WO2017121282A1 - 用于植入型舌牵拉装置的涡轮蜗杆型牵拉器 - Google Patents

用于植入型舌牵拉装置的涡轮蜗杆型牵拉器 Download PDF

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Publication number
WO2017121282A1
WO2017121282A1 PCT/CN2017/070315 CN2017070315W WO2017121282A1 WO 2017121282 A1 WO2017121282 A1 WO 2017121282A1 CN 2017070315 W CN2017070315 W CN 2017070315W WO 2017121282 A1 WO2017121282 A1 WO 2017121282A1
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WIPO (PCT)
Prior art keywords
worm
turbine
hole
traction
fixing device
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Application number
PCT/CN2017/070315
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English (en)
French (fr)
Inventor
周星
张湘民
Original Assignee
周星
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
Priority claimed from CN201710005657.0A external-priority patent/CN106963540A/zh
Application filed by 周星 filed Critical 周星
Priority to US16/610,634 priority Critical patent/US11877949B2/en
Publication of WO2017121282A1 publication Critical patent/WO2017121282A1/zh

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    • 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
    • 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 worm-and-worm type retractor for an implantable tongue pull device, particularly for treating snoring and obstructive sleep apnea hypopnea syndrome (Obstructive Sleep Apnea/Hypopnea Syndrome, hereinafter referred to as OSAHS) a retractor for an implantable tongue pull device.
  • OSAHS obstructive Sleep Apnea/Hypopnea Syndrome
  • Obstructive sleep apnea hypopnea syndrome is a sleep-disordered disorder characterized by snoring, apnea, and hypopnea due to collapse and occlusion of the soft tissue of the upper airway during sleep.
  • OSAHS For the pathogenesis of OSAHS, it is generally believed that many factors work together. In addition to the narrow anatomy of the upper airway, the main reason is the relaxation of the pharyngeal muscle that maintains the upper airway during sleep, and the collapse of the soft tissue.
  • the obstruction site is mostly located in the pharyngeal plane or the pharyngeal plane.
  • the present inventors have disclosed an implantable tongue-root traction device in the Chinese patent application CN102198010A, which has achieved good clinical efficacy, Suitable for surgical treatment of patients with moderate or severe OSAHS due to collapse of the tongue.
  • a worm-type retractor for an implantable tongue pulling device comprising a control switch 301 capable of adjusting the pulling force of the traction wire 2, a traction wire fixing device 302 capable of fixing the traction wire 2, and a housing 304; control switch 301 And a traction wire fixture 302 is mounted within the housing 304;
  • the control switch 301 is a worm gear structure composed of a worm 301-1 and a turbine 301-2; the worm 301-1 is rotated to drive the turbine 301-2 to rotate in a clockwise or counterclockwise direction;
  • the traction line fixing device 302 is disposed on the turbine 301-2;
  • the housing 304 includes an inner cover 304-2; the control switch 301 is mounted on the housing 304 through the inner cover 304-2, and the pull wire fixing device 302 connected to the turbine 301-2 is The through hole 304-2-1 on the inner cover 304-2 protrudes.
  • This type of traction line fixing device 302 is exposed, and the technical solution built in the worm worm facilitates the installation of the puller wire 2 on the one hand, and the worm and worm structure is installed on the other hand due to the protection of the inner cover 304-2.
  • the mounting groove between the housing 304 and the inner cover 304-2 avoids the risk of the traction wire 2 being hinged by the worm structure due to slippage and displacement.
  • the housing 304 includes a lower cover 304-1, and the control switch 301 and the pull wire fixing device 302 are mounted in the lower cover 304-1.
  • the control switch 301 includes at least one turbine 301-2 and at least one worm 301-1.
  • the control switch 301 includes two turbines 301-2 and one worm 301-1; when the worm 301-1 rotates along the right hand, the right turbine rotates clockwise, and the left turbine rotates counterclockwise. Pulling the pull wire 2 to increase the pulling force; when the worm 301-1 rotates in the reverse direction, the right side turbine rotates in the counterclockwise direction, and the left side turbine rotates in the clockwise direction to loosen the pull line 2, so that The pulling force is reduced.
  • the worm 301-1 is provided with an adjustment hole 301-1-1 which is non-circular.
  • the adjustment hole 301-1-1 generally adopts a polygonal hole such as a triangular hole, a square hole, a pentagonal hole, or a hexagonal hole.
