WO2000066050A1 - Implant lateral pharynge - Google Patents

Implant lateral pharynge Download PDF

Info

Publication number
WO2000066050A1
WO2000066050A1 PCT/EP2000/003607 EP0003607W WO0066050A1 WO 2000066050 A1 WO2000066050 A1 WO 2000066050A1 EP 0003607 W EP0003607 W EP 0003607W WO 0066050 A1 WO0066050 A1 WO 0066050A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
implanted
throat
tongue
parts
Prior art date
Application number
PCT/EP2000/003607
Other languages
German (de)
English (en)
Inventor
Wolfgang Fege
Original Assignee
Wolfgang Fege
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Wolfgang Fege filed Critical Wolfgang Fege
Priority to EP00920730A priority Critical patent/EP1175190A1/fr
Publication of WO2000066050A1 publication Critical patent/WO2000066050A1/fr

Links

Classifications

    • 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
    • A61F2/08—Muscles; Tendons; Ligaments
    • 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

Definitions

  • the invention relates to a pharyngeal side implant.
  • OSAS obstructive sleep apnea syndrome
  • REM rapid eye movement
  • the OSAS is in need of treatment because cardiac muscle damage, coronary artery disease, cerebral vascular disease with an increase in stroke and cerebral reduction as well as high blood pressure crises and a large number of hormonal disorders can occur due to the regular oxygen desaturation of the blood during sleep.
  • the frequent lack of deep sleep phases, the disturbance of REM sleep phases and the frequent awakening lead to listlessness, daytime tiredness and a tendency to fall asleep during the day, which can lead to accidents when operating machines or driving a car.
  • oral prostheses are known, which before to be used for falling asleep in the throat and have the purpose of pushing the base of the tongue forward.
  • oral prostheses are only promising if the OSAS is mild and are also complicated because of the complexity
  • Surgical therapeutic measures are also known for the treatment of OSAS, which essentially consist in improving the air passage in the nasal and nasopharynx area. Attempts have even been made to advance the lower and upper jaw or a sawn-out quadrilateral of the lower jaw in the chin area with attached tongue muscles, in order to improve the air passage. This is a major surgical procedure, which is a considerable burden for the patient and, moreover, rarely delivers acceptable results since, like the surgical therapy measures described above, it only treats indirectly because the relapse of the patient
  • Tongue body and its application to the back of the throat and the associated closure of the airway is not causally avoided.
  • the unpublished German patent application with the official file number 197 56 956 describes an implant for implantation in a tongue, which has a fastening part for fastening to the hyoid bone or to the tissue located to the side of the tongue, as well as a support part which extends from the fastening part in extends the area of the base of the tongue and essentially transverse to the direction of the tongue.
  • the invention has for its object to provide a pharyngeal implant through which the OSAS is effectively avoided or reduced and impairments of the patient, such as difficulty swallowing and disturbances during sleep, are largely avoided, in particular in the event that the tongue-type implant according to German patent application 197 56 956 is not sufficient for the treatment of OSAS.
  • the basic idea of this teaching is to create a pharyngeal side implant that can be implanted such that one end of the implant is arranged on the cervical vertebra side and the other end on the tongue side edge side.
  • the pharyngeal side implant according to the invention can advantageously be used if the supporting effect of the above-mentioned basic tongue implant is insufficient and a basic tongue implant reinforcement or a changing basic tongue implant should not be carried out for various reasons.
  • a possible reason for this would be that too much impairment of the basic tongue mobility is feared or that the basic tongue implant has healed up so well that further surgical manipulation in the area of the implant leads to the fear of excessive scarring or a different deterioration in the result of the operation.
  • the main effect of the pharyngeal side implant according to the invention would be to support the edge of the tongue; a side effect would be the support of the lateral throat tissue.
  • the pharyngeal side implant according to the invention can also be used advantageously if an essential further cause of the OSAS is seen in the collapse of the lateral throat walls.
  • the main effect of the pharyngeal side implant would be to support the lateral pharynx tissue, with the side effect of supporting the edge of the tongue.
  • the lateral edge of the tongue can be supported more than if only a basic tongue implant is used, without the entire supporting force being transmitted across the base of the tongue, ie the tongue remains more mobile than with the sole basic tongue support and the swallowing process is less is impaired, since the support force is better distributed in the entire throat cross-section and / or over part of the length of the throat.
  • the implant parts of the implants are advantageously curved, such that in the implanted state the convex side faces the inside of the throat or the throat mucosa. As a result, particularly good support effects are exerted on the lateral edge of the tongue and / or the lateral throat tissue.
