casing ( 304 ) is a closed container, in which the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted.
  • the control switch ( 301 ) is a pair of concave and convex gears engaged with each other, and is formed by positioning convex steps ( 301 A) on a convex gear ( 301 A 1 ) fixed to a top cover ( 304 G) of the casing and positioning concave grooves ( 301 B) on a concave gear ( 301 B 1 ) fixed to the top of the pull line fixing device ( 302 ).
  • the concave gear ( 301 B 1 ) is pressed, the positioning concave grooves ( 301 B) and the positioning convex steps ( 301 A) detach from one another, that is, a detached state is entered.
  • the concave gear ( 301 B 1 ) is rotated to drive the shaft of the pull line fixing device ( 302 ) to rotate, so as to achieve the objective of tightening the pull line ( 2 ) or loosening the pull line ( 2 ).
  • the concave gear ( 301 B 1 ) is released, under the action of a spring ( 302 H), the positioning concave grooves ( 301 B) and the positioning convex steps ( 301 A) are combined together, so that the shaft of the pull line fixing device ( 302 ) cannot rotate, thereby achieving positioning.
  • the pull line fixing device ( 302 ) is a rotary shaft structure.
  • the concave gear ( 301 B 1 ) is disposed at the top of the pull line fixing device ( 302 ) to serve as a part of the control switch ( 301 ).
  • a bobbin ( 302 L) and a thread hole ( 302 A) are provided in the middle of the pull line fixing device ( 302 ), where the bobbin ( 302 L) is used for winding the pull line ( 2 ), and the thread hole ( 302 A) is used for fixing the pull line ( 2 ).
  • a spring positioning post ( 302 D) is disposed at the bottom of the pull line fixing device ( 302 ), and is used for positioning the spring ( 302 H).
  • the casing ( 304 ) is a cylindrical casing, having a side hole at the right side thereof.
  • the casing ( 304 ) includes the top cover ( 304 G) at the upper part thereof, where a silica gel plug ( 304 D) may be mounted in a through hole ( 304 G 2 ) of the top cover ( 304 G).
  • a screwdriver may be used to press and rotate the concave gear ( 301 B 1 ); and after the silica gel plug ( 304 D) is mounted, human tissues are blocked from growing and penetrating into the casing ( 304 ).
  • the top cover ( 304 G) includes the convex gear ( 301 A 1 ) at the lower part thereof, where the convex gear ( 301 A 1 ) and the concave gear ( 301 B 1 ) form a pair of concave and convex gears engaged with each other, and the positioning convex steps ( 301 A) on the convex gear ( 301 A 1 ) and the positioning concave grooves ( 301 B) on the concave gear ( 301 B 1 ) form the control switch ( 301 ).
  • the top cover ( 304 G) includes a pair of fixing lugs on a side surface thereof, and screw holes ( 304 C) are formed on the fixing lugs.
  • the main body ( 304 L) of the casing ( 304 ) includes a pair of fixing lugs at the upper part thereof, and screw holes ( 304 C) are formed on the fixing lugs, where the screw holes ( 304 C) are used for connecting the top cover ( 304 G) and the main body ( 304 L), which may be fixed to the mandible by using screws.
  • the main body ( 304 L) includes a positioning slot for mounting the spring ( 302 H) at the lower part thereof, where the spring ( 302 H) is mounted in the positioning slot, with one end connected to the spring positioning post ( 302 D) at the bottom part of the pull line fixing device ( 302 ).
  • the main body ( 304 L) has a side hole ( 304 N) on a side surface thereof.
  • the bottom cover ( 304 H) is thread-connected to the main body ( 304 L).
  • the bottom cover ( 304 H) has an elliptical thread hole ( 304 A), and a seal ring ( 304 B) can be fixed by tightening the bottom cover ( 304 H).
  • the pull line ( 2 ) is sequentially passed through the thread hole ( 304 A) and the seal ring ( 304 B), and after entering the side hole ( 304 N) of the main body ( 304 L), is wound onto the bobbin ( 302 L), and the ends of the pull line ( 2 ) are fixed to the thread hole ( 304 A).
  • the pull line ( 2 ) is tightened, and when the bobbin ( 302 L) is rotated clockwise, the pull line ( 2 ) is loosened.
  • This embodiment shows a retractor ( 3 ) that is adjusted by winding, and has advantages such as reliable structure and convenient adjustment.
  • Embodiment 18 lies in the following aspects:
  • an anti-cutting buffer device ( 303 ) is included.
  • the anti-cutting buffer device ( 303 ) adopts a densely wrapped coil spring structure, is disposed in the casing ( 304 ), and mounted at a part of the pull line ( 2 ) that is located in the casing ( 304 ).
  • Two ends of the densely wrapped coil spring of the anti-cutting buffer device ( 303 ) are respectively connected to the pull line ( 2 ), where the pull line ( 2 ) at one end is fixed to the thread hole ( 302 A), and wound onto the bobbin ( 302 L), and the other end is connected to the pull line ( 2 ), which is passed through the seal ring ( 304 B) and the thread hole ( 304 A), and then fixed to the pull plate ( 1 ).