  • the worm 301-1 can be rotated by inserting a special screwdriver.
  • the pull wire fixing device 302 includes a through hole 302-1 and a wire groove 302-2 for fixing the pull wire 2, and a center line of the through hole 302-1 is three-dimensionally intersected with the wire groove 302-2. Generally, the center line of the through hole 302-1 may be perpendicular to the line groove 302-2.
  • the housing 304 includes a lower jaw front fixing plate 304-3; the lower jaw front fixing plate 304-3 is provided with a through hole 304-3-1 and a slot 304-3-2 through which the fixing screw 10 passes;
  • the slot 304-3-2 divides the mandible front fixing plate 304-3 into left and right sides. Since the slot hole 304-3-2 is provided, the mandible front fixing plate 304-3 can be adapted to different mandibular shapes, and has a good shape adjustment effect, and the mandible front fixing plate 304 is conveniently fixed by the fixing screw 10. 3 is fixed to the mandible 5 to fix the retractor 3 to the mandible 5.
  • control switch 301 composed of the turbine 301-2 and the worm 301-1 is first installed in the mounting groove 304-4 of the housing 304. Then, the inner cover 304-2 is covered, and the pull wire fixing device 302 connected to the turbine 301-2 is extended from the through hole 304-2-1 on the inner cover 304-2. Finally, use the screw 304-5 The lower cover 304-1 is fixed to the housing 304, that is, the assembly of the retractor 3 is completed.
  • a small incision is made through the oral cavity, and a small incision is made in the back of the tongue, and the traction plate 1 is implanted in the tongue 9 of the proximal pharynx. Then, a small incision of about 6 mm is opened in the lower part of the mandible 5, and the mandibular anterior fixation plate 304-3 of the retractor 3 is fixed on the mandible 5 with the fixing screw 10 similar to the nail structure.
  • the retractor 3 is fixed to the mandible 5; at this time, the mandibular front fixing plate 304-3 is in front of the mandible 5, the main body of the retractor 3, and the casing 304 of the worm worm structure is mounted.
  • the traction wire 2 is then passed through the tongue 9 with a special instrument and guided from the traction plate 1 implanted in the tongue 9 of the tongue back to the vicinity of the small incision of the mandible 5.
  • the lower cover 304-1 of the casing 304 is removed, and the pull wire 2 is attached and fixed to the pull wire fixing device 302 connected to the turbine 301-2.
  • the through hole 302-1 and the wire groove 302-2 of the pull wire fixing device 302 can firmly connect the pull wire 2 to the pull wire fixing device 302.
  • one end of the pull wire 2 is connected to the traction plate 1, and the other end is connected to the pull wire fixing device 302 of the retractor 3.
  • the lower cover 304-1 is reinstalled on the housing 304 by the screws 304-5, and the incision is sutured, that is, the worm-type traction type for the implant type tongue pulling device of the present invention is completed. Clinical implantation of the puller.
  • a special screwdriver 4 whose head shape matches the shape of the adjusting hole 301-1-1 is selected, and after the special screwdriver 4 is pierced through the skin of the mandible, The head of the special screwdriver 4 is inserted into the adjustment hole 301-3-1, and the special screwdriver 4 is rotated, thereby rotating the worm 301-1 of the control switch 301, and by rotating the turbine 301-2, The pull wire 2 is loosened or tensioned to adjust the magnitude of the pulling force of the pull wire 2.
  • the control switch 301 includes a turbine 301-2 and a worm 301-1; when the worm 301-1 rotates along the right hand, the turbine 301-2 rotates in a clockwise direction, and the traction line 2 is tightened. The pulling force is increased; when the worm 301-1 is rotated in the reverse direction, the turbine 301-2 is rotated in the counterclockwise direction to loosen the pulling wire 2, so that the pulling force is reduced.
  • the housing 304 includes an upper cover 304-6; the upper cover 304-6 is provided with a positioning hole 304-6-1.
  • the positioning holes 304-6-1 are matched to the dimensions of the end 302-3 of the pull wire fixture 302.
  • the lower cover 304-1 is provided with a through hole 304-1-1 through which the fixing screw 10 passes.