  • FIG. 1 shows a cross section through the facial skull at the level of the back of the tongue with two implant parts of an inserted implant according to the invention
  • 2 shows an oral cavity from the front with the palate and cheek mucosa removed on the left side and inserted two-part implants
  • FIG. 3 shows a lateral sagittal section through the lower facial skull (the mouth and nose area opened from the right by removing the right lower and upper jaw) with two implanted Implant parts of implants according to the invention.
  • FIGS. 1 to 3 The anatomical parts shown schematically in FIGS. 1 to 3 are designated with reference numerals as follows:
  • FIG. 1 shows the arrangement of a first implant 1 with a left implant part 46 and a right implant part 52.
  • the implant parts 46, 52 each have a front end 50, 56 on the tongue edge and a rear end 48, 54 on the cervical vertebra side.
  • the implant 48, 54 on the cervical vertebra side can be connected to the spine 38, for example by means of a screw; however, it can also be arranged at a distance from the spine and end in the tissue adjacent to the spine, as a result of which a greater or lesser degree of mobility is maintained in all directions for this implant end, the mobility in the direction of the spine being limited by the latter itself.
  • the mobility in the other directions is mainly limited by the elasticity of the tissue located between the end of the implant and the spine, but also by restoring forces of the remaining tissue adjacent to the implant.
  • the front end 50, 56 of the implant parts on the side of the tongue side can be arranged in the region of the side of the tongue side or rest against the side of the tongue side or be implanted in the side of the tongue.
  • the two implant parts 46, 52 are preferably implanted through a slot in the lateral tongue back 4 and each extend in a curved shape behind the tonsil to the cervical vertebrae. per 38.
  • the bent implant parts are arranged so that in the implanted state the convex side of the implant parts faces the inside of the throat or the pharynx mucosa.
  • the implant parts 46, 52 of the implant 1 can thus perform two functions, namely supporting the lateral tongue areas against falling back and supporting the throat side wall against collapsing towards the middle of the throat.
  • FIG. 2 which shows the oral cavity from the front with the palate and cheek mucosa removed on the left, shows on the one hand the arrangement of the implant 1 described in connection with FIG. 1 and the arrangement of a further implant 1 '.
  • the further pharyngeal side implant 1 ' likewise has two implant parts, a left implant part 60 and a right implant part 61. These implant parts 60, 61 are preferably implanted at an angle of approximately 45 ° to the implant parts 46, 52 and are used in particular to support the side wall of the throat.
  • implant parts 60, 61 run obliquely from the front up through the front lateral soft palate to the rear below the lateral spine and have no contact with the tongue. They each have a front end of the soft palate or throat wall 72, 74 and a rear end of the cervical vertebra 76, 78 and, like the implant parts 46, 52 of the implant 1, are curved such that in the implanted state the convex side faces the inside of the throat or the pharynx mucosa.
  • the use of the implant 1 ' that is to say the implant parts 60 and 61, has advantages in particular if the throat above the back of the tongue, that is to say in the region of the palate arches, collapses during sleep and this region is to be supported.
  • the rear end 76, 78 of the implant parts 60, 61 of the implant 1 ' is fastened to or supported on the cervical spine 38 or is fastened or supported in the tissue lying in front of it.
  • the front end 72, 74 of the inserted implant parts 60, 61 is attached to or is supported on the tissue located in the vicinity of the lateral hard palate posterior margin 6 and / or the pterygoid bone 70.
  • FIG 3 shows the respective right implant parts 52 of the implant 1 and 61 of the implant 1 'according to the invention in the respectively implanted position, the right side face with opening of the right mouth and right nose being shown in the drawing for better illustration is removed.
  • the implant parts 46, 52, 60, 61 are essentially strip-shaped, whereby strip-shaped should also be understood to mean a structure that is flat but at different points also of different thicknesses and widths.
  • the longitudinal extent of the implant parts is preferably greater than the implant thickness, it being possible for the transverse extent to be variable.
  • the implant parts have, at least after the implantation, a shape which is convexly curved with respect to the side wall of the pharynx.
  • the implants 1 and 1 ' can be used individually and in combination with one another or individually or together. can be used with a basic tongue implant, especially if it has been proven from the outset that OSAS both causes the tongue to fall back and the side of the throat to collapse. The choice of implants depends on which structures collapse significantly during sleep.
  • the lateral pharynx implants according to the invention are preferably very soft in order not to irritate or injure the essential structures such as nerves and vessels. They consist of cultivated, body-own tissue or of plastic or a combination of both materials. Instead of grown, body-own tissue, body-own tissue taken elsewhere can also be used.