  • the side surface ( 304 M) of the casing ( 304 ) has a flat plate shape, and the side hole ( 304 N) is long, to which the bottom cover ( 304 H) of the casing, the seal ring ( 304 B), and a fixing nut ( 3041 ) are mounted sequentially.
  • the screw holes ( 304 C) for fixing the casing ( 304 ) to the mandible are provided on the side surface ( 304 M) of the casing, which facilitates mounting onto the mandible.
  • the control switch ( 301 ) of this embodiment is a concave-convex engagement structure, where the control switch ( 301 ) is positioned through concave-convex engagement between a positioning convex step ( 301 A) on a loosening switch ( 301 D) and positioning concave grooves ( 301 B) on a tightening switch ( 301 C).
  • the retractor ( 3 ) of this embodiment includes a control switch ( 301 ), a pull line fixing device ( 302 ), and a retractor casing ( 304 ).
  • the casing ( 304 ) is a closed container, in which the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted.
  • the control switch ( 301 ) is divided into a tightening switch ( 301 C) and a loosening switch ( 301 D).
  • the tightening switch ( 301 C) adopts a ratchet structure.
  • the tightening switch ( 301 C) includes ratchet ( 301 B 2 ) at the bottom thereof, and the ratchet ( 301 B 2 ) includes positioning concave grooves ( 301 B).
  • the loosening switch ( 301 D) includes a positioning convex step ( 301 A), and the positioning convex step ( 301 A) and the positioning concave grooves ( 301 B) on the ratchet form a concave-convex engagement.
  • the positioning convex step ( 301 A) includes a spring positioning post ( 301 G) at the bottom thereof, and the spring positioning post ( 301 G) is mounted with a spring ( 301 E).
  • the pull line fixing device ( 302 ) is a shaft winding structure, where the bobbin ( 302 L) includes a thread hole ( 302 A).
  • the thread hole ( 302 A) is used for fixing the pull line ( 2 ), and the bobbin ( 302 L) is used for winding the pull line ( 2 ).
  • the bobbin ( 302 L) is connected to the tightening switch ( 301 C). When the tightening switch ( 301 C) is rotated, the bobbin ( 302 L) rotates along therewith.
  • the casing ( 304 ) is a cylindrical casing, having a side hole ( 304 N) at the right side thereof, where the side hole ( 304 N) has an internal thread, which can be engaged with an external thread of a bottom cover ( 304 H).
  • a seal ring ( 304 B) and the bottom cover ( 304 H) may be sequentially mounted to the side hole ( 304 N).
  • the pull line ( 2 ) is sequentially passed through a thread hole ( 304 A) and the seal ring ( 304 B), and after entering the side hole ( 304 N) of the main body ( 304 L), is wound onto the bobbin ( 302 L), and the ends of the pull line ( 2 ) are fixed to the thread hole ( 304 A).
  • the pull line ( 2 ) is tightened, and when the bobbin ( 302 L) is rotated anticlockwise, the pull line ( 2 ) is loosened.
  • the casing ( 304 ) includes a top cover ( 304 G) at the upper part thereof, where a silica gel plug ( 304 D) may be mounted in a through hole ( 304 G 2 ) of the top cover ( 304 G).
  • the tightening switch ( 301 C) may be rotated to tighten the pull line ( 2 ); or the loosening switch ( 301 D) may be pressed so that the tightening switch ( 301 C) is in a loosened state, thereby loosening the pull line ( 2 ).
  • the top cover ( 304 G) and the main body ( 304 L) of the casing ( 304 ) may be fixed to each other by using screws or by welding.
  • the casing ( 304 ) may be fixed to the mandible by using screws.
  • the silica gel plug ( 304 D) may be manufactured into a color similar to that of the skin at the mandible of the human body, so that since titanium alloys have high biocompatibility, the top cover ( 304 G) made of medical grade titanium metal of the casing can be exposed out of the skin at the mandible of the human body, and the silica gel plug ( 304 D) that is manufactured into a color similar to that of the skin at the mandible of the human body has a beautifying function, and also facilitates adjusting the tension of the pull line ( 2 ) after surgery. For example, when adjustment is needed, the silica gel plug ( 304 D) removed first, and after adjustment, the silica gel plug ( 304 D) is mounted. The adjustment of the tension of the pull line ( 2 ) after surgery is based on the following principle:
  • the loosening switch ( 301 D) is pressed so as to adjust the control switch ( 301 ) to an “off” state, and at this time, the pull lines ( 2 ) apply a small pulling force to the tongue base portion or are completely in a loosened state, and the tongue is capable of moving freely during speaking, swallowing and other activities.
  • the tightening switch ( 301 C) is tightened so as to adjust the control switch ( 301 ) to an “on” state, and at this time, a large pulling force is applied to the tongue base portion, so that the tongue base portion is in an effective retracted state, and the tongue base portion is pulled forward, so as to maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • this embodiment shows a button-type single-switch push-pull retractor, which is particularly suitable for being mounted at the bottom portion of the mandible to retract the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) so as to treat OSAHS, and allows the patient to adjust the pulling degree of the tongue from a position outside the skin at the bottom portion of the mandible after surgery, so as to achieve good comfort.