  • the inner cover 304-2 is further provided with a mounting hole 304-2-2 through which the fixing screw 10 passes and a positioning end 304-2-3 for positioning the traction wire fixing device 302;
  • the positioning end 304-2- 3 is provided with a through hole 304-2-31 through which the pull wire 2 passes and a positioning hole 304-2-32 for positioning the pull wire fixing device 302; connected to the turbine 301-2
  • the pull wire fixing device 302 protrudes from the through hole 304-2-1 on the inner cover 304-2 and is installed in the mounting groove 304-2-33 of the positioning end 304-2-3, and passes through The positioning holes 304-2-32 position the traction wire fixing device 302.
  • the control switch 301 composed of the turbine 301-2 and the worm 301-1 is first installed in the mounting groove 304-4 of the housing 304 to adjust the worm 301-1.
  • the hole 301-1-1 is aligned with the adjustment through hole 304-1-2 of the lower cover 304-1.
  • the inner cover 304-2 is covered, and the pull wire fixing device 302 connected to the turbine 301-2 is extended from the through hole 304-2-1 on the inner cover 304-2.
  • the positioning hole 304-6-1 on the upper cover 304-6 is aligned with the end 302-3 of the traction wire fixing device 302, and the upper cover 304-6 is covered, and the upper cover 304 is The positioning plate 304-6-2 at the lower end of the -6 is inserted into the upper cover mounting groove 304-2-4 on the inner cover 304-2, and the assembly of the retractor 3 can be completed.
  • a small incision is made through the oral cavity, and a small incision is made in the back of the tongue, and the traction plate 1 is implanted in the tongue 9 of the proximal pharynx. Then, a mounting groove having a width of about 6 mm and a depth of about 6 mm is opened in the middle of the lower portion of the mandible 5, and the fixing screw 10 similar to the bone nail structure is passed through the through hole 304-1-1 on the lower cover 304-1.
  • the positioning end 304-2-3 of the device 302 and the inner cover 304-2 is embedded in a mounting groove in front of the mandible 5, and the other portion of the retractor 3 is suspended in the lower portion of the mandible 5.
  • the traction wire 2 is then passed through the tongue 9 with a special instrument and guided from the traction plate 1 implanted in the tongue 9 of the tongue back to the vicinity of the small incision of the mandible 5.
  • the upper cover 304-6 of the housing 304 is removed, and the pull wire 2 is mounted and fixed to the pull wire fixing device 302 connected to the turbine 301-2.
  • the through hole 302-1 and the wire groove 302-2 of the pull wire fixing device 302 can firmly connect the pull wire 2 to the pull wire fixing device 302.
  • one end of the pull wire 2 is connected to the traction plate 1, and the other end is connected to the pull wire fixing device 302 of the retractor 3.
  • the positioning hole 304-6-1 on the upper cover 304-6 is aligned with the end 302-3 of the traction wire fixing device 302, and the upper cover 304-6 is covered, and the upper cover is attached.
  • the positioning plate 304-6-2 at the lower end of the 304-6 is inserted into the upper cover mounting groove 304-2-4 on the inner cover 304-2, and the upper cover 304-6 is reinstalled on the housing 304.
  • the suture incision that is, the clinical implantation of the worm-type retractor for the implant-type tongue pulling device of the present invention is completed.
  • a special screwdriver 4 whose head shape matches the shape of the adjusting hole 301-1-1 is selected, and after the special screwdriver 4 is pierced through the skin of the mandible, The head of the special screwdriver 4 is inserted into the adjustment hole 301-3-1 through the adjustment through hole 304-1-2 on the lower cover 304-1, and the special screwdriver 4 is rotated, thereby rotating the control.
  • the worm 301-1 of the switch 301 rotates the turbine 301-2 to loosen or tighten the traction wire 2, thereby adjusting the magnitude of the pulling force of the traction wire 2.
  • the retractor 3 is made of a medical material. Thereby, the retractor 3 is ensured to have good biocompatibility after being implanted into the human body.
  • the worm-type traction device for implantable tongue pulling device of the invention comprises a control switch 301 capable of adjusting the pulling force of the traction wire 2, a traction wire fixing device 302 capable of fixing the traction wire 2 and a casing 304;
  • the switch 301 and the pull wire fixing device 302 are mounted in a casing 304.
  • the control switch 301 is a worm gear structure composed of a worm 301-1 and a turbine 301-2. Since the control switch 301 employs a worm gear structure, the turbine 301-2 can be driven by rotating the worm 301-1, thereby rotating the traction line fixing device 302 connected to the turbine 301-2.