Landscapes

  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Transplantation (AREA)
  • Nursing (AREA)
  • Rehabilitation Therapy (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Otolaryngology (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Prostheses (AREA)
  • Rheumatology (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

L'invention concerne un implant latéral pharyngé comprenant un premier et/ou un second implant (1; 1') qui présentent dans chaque cas deux parties d'implant (46, 52; 60, 61) présentant chacune des extrémités avant situées côté bord latéral de la langue ou côté paroi latérale pharyngée ou côté bord du voile du palais (50, 56; 72, 74), de même qu'elles présentent chacune une extrémité arrière située côté vertèbres cervicales (48, 54; 76, 78). Les deux parties d'implant (46 et 52 et/ou 60 et 61) des implants (1, 1') sont de préférence cintrées, de manière qu'à l'état implanté, la face convexe soit tournée vers la surface intérieure du pharynx ou la muqueuse du pharynx. L'extrémité arrière (48, 54; 76, 78) des parties d'implant est fixée sur la colonne vertébrale au niveau des cervicales (38) ou prend appui dessus ou est implantée (fixée) en saillie sur le tissu situé devant ou dans ledit tissu.
PCT/EP2000/003607 1999-05-03 2000-04-20 Implant lateral pharynge WO2000066050A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP00920730A EP1175190A1 (fr) 1999-05-03 2000-04-20 Implant lateral pharynge

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE1999120114 DE19920114A1 (de) 1999-05-03 1999-05-03 Rachenseitenimplantat
DE19920114.5 1999-05-03

Publications (1)

Publication Number Publication Date
WO2000066050A1 true WO2000066050A1 (fr) 2000-11-09

Family

ID=7906689

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2000/003607 WO2000066050A1 (fr) 1999-05-03 2000-04-20 Implant lateral pharynge

Country Status (3)

Country Link
EP (1) EP1175190A1 (fr)
DE (1) DE19920114A1 (fr)
WO (1) WO2000066050A1 (fr)

Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009542377A (ja) * 2006-07-06 2009-12-03 クワイエセンス メディカル インコーポレイテッド 睡眠時無呼吸症処置用の装置及び方法
US7686021B2 (en) * 2002-02-04 2010-03-30 Medtronic Xomed, Inc. Pharyngeal tissue stabilization
US8186355B2 (en) 2005-11-09 2012-05-29 Koninklijke Philips Electronics N.V. Glossoplasty using tissue anchor glossopexy with volumetric tongue reduction
US8327854B2 (en) 2008-05-12 2012-12-11 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8413661B2 (en) 2008-08-14 2013-04-09 Ethicon, Inc. Methods and devices for treatment of obstructive sleep apnea
US8523760B2 (en) 2008-01-03 2013-09-03 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8733363B2 (en) 2010-03-19 2014-05-27 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US8776799B2 (en) 2010-03-19 2014-07-15 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US8905033B2 (en) 2011-09-28 2014-12-09 Ethicon, Inc. Modular tissue securement systems
US8915252B2 (en) 2008-12-01 2014-12-23 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US8973582B2 (en) 2011-11-30 2015-03-10 Ethicon, Inc. Tongue suspension device and method
US9161855B2 (en) 2011-10-24 2015-10-20 Ethicon, Inc. Tissue supporting device and method
US9173766B2 (en) 2012-06-01 2015-11-03 Ethicon, Inc. Systems and methods to treat upper pharyngeal airway of obstructive sleep apnea patients
US9326886B2 (en) 2009-10-29 2016-05-03 Ethicon, Inc. Fluid filled implants for treating obstructive sleep apnea
US9439801B2 (en) 2012-06-29 2016-09-13 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9510922B2 (en) 2010-05-21 2016-12-06 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9707122B2 (en) 2010-07-26 2017-07-18 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9877862B2 (en) 2009-10-29 2018-01-30 Ethicon, Inc. Tongue suspension system with hyoid-extender for treating obstructive sleep apnea
US9974683B2 (en) 2009-10-30 2018-05-22 Ethicon, Inc. Flexible implants having internal volume shifting capabilities for treating obstructive sleep apnea
US10470760B2 (en) 2011-12-08 2019-11-12 Ethicon, Inc. Modified tissue securement fibers