  • This embodiment shows a retractor ( 3 ), in which after the control switch ( 301 ) is pressed, the position of the pull line fixing device ( 302 ) can be conveniently adjusted by pushing or pulling, so as to tighten or loosen the pull line ( 2 ); and once the control switch ( 301 ) is released, the control switch ( 301 ) can be automatically locked and positioned.
  • the retractor ( 3 ) of this embodiment includes a control switch ( 301 ), a pull line fixing device ( 302 ), and a retractor casing ( 304 ).
  • the casing ( 304 ) is a closed container, in which the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted.
  • the control switch ( 301 ) is a concave-convex engagement structure formed by a beam-type positioning convex step ( 301 A) and a tooth rack-type positioning concave groove ( 301 B), specifically:
  • the control switch ( 301 ) includes a beam-type positioning convex step ( 301 A), and the beam-type positioning convex step ( 301 A) is provided on the pull line fixing device ( 302 ) and connected to an adjustment handle ( 301 F).
  • the pull line fixing device ( 302 ) includes a thread hole ( 302 A) and a bolt ( 302 I) for fixing the pull line ( 2 ).
  • the pull line fixing device ( 302 ), the pull line fixing bolt ( 302 I), the beam-type positioning convex step ( 301 A), the adjustment handle ( 301 F), a spring ( 301 E) and a positioning slide-block cover ( 302 M 1 ) are sequentially mounted in a positioning slide block ( 302 M), and can slide in a positioning slot opening ( 304 P) and a positioning concave groove ( 304 F) of the casing as a whole.
  • the tooth rack-type positioning concave groove ( 301 B) of the control switch ( 301 ) is provided on the casing ( 304 ), and two tooth racks ( 301 B 3 ) are symmetrically distributed in parallel at the upper part of the main body ( 304 L).
  • the positioning slide block ( 302 M) of the pull line fixing device can slide in the positioning slot opening ( 304 P) between the two tooth racks ( 301 B 3 ).
  • the pull line fixing device ( 302 ) includes a thread hole ( 302 A) and a fixing bolt ( 302 I) for fixing the pull line.
  • the pull line ( 2 ) is passed through the thread hole ( 302 A), and the fixing bolt ( 302 I) is tightened, so as to fix the pull line ( 2 ).
  • the pull line fixing device ( 302 ) further includes a positioning slide block ( 302 M), where the positioning slide block ( 302 M) is a rectangular casing.
  • the positioning slide block ( 302 M) includes a positioning slide-block cover ( 302 M 1 ) and a positioning slide-block slot opening ( 302 M 2 ).
  • the adjustment handle ( 301 F), the spring ( 301 E), the thread hole ( 302 A) and the fixing bolt ( 302 I) are sequentially mounted in the positioning slide block ( 302 M).
  • the beam-type positioning convex step ( 301 A) of the control switch ( 301 ) is passed through the positioning slide-block slot opening ( 302 M 2 ), and is capable moving vertically in a direction perpendicular to the positioning slide-block slot opening ( 302 M 2 ).
  • the retractor casing ( 304 ) includes a main body ( 304 L), and the main body ( 304 L) includes a vertical fixing plate ( 304 L 1 ) and a horizontal fixing plate ( 304 L 2 ).
  • the vertical fixing plate ( 304 L 1 ) and the horizontal fixing plate ( 304 L 2 ) each includes screw holes ( 304 C), and the screw holes ( 304 C) are used for fixing the retractor casing ( 304 ) to the mandible ( 5 ) by using screws ( 10 ).
  • the main body ( 304 L) further includes two symmetrical tooth racks ( 301 B 3 ), and a positioning slot opening ( 304 P) is formed between the two tooth racks ( 301 B 3 ).
  • the positioning slot opening ( 304 P) is engaged with the positioning slide block ( 302 M) of the pull line fixing device, so that the positioning slide block ( 302 M) is capable of sliding back and forth along the length direction of the positioning slot opening ( 304 P).
  • the retractor casing ( 304 ) includes a top cover ( 304 G), and the top cover ( 304 G) includes a positioning concave groove ( 304 F).
  • the positioning concave groove ( 304 F) cooperates with the positioning slot opening ( 304 P) in the vertical direction so as to achieve spatial positioning.
  • the positioning slide block ( 302 M) is disposed on the positioning concave groove ( 304 F), and is capable of moving back and forth along the length direction of the positioning slot opening ( 304 P) and the length direction of the positioning concave groove ( 304 F).
  • the retractor casing ( 304 ) further includes a top cover seal ring ( 304 B 1 ) and a fixing plate ( 304 B 2 ) for fixing the top cover seal ring.
  • the top cover seal ring ( 304 B 1 ) is made of a medical film material, and therefore is soft and durable.