  • the tension wire 2 is tightened or loosened, and the tension of the traction wire 2 is adjusted, which has the advantages of compact structure, small volume and convenient adjustment.
  • FIG. 1 is a perspective view showing the structure of a reciprocator of a twin-turbo of the present invention.
  • Figure 2 is a front elevational view of Figure 1.
  • Fig. 3 is a cross-sectional view taken along line A-A of Fig. 2;
  • Fig. 4 is a schematic view showing the structure of the retractor of the twin-turbo of the present invention after the lower cover is opened.
  • Figure 5 is an exploded view of Figure 1.
  • Figure 6 is a schematic view showing the structure of a single turbine retractor of the present invention.
  • Figure 7 is an exploded view of Figure 6.
  • Figure 8 is a schematic view showing the operation of the retractor of the present invention.
  • Figure 9 is a schematic view showing the structure of a single-turbo retractor of the present invention.
  • Figure 10 is a schematic view of the structure of Figure 9 in a bottom view
  • Figure 11 is a plan view of Figure 9.
  • Fig. 12 is a cross-sectional view taken along line B-B of Fig. 11;
  • Fig. 13 is a cross-sectional view taken along line C-C of Fig. 12;
  • Fig. 14 is a schematic view showing the structure of the retractor when the upper cover is opened and viewed from the front.
  • Figure 15 is a rear elevational view of Figure 14.
  • Figure 16 is an exploded view of Figure 9.
  • Figure 17 is a schematic view showing the operation of a single-turbo retractor of the present invention.
  • 1 is a traction plate
  • 2 is a traction line
  • 3 is a puller
  • 4 is a special screwdriver
  • 5 is a mandible
  • 9 is a tongue
  • 10 is a fixing screw.
  • 301 is a control switch
  • 302 is a traction wire fixing device
  • 304 is a housing.
  • 301-1 is a worm and 301-2 is a turbine.
  • 302-1 is a through hole for fixing the fixed traction line
  • 302-2 is a wire groove
  • 302-3 is an end portion of the traction wire fixing device.
  • 304-1 is the lower cover
  • 304-2 is the inner cover
  • 304-3 is the lower front fixed plate
  • 304-4 is the mounting groove
  • 304-5 is the screw
  • 304-6 is the upper cover.
  • 301-1-1 is the adjustment hole on the worm;
  • 304-1-1 is the through hole for the screw to pass through the lower cover,
  • 304-1-2 is the adjustment through hole for the screwdriver to pass through,
  • 304-2-1 is inside Cover the through hole for the traction wire fixing device to pass through,
  • 304-2-2 is the mounting hole for the screw to pass through the inner cover,
  • 304-2-3 is the positioning end of the positioning traction wire fixing device,
  • 304-2-4 is the upper Cover mounting groove;
  • 304-2-31 is a through hole through which the traction wire passes,
  • 304-2-32 is a positioning hole of the traction wire fixing device, and
  • 304-2-33 is a mounting groove for installing a traction wire fixing device;
  • 304-3 -1 is a through hole for fixing screws on the fixing plate,
  • 304-3-2 is a slot on the front fixed plate of the lower jaw;
  • 304-6-1 is a positioning hole, and
  • 304-6-2 is a positioning plate.
  • Embodiment 1 Dual Turbo Puller for Implantable Tongue Pulling Device of the Present Invention
  • the retractor 3 includes a control switch 301 capable of adjusting the pulling force of the traction wire 2, a traction wire fixing device 302 capable of fixing the traction wire 2, and a housing 304.
  • the control switch 301 and the pull wire fixture 302 are mounted within the housing 304.
  • the control switch 301 is a worm gear structure composed of a worm 301-1 and a turbine 301-2. Rotating the worm 301-1 can drive the turbine 301-2 to rotate in a clockwise or counterclockwise direction.
  • the traction line fixing device 302 is provided on the turbine 301-2.
  • the housing 304 includes an inner cover 304-2, and the control switch 301 is mounted on the housing 304 via an inner cover 304-2, and the pull wire fixing device 302 connected to the turbine 301-2 is from the inner The through hole 304-2-1 on the cover 304-2 protrudes.