Families Citing this family (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6431174B1 (en) 2000-08-10 2002-08-13 Pi Medical, Inc. Method and apparatus to treat conditions of the naso-pharyngeal area
US6450169B1 (en) 1999-09-17 2002-09-17 Pi Medical, Inc. Braided implant for snoring treatment
US6250307B1 (en) 1999-09-17 2001-06-26 Pi Medical, Inc. Snoring treatment
US7017582B2 (en) 2002-02-04 2006-03-28 Restore Medical Inc. Stiffening pharyngeal wall treatment
US7647931B2 (en) 2002-12-30 2010-01-19 Quiescence Medical, Inc. Stent for maintaining patency of a body region
US7992566B2 (en) * 2002-12-30 2011-08-09 Quiescence Medical, Inc. Apparatus and methods for treating sleep apnea
US7237554B2 (en) 2003-10-31 2007-07-03 Restore Medical, Inc. Airway implant
US7213599B2 (en) * 2003-10-31 2007-05-08 Restore Medical, Inc. Airway implant
EP1691760B1 (fr) * 2003-11-20 2012-06-27 Koninklijke Philips Electronics N.V. Dispositifs permettant de fixer des tissus dans le conduit pharyngien
DE102005000702B4 (de) 2005-01-04 2007-08-23 Klinikum Der Universität Regensburg Vorrichtung zur mittigen Implantation in einen Zungenkörper
US7337781B2 (en) 2005-04-15 2008-03-04 Restore Medical, Inc. Implant for tongue
US8517028B2 (en) 2006-06-23 2013-08-27 Medtronic Xomed, Inc. Stiffening procedure for sleep apnea
US20080078411A1 (en) 2006-10-03 2008-04-03 Restore Medical, Inc. Tongue implant for sleep apnea
US20080078412A1 (en) 2006-10-03 2008-04-03 Restore Medical, Inc. Tongue implant
WO2012082791A2 (fr) 2010-12-13 2012-06-21 Quiescence Medical, Inc. Appareil et méthodes pour traiter l'apnée du sommeil

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU1801414C (ru) * 1990-08-04 1993-03-15 Московский научно-исследовательский онкологический институт им.П.А.Герцена Протез черпаловидного хр ща
DE19501363A1 (de) * 1995-01-18 1995-09-21 Hans D Dipl Ing Weitermann Mechanische Schienung der Atemwege zur Verhinderung des Schnarchens und der Atemstillstände
DE19636680C1 (de) * 1996-09-10 1998-04-16 Ende Mathias Am Vorrichtung zum Verhindern des Schnarchens
WO1999032057A1 (fr) * 1997-12-20 1999-07-01 Wolfgang Fege Implant destine a etre implante dans une langue