  • the fixing plate ( 304 B 2 ) is used for fixing the top cover seal ring ( 304 B 1 ), and the fixing plate ( 304 B 2 ) is fixed to the main body ( 304 L) by means of close fit or using a screw.
  • the fixing plate ( 304 B 2 ) includes a thread hole ( 304 A) for the pull line ( 2 ) to pass through.
  • the retractor ( 3 ) of the present invention can be fixed to the mandible by using screws.
  • the patient can adjust the pulling degree of the pull line ( 2 ) to the tongue dorsum portion and/or the tongue base portion after surgery by pressing the control switch ( 301 ) from a position outside the bottom portion of the mandible of the patient and at the same time pushing or pulling the control switch ( 301 ).
  • the adjustment is based on the following principle:
  • control switch ( 301 ) In a non-sleep state, the control switch ( 301 ) is pressed and pushed toward the tongue base portion so that the pull lines ( 2 ) apply a small pulling force to the tongue base portion or are completely in a loosened state, and then the control switch ( 301 ) is released so that the control switch ( 301 ) is automatically positioned and locked, that is, the control switch ( 301 ) is adjusted to an “off” state, and at this time, the tongue base portion is almost unconstrained, and the tongue is capable of moving freely during speaking, swallowing and other activities.
  • control switch ( 301 ) Before sleep, the control switch ( 301 ) is pressed and pulled toward the mandible so that the control switch ( 301 ) is adjusted to an “on” state, and at this time, the pull lines ( 2 ) apply a large pulling force to the tongue base portion, so that the tongue base portion is in an effective retracted state, and the tongue base portion is pulled forward, so as to maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • control switch ( 301 ) may be pressed and pulled toward the mandible, and then released at a proper position, so that the pull line ( 2 ) applies a proper pulling force to the tongue base portion, so as to move the tongue base portion forward while ensuring comfort during movement of the tongue, and maintain the palatopharyngeal portion open, thereby preventing OSAHS.
  • this embodiment shows a double-button ratchet-type retractor, which is particularly suitable for being mounted at the front portion of the mandible to retract the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) so as to treat OSAHS, and allows the patient to adjust the pulling degree of the tongue by pressing a switch from a position outside the skin at the bottom portion of the mandible after surgery, so as to achieve good comfort.
  • This embodiment shows a double-button ratchet-type retractor ( 3 ), which has the following characteristics:
  • the control switch ( 301 ) is divided into a tightening switch ( 301 C) and a loosening switch ( 301 D), and adopts a ratchet ( 301 B 2 ) as an adjustment structure.
  • a positioning convex step ( 301 A) on the tightening switch ( 301 C) pushes the ratchet ( 301 B 2 ) to rotate by one step, so as to drive the pull line fixing device ( 302 ) to move to tighten the pull lines ( 2 ).
  • a positioning convex step ( 301 A) on the loosening switch ( 301 D) is used for stopping reverse rotation of the ratchet ( 301 B 2 ), so as to prevent loosening of the tightened pull lines ( 2 ).
  • the loosening switch ( 301 D) is pressed, the ratchet ( 301 B 2 ) is released, so that the ratchet ( 301 B 2 ) is in a free state, which drives the pull line fixing device ( 302 ) to enter a loosened state, thereby loosening the pull line ( 2 ).
  • the retractor ( 3 ) includes a control switch ( 301 ), a pull line fixing device ( 302 ), and a retractor casing ( 304 ).
  • the control switch ( 301 ) is divided into a tightening switch ( 301 C) and a loosening switch ( 301 D). Both the tightening switch ( 301 C) and the loosening switch ( 301 D) adopt a pushrod structure, and a spring ( 301 E) is used for restoring the pushrod.
  • the tightening switch ( 301 C) and the loosening switch ( 301 D) each include a positioning convex step ( 301 A), where the positioning convex step ( 301 A) adopts a reed structure.
  • the positioning convex step ( 301 A) on the tightening switch ( 301 C) includes a wedge-shaped slide block ( 301 A 1 ) and a spring ( 301 E 1 ), where the spring ( 301 E 1 ) is mounted on the wedge-shaped slide block ( 301 A 1 ).
  • the positioning convex step ( 301 A) on the loosening switch ( 301 D) includes a wedge-shaped slide block ( 301 A 2 ) and a spring ( 301 E 2 ), where the spring ( 301 E 2 ) is mounted on the wedge-shaped slide block ( 301 A 2 ).
  • the positioning convex step ( 301 A) on the loosening switch ( 301 D), that is, the wedge-shaped slide block ( 301 A 2 ), is used for stopping reverse rotation of the ratchet ( 301 B 2 ), so as to prevent loosening of the tightened pull lines ( 2 ).
  • the positioning convex step ( 301 A) on the loosening switch ( 301 D) detaches from the ratchet ( 301 B 2 ), that is, the wedge-shaped slide block ( 301 A 2 ) detaches from the ratchet ( 301 B 2 ), and the ratchet ( 301 B 2 ) is released from the wedge-shaped slide block ( 301 A 2 ), so that the ratchet ( 301 B 2 ) is in a free state, which drives the pull line fixing device ( 302 ) to enter a loosened state, thereby loosening the pull line ( 2 ).