  • This method of exposing the traction wire fixing device 302 to the outside, and the built-in technology of the worm and worm, on the one hand, facilitates the installation of the puller wire 2; on the other hand, due to the protection of the inner cover 304-2, the worm worm structure is installed at In the mounting groove between the housing 304 and the inner cover 304-2, the traction wire 2 is prevented from being slipped and displaced by the turbine The risk of the rod structure being hinged.
  • the housing 304 includes a lower cover 304-1, and the control switch 301 and the pull wire fixing device 302 are mounted in the lower cover 304-1.
  • the control switch 301 includes at least one turbine 301-2 and at least one worm 301-1.
  • control switch 301 includes two turbines 301-2 and one worm 301-1; when the worm 301-1 rotates along the right hand, the right turbine rotates clockwise, and the left turbine Rotating in the counterclockwise direction, tensioning the traction wire 2 causes the pulling force to increase; when the worm 301-1 rotates in the reverse direction, the right turbine rotates counterclockwise, and the left turbine rotates clockwise The traction line 2 is loosened, so that the pulling force is reduced.
  • the worm 301-1 is provided with an adjustment hole 301-1-1 which is non-circular.
  • the adjustment hole 301-1-1 generally adopts a polygonal hole such as a triangular hole, a square hole, a pentagonal hole, or a hexagonal hole.
  • the worm 301-1 can be rotated by inserting a special screwdriver.
  • the pull wire fixing device 302 includes a through hole 302-1 and a wire groove 302-2 for fixing the pull wire 2, and a center line of the through hole 302-1 is three-dimensionally intersected with the wire groove 302-2. Typically, the center line of the through hole 302-1 is perpendicular to the wire groove 302-2.
  • the housing 304 includes a lower jaw front fixing plate 304-3; the lower jaw front fixing plate 304-3 is provided with a through hole 304-3-1 and a slot 304-3-2 through which the fixing screw 10 passes;
  • the slot 304-3-2 divides the mandible front fixing plate 304-3 into left and right sides.
  • the retractor 3 is made of a medical material.
  • the control switch 301 When assembling, the control switch 301 is first installed in the mounting groove 304-4 of the housing 304, and the pull wire fixing device 302 connected to the turbine 301-2 is removed from the inner cover 304-2.
  • the upper through hole 304-2-1 is extended, the inner cover 304-2 is covered, and the lower cover 304-1 is fixed on the housing 304 by the screw 304-5, that is, the completion is completed.
  • the assembly of the retractor 3 is carried out.
  • a small incision is made through the oral cavity, and a small incision is made in the back of the tongue, and the traction plate 1 is implanted in the tongue 9 of the proximal pharynx. Then, a small incision of about 6 mm is opened in the lower part of the mandible 5, and the mandibular anterior fixation plate 304-3 of the retractor 3 is fixed on the mandible 5 with the fixing screw 10 similar to the nail structure.
  • the retractor 3 is fixed to the mandible 5; at this time, the mandibular front fixing plate 304-3 is in front of the mandible 5, the main body of the retractor 3, and the casing 304 of the worm worm structure is mounted. Suspended in the lower part of the mandible 5. The traction wire 2 is then passed through the tongue 9 with a special instrument and guided from the traction plate 1 implanted in the tongue 9 of the tongue back to the vicinity of the small incision of the mandible 5.
  • the lower cover 304-1 of the casing 304 is removed, and the traction wire 2 is fixedly mounted to the turbine 301-2.
  • the traction line fixture 302 is described.
  • the through hole 302-1 and the wire groove 302-2 of the pull wire fixing device 302 can firmly connect the pull wire 2 to the pull wire fixing device 302.
  • one end of the pull wire 2 is connected to the traction plate 1, and the other end is connected to the pull wire fixing device 302 of the retractor 3.
  • the lower cover 304-1 is reinstalled on the housing 304 by the screws 304-5, and the incision is sutured, that is, the worm-type traction type for the implant type tongue pulling device of the present invention is completed. Clinical implantation of the puller.
  • a special screwdriver 4 whose head shape matches the shape of the adjusting hole 301-1-1 is selected, and after the special screwdriver 4 is pierced through the skin of the mandible, The head of the special screwdriver 4 is inserted into the adjustment hole 301-3-1, and the special screwdriver 4 is rotated, thereby rotating the worm 301-1 of the control switch 301, and by rotating the turbine 