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU1801414C (ru) * 1990-08-04 1993-03-15 Московский научно-исследовательский онкологический институт им.П.А.Герцена Протез черпаловидного хр ща
DE19501363A1 (de) * 1995-01-18 1995-09-21 Hans D Dipl Ing Weitermann Mechanische Schienung der Atemwege zur Verhinderung des Schnarchens und der Atemstillstände
DE19636680C1 (de) * 1996-09-10 1998-04-16 Ende Mathias Am Vorrichtung zum Verhindern des Schnarchens
WO1999032057A1 (fr) * 1997-12-20 1999-07-01 Wolfgang Fege Implant destine a etre implante dans une langue

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Title
SOVIET PATENTS ABSTRACTS Section PQ Week 9422, 20 July 1994 Derwent World Patents Index; Class P32, AN 94-181056, XP002143671 *

Cited By (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8430900B2 (en) 2002-02-04 2013-04-30 Medtronic Xomed, Inc. Pharyngeal wall treatment
US7686021B2 (en) * 2002-02-04 2010-03-30 Medtronic Xomed, Inc. Pharyngeal tissue stabilization
US8424531B2 (en) 2002-02-04 2013-04-23 Medtronic Xomed, Inc. Pharyngeal wall treatment
US8186355B2 (en) 2005-11-09 2012-05-29 Koninklijke Philips Electronics N.V. Glossoplasty using tissue anchor glossopexy with volumetric tongue reduction
US9393067B2 (en) 2005-11-09 2016-07-19 Koninklijke Philips N.V. Glassoplasty using tissue anchor glossopexy with volumetric tongue reduction
JP2009542377A (ja) * 2006-07-06 2009-12-03 クワイエセンス メディカル インコーポレイテッド 睡眠時無呼吸症処置用の装置及び方法
US8523760B2 (en) 2008-01-03 2013-09-03 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8747296B2 (en) 2008-01-03 2014-06-10 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8991398B2 (en) 2008-05-12 2015-03-31 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8707960B2 (en) 2008-05-12 2014-04-29 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8327854B2 (en) 2008-05-12 2012-12-11 Revent Medical, Inc. Partially erodable systems for treatment of obstructive sleep apnea
US8413661B2 (en) 2008-08-14 2013-04-09 Ethicon, Inc. Methods and devices for treatment of obstructive sleep apnea
US9144511B2 (en) 2008-08-14 2015-09-29 Ethicon, Inc. Methods and devices for treatment of obstructive sleep apnea
US8915252B2 (en) 2008-12-01 2014-12-23 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US9326886B2 (en) 2009-10-29 2016-05-03 Ethicon, Inc. Fluid filled implants for treating obstructive sleep apnea
US9877862B2 (en) 2009-10-29 2018-01-30 Ethicon, Inc. Tongue suspension system with hyoid-extender for treating obstructive sleep apnea
US9974683B2 (en) 2009-10-30 2018-05-22 Ethicon, Inc. Flexible implants having internal volume shifting capabilities for treating obstructive sleep apnea
US8776799B2 (en) 2010-03-19 2014-07-15 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9381109B2 (en) 2010-03-19 2016-07-05 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US8733363B2 (en) 2010-03-19 2014-05-27 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9510922B2 (en) 2010-05-21 2016-12-06 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US9707122B2 (en) 2010-07-26 2017-07-18 Revent Medical, Inc. Systems and methods for treatment of sleep apnea
US8905033B2 (en) 2011-09-28 2014-12-09 Ethicon, Inc. Modular tissue securement systems
US9592046B2 (en) 2011-09-28 2017-03-14 Ethicon, Inc. Modular tissue securement systems
US9161855B2 (en) 2011-10-24 2015-10-20 Ethicon, Inc. Tissue supporting device and method
US8973582B2 (en) 2011-11-30 2015-03-10 Ethicon, Inc. Tongue suspension device and method
US10470760B2 (en) 2011-12-08 2019-11-12 Ethicon, Inc. Modified tissue securement fibers
US9173766B2 (en) 2012-06-01 2015-11-03 Ethicon, Inc. Systems and methods to treat upper pharyngeal airway of obstructive sleep apnea patients
US9439801B2 (en) 2012-06-29 2016-09-13 Revent Medical, Inc. Systems and methods for treatment of sleep apnea

Also Published As

Publication number Publication date
EP1175190A1 (fr) 2002-01-30
DE19920114A1 (de) 2000-11-09

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