  • the pull line fixing device ( 302 ) includes a thread hole ( 302 A), a pull line fixing bolt ( 302 I), and a bobbin ( 302 L).
  • the pull line ( 2 ) is passed through the thread hole ( 302 A) and fixed by the pull line fixing bolt ( 302 I), and may be wound onto the bobbin ( 302 L).
  • the pull line fixing device ( 302 ) is connected to the ratchet ( 301 B 2 ) of the control switch ( 301 ), and the ratchet ( 301 B 2 ) of the control switch ( 301 ) is rotated to drive the bobbin ( 302 L), thereby winding or loosening the pull line ( 2 ).
  • the retractor casing ( 304 ) is used for fixing and mounting the control switch ( 301 ) and the pull line fixing device ( 302 ), and includes a main body ( 304 L), a top cover ( 304 G), screws ( 304 J), a thread hole ( 304 A), a silica gel film ( 304 K), a seal ring ( 304 B), a casing side plate ( 304 L 1 ), and screw holes ( 304 C).
  • the control switch ( 301 ) and the pull line fixing device ( 302 ) are mounted in the retractor casing ( 304 ).
  • the top cover ( 304 G) is fixed to the main body ( 304 L) by using the screws ( 304 J).
  • the pull line ( 2 ) is passed through the thread hole ( 304 A) and the seal ring ( 304 B), and then fixed into the thread hole ( 302 A) of the pull line fixing device ( 302 ) by the pull line fixing bolt ( 302 I).
  • Buttons of the tightening switch ( 301 C) and the loosening switch ( 301 D) are wrapped by the silica gel film ( 304 K), and the silica gel film ( 304 K) and the seal ring ( 304 B) are fixed to the main body ( 304 L) by the casing side plate ( 304 L 1 ).
  • the screw holes ( 304 C) are used for fixing the retractor casing ( 304 ) to the mandible ( 5 ).
  • a restoring spring ( 305 ) may further be mounted.
  • the restoring spring ( 305 ) is a coil spring, which may provide a force for driving reverse rotation of the ratchet ( 301 B 2 ), so that the ratchet ( 301 B 2 ) reversely rotates rapidly, and drives the pull line fixing device ( 302 ) to enter a loosened state, thereby achieving fast loosening of the pull line ( 2 ).
  • the restoring spring ( 305 ) has one end fixed to the bobbin ( 302 L) and the other end fixed to the main body ( 304 L).
  • the retractor ( 3 ) may further be provided with a protective sheath ( 306 ).
  • the protective sheath ( 306 ) is a thin wall tube made of a medical flexible material, and is mounted in the retractor casing ( 304 ), and sequentially passed through the thread hole ( 304 A) and the seal ring ( 304 B) on the casing, the thread hole ( 302 A) on the pull line fixing device, the top cover seal ring ( 304 B 1 ) of the casing, and a through hole ( 304 A 1 ) on a nut for fixing the top cover seal ring of the casing.
  • the pull line ( 2 ) may be passed along the protective sheath ( 306 ), which not only provides a routing function, but also protects the pull line ( 2 ). Refer to FIG. 22J to FIG. 22P .
  • the retractor ( 3 ) is fixed to the lower part of the mandible ( 5 ), and tightened by using screws. Then, one end of each of four pull lines ( 2 ) is fixed to a corresponding one of four corners of the pull plate ( 1 ). Next, a surgical knife is used to incise the mucous membrane of the tongue base portion, and the pull plate ( 1 ) is implanted into the muscular layer under the mucous membrane layer of the tongue base portion and/or the tongue dorsum portion of the human body. A special surgical retractor is penetrated into the tongue body from a position close to the mandible ( 5 ), and the four pull lines ( 2 ) are respectively drawn to the vicinity of the mandible ( 5 ) by using the surgical retractor.
  • the pull lines ( 2 ) are guided into the protective sheath ( 306 ) from the bottom end of the protective sheath ( 306 ), and then drawn out from the top end of the protective sheath ( 306 ).
  • the pull lines ( 2 ) are properly tightened so as to maintain effective pulling to the tongue base portion.
  • the pull lines ( 2 ) drawn out from the top end of the protective sheath ( 306 ) is tied, and then the protective sheath ( 306 ) and the pull lines ( 2 ) are properly pulled downward, so that the protective sheath ( 306 ) and the pull lines ( 2 ) enter the casing ( 304 ) of the retractor.
  • pull line fixing bolt ( 302 I) is tightened to fix the pull lines ( 2 ) to the thread hole ( 302 A) of the pull line fixing device, thus completing the whole mounting process.
  • the surgical incisions are sutured, thus completing the surgical operation. Refer to FIG. 22J to FIG. 22P .
  • this embodiment is basically the same as the technical solution of Embodiment 22.
  • the pull line fixing device ( 302 ) connected to the ratchet ( 301 B 2 ) being the core component of the control switch ( 301 ) of the retractor is the bobbin ( 302 L)
  • the pull line ( 2 ) is wound onto the bobbin ( 302 L)
  • the rotation of the bobbin ( 302 L) is controlled by controlling the rotation of the ratchet ( 301 B 2 ), so as to control the tightening and loosening degrees of the pull line ( 2 ).
  • the difference lies in that: the pull line fixing device ( 302 ) connected to the ratchet ( 301 B 2 ) being the core component of the control switch ( 301 ) of the retractor is a thread-bolt structure, and the position of the binding plate ( 302 C) on the thread-bolt structure is controlled through rotation of the ratchet ( 301 B 2 ), so as to adjust the tightening degree or loosening degree of the pull line ( 2 ).
  • a Tongue Pulling Device of the Present Invention that is Adjusted by the Patient from a Position Between the Lower Lip and the Lower Teeth after Surgery
  • FIG. 24A to FIG. 24C a tongue pulling device of the present invention that is adjusted by the patient from a position between the lower lip and the lower teeth after surgery is shown.
  • the tongue pulling device of the present invention is mounted on the front surface of the mandible and close to the bottom portion of the mandible, so that the control switch ( 301 ) of the adjusted retractor faces upward. In this way, after surgery, the lower lip is pulled apart, and a screwdriver ( 9 ) is inserted into a cross slot of the control switch ( 301 ) to rotate the bolt that serves as the control switch ( 301 ), so as to tighten or loosen the pull line ( 2 ).
  • Adjustment can be carried out from a position between the lower lip and the lower teeth, a small surgical wound is created, the appearance of the patient is not affected, and adjustment by the patient is facilitated.
  • a Tongue Pulling Device of the Present Invention that is Adjusted by the Patient from the Bottom Portion of the Mandible after Surgery
  • FIG. 25A and FIG. 25B a tongue pulling device of the present invention that is adjusted by the patient from the bottom portion of the mandible after surgery is shown.
  • the tongue pulling device of the present invention is mounted on the front surface of the mandible and close to the bottom portion of the mandible.
  • the silica gel plug ( 304 D) of the casing of the tongue pulling device of the present invention is outside the skin at the bottom portion of the mandible, and has the same color as that of the skin at the bottom portion of the mandible.
  • the silica gel plug ( 304 D) is removed, and the screwdriver ( 9 ) is used to press the control switch ( 301 ) upward and at the same time rotate the control switch ( 301 ), so as to tighten or loosen the pull line ( 2 ) to adjust the tension of the pull line ( 2 ), thereby controlling the pulling degree of the tongue base portion and/or the tongue dorsum portion.
  • FIG. 26A and FIG. 26B a double-retractor tongue pulling device of the present invention is shown.
  • the difference lies in that: two retractors ( 3 ) are mounted on the front portion of the mandible and close to the bottom portion of the mandible, and the distance between the two retractors ( 3 ) is about 10 mm to 25 mm.
  • retractors ( 3 ) having a small diameter and having an anti-cutting buffer device ( 303 ) are generally used, so as to achieve the objective of minimal invasive treatment.
  • Embodiment 1 lies in that: the pull plate ( 1 ) of Embodiment 1 is formed by a titanium metal plate subjected to a metal stamping manufacturing process, and is one component; while in this embodiment, the pull plate ( 1 ) is formed by two components, that is, the pull plate ( 1 ) of the present invention is divided into a left-side pull plate ( 109 A) and a right-side pull plate ( 109 B), where the left-side pull plate ( 109 A) is assembled to the right-side pull plate ( 109 B) through a mechanical connection mechanism ( 109 E).
  • a gap ( 109 C) and junctions ( 109 D) are formed between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B).
  • the gap ( 109 C) is required to provide such a space that can maintain normal survival and tension of the tongue tissues in the gap, particularly, continuity of musculus genioglossus and other fibrous tissues to the fibrous tissues under the mucous membrane of the tongue dorsum or the tongue base, which on one hand reduces the wound, and on the other hand increases the pulling force to the tongue dorsum ( 42 ) and/or the tongue base ( 41 ).
  • the maximum width (H 109 ) of the gap ( 109 C) is 1 mm to 10 mm, and preferably 2 mm to 5 mm.
  • the length (L 109 ) of the gap ( 109 C) is 5 mm to 20 mm, and preferably 5 mm to 15 mm.
  • the mechanical connection mechanism ( 109 E) is a mechanical fixing mechanism capable of fixing two metal plates, and is for example a rivet structure, a concave-convex engagement structure, a thread fixing structure or other mechanical fixing mechanisms.
  • the rivet structure is adopted. Titanium metal rivets ( 109 E 1 ) are used at the junctions ( 109 D) between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) to rivet the left-side pull plate ( 109 A) to the right-side pull plate ( 109 B).
  • the pull line ( 2 ) has one end fixed to the pull line fixing structure ( 102 ) so as to be connected to the pull plate ( 1 ), and the other end fixed to the retractor ( 3 ) so as to be connected to the retractor ( 3 ).
  • the four pull lines ( 2 ) spatially position the pull plate ( 1 ). Meanwhile, the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) are combined through the rivets ( 109 E 1 ), and fibrous tissues of the tongue muscles are sandwiched in the gap ( 109 C) between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B).
  • the gap ( 109 C) Through the gap ( 109 C), the continuity of musculus genioglossus and other fibrous tissues to the fibrous tissues under the mucous membrane of the tongue dorsum or the tongue base is maintained. On one hand, the wound is reduced. On the other hand, since the rivets ( 109 E 1 ) are inserted for fixing, and fibrous tissues of musculus genioglossus are sandwiched between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B), the capability of spatially positioning the pull plate ( 1 ) is further improved, thereby effectively preventing shifting of the pull plate ( 1 ); and the pulling force to the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) is increased.
  • a surgical method for implanting the tongue pulling device of the present invention mainly includes the following steps:
  • surgical sites such as the tongue and the oral cavity are disinfected under anesthesia according to general requirements of oral cavity, head and neck surgeries.
  • the pull lines ( 2 ) are drawn to the vicinity of the mandible ( 5 ) by using a guide needle.
  • the contact area between the pull plate ( 1 ) and the retracted portion of the tongue body is increased, so that the pressure generated during pulling is greatly reduced, which not only improves the pulling effect, but also avoids cutting the tongue tissues when the tongue body is retracted, thereby reducing injuries.
  • the combined-type pull plate ( 1 ) formed by the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) continuity of musculus genioglossus and other fibrous tissues to the fibrous tissues under the mucous membrane of the tongue dorsum or the tongue base is maintained to the maximum extent, thereby further enhancing the capability of spatially positioning the pull plate ( 1 ) and improving the effect of retracting the tongue dorsum ( 42 ) and/or the tongue base ( 41 ).
  • the retractor ( 3 ) is conveniently fixed to the mandible ( 5 ), and the pull lines ( 2 ) are fixed to the retractor ( 3 ), so that the pulling degree of the pull lines ( 2 ) can be conveniently adjusted to accurately control the pulling distance and the pulling force, thereby achieving an optimal therapeutic effect.
  • the double-button type retractor ( 3 ) that can be adjusted after surgery not only the doctor can conveniently adjust and fix the pull lines ( 2 ) during surgery, but also woundless adjustment can be achieved after surgery.
  • Embodiment 27 lies in the following aspects.
  • the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) of this embodiment have a U-shaped cross section, as shown in FIG. 28E and FIG. 28F ; while the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) of Embodiment 27 have an L-shaped cross section, as shown in FIG. 27E and FIG. 27F .
  • the mechanical connection mechanism ( 109 E) between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) adopts a concave-convex engagement structure, where convex steps on the lock screw ( 109 E 4 ) and a concave groove on a lock nut ( 109 E 3 ) form the concave-convex engagement structure, as shown in FIG. 28E , FIG. 28 E 1 and FIG. 28J ; while the rivet structure is adopted in Embodiment 27, as shown in FIG. 27E , FIG. 27 E 1 and FIG. 27I .
  • the gap ( 109 C) formed between the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B) in this embodiment is accomplished through corresponding curvatures of assembled edges of the left-side pull plate ( 109 A) and the right-side pull plate ( 109 B), as shown in FIG. 28A , FIG. 28G and FIG. 28H ; while in Embodiment 27, it is adjusted through the height of rivet posts ( 109 E 2 ) of the rivet structure, as shown in FIG. 27I .
  • This embodiment shows a pull line ( 2 ) of the present invention, which, as shown in FIG. 29A , is different from Embodiment 10 in that: the pull line ( 2 ) is formed by spirally braiding a plurality of metal wires having a diameter of 0.1 mm to 0.5 mm. In this embodiment, it is specifically formed by spirally braiding five titanium-nickel shape memory alloy (Nitinol alloy) wires having a diameter of 0.2 mm.
  • the metal wires of such a small cable structure of braided Nitinol alloy wires not only have high biocompatibility, but also have a large tensile strength and high fatigue resistance, and therefore are suitable for manufacturing the pull line ( 2 ) of the present invention.
  • this embodiment shows a composite pull line ( 2 ) of a corrugated tube type of the present invention, and is different from Embodiment 29 and Embodiment 10 in that: a spiral line formed by spirally braiding a plurality of metal wires is used as the draw line ( 201 ), and a corrugated tube is used as the sleeve ( 202 ), so as to form a composite pull line ( 2 ).
  • the corrugated tube used as the sleeve ( 202 ) may be continuous; or may be discontinuous, and sleeved on the draw line ( 201 ) in segments, as shown in FIG. 30B .
  • the corrugated tube in this embodiment may be made of a medical metal material or a medical polymer material.
  • Metal corrugated tubes include titanium and titanium alloy corrugated tubes, medical grade stainless steel corrugated tubes and the like.
  • the corrugated tubes of medical polymer materials include medical grade polytetrafluoroethylene corrugated tubes, medical grade terylene corrugated tubes, medical grade polythene corrugated tubes, medical grade polyurethane corrugated tubes and the like.
  • this embodiment shows a composite pull line ( 2 ) of a coil spring tube type of the present invention, which is different from Embodiment 30 and Embodiment 10 in that: the sleeve ( 202 ) is a coil spring tube.
  • the coil spring tube used as the sleeve ( 202 ) may be continuous, and sleeved on the draw line ( 201 ), as shown in FIG. 31A ; or may be discontinuous, and sleeved on the draw line ( 201 ) in segments, as shown in FIG. 31B .
  • this embodiment shows a pull line ( 2 ) of a pearl necklace type of the present invention, which is different from Embodiment 29 and Embodiment 10 in that: the draw line ( 201 ) is provided with beads ( 203 ), and the beads ( 203 ) may be riveted to the draw line ( 201 ), or may be strung on the draw line ( 201 ) in the form a pearl necklace, so that the string of beads ( 203 ) constitutes the sleeve ( 202 ).
  • the beads ( 203 ) constituting the sleeve ( 202 ) are made of a medical metal material or a medical polymer material, which is selected from a group consisting of: metal materials, including titanium and titanium alloy and medical grade stainless steel; and polymer materials, including medical grade polytetrafluoroethylene, medical grade polycarbonate (PC), medical grade polythene (PE), medical grade polyurethane (PU) and medical grade polypropylene (PP).
  • the beads made of a medical polymer material are less easily detected by X-ray than metal beads.
  • the beads are specifically made of titanium metal, and are each provided with a through hole matching with the draw line ( 201 ), for the draw line ( 201 ) to pass through.
  • the titanium metal beads are strung on the draw line ( 201 ) to form the sleeve ( 202 ), so as to increase the contact area between the tongue tissues and the pull line ( 2 ), and facilitate growth and attachment of the tongue tissues.
  • the present invention provides a method for treating OSAHS, including:
  • providing an implanted tongue pulling device where the tongue pulling device is implanted into the mandible ( 5 ) and the tongue body ( 4 ) of a human body to tighten the tongue dorsum ( 42 ) and/or the tongue base ( 41 ), is suitable for treating OSAHS, and includes:
  • a pull plate ( 1 ) being a flat implant capable of being implanted under the mucous membrane layer of the tongue body, and including through holes ( 101 ) allowing growth and penetration of fibrous tissues and pull line fixing mechanisms ( 102 );
  • a pull line ( 2 ) being a thread made of a material capable of being implanted into the human body for a long term
  • pull line ( 2 ) has one end connected to the pull plate ( 1 ) and the other end fixed to the retractor ( 3 );
  • the patient after surgery can adjust the tightening degree of the implanted tongue pulling device of the present invention to the tongue dorsum ( 42 ) and/or the tongue base ( 41 ).
  • the pulling force of the tongue pulling device of the present invention to the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) is small so as to facilitate the movement of the tongue.
  • the pulling force of the tongue pulling device of the present invention to the tongue dorsum ( 42 ) and/or the tongue base ( 41 ) may be increased to adjust the forward pulling distance of the tongue dorsum ( 42 ) and/or the tongue base ( 41 ), so as to keep the palatopharyngeal portion open, thereby preventing OSAHS.
  • the tongue pulling device of the present invention has overcome numerous technical barriers, particularly, problems such as how to avoid cutting the tongue muscles and how to create a conduit for minimally invasive surgery.
  • Current clinical studies indicate that after surgery, the patients feel good, and have normal speech and swallowing functions. Therefore, the present invention surely has good efficacy, and is an effective method for treating OSAHS.

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  • Vascular Medicine (AREA)
  • Public Health (AREA)
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  • Pulmonology (AREA)
  • Otolaryngology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
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  • Orthopedics, Nursing, And Contraception (AREA)
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US13/824,287 2010-09-29 2011-09-26 Implanted tongue pulling device, pull plate, pull line, retractor and method Abandoned US20130180528A1 (en)

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CN201010299195.6A CN102198010B (zh) 2010-09-29 2010-09-29 植入型舌牵拉装置、牵引板、牵引线、牵拉器及方法
PCT/CN2011/080177 WO2012041205A1 (zh) 2010-09-29 2011-09-26 植入型舌牵拉装置、牵引板、牵引线、牵拉器及方法

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CA2812914A1 (en) 2012-04-05
KR101922139B1 (ko) 2018-11-26
EP2623072B1 (en) 2019-02-27
US20150366701A1 (en) 2015-12-24
US20170296376A1 (en) 2017-10-19
US11000403B2 (en) 2021-05-11
JP2013544541A (ja) 2013-12-19
CN102198010B (zh) 2015-11-25
WO2012041205A1 (zh) 2012-04-05
JP6302968B2 (ja) 2018-03-28
KR20140038919A (ko) 2014-03-31
EP2623072A1 (en) 2013-08-07
CN102198010A (zh) 2011-09-28
CA2812914C (en) 2018-06-12
SG189075A1 (en) 2013-05-31
CA3002395C (en) 2020-04-28
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AU2011307718A1 (en) 2013-05-02
US9724229B2 (en) 2017-08-08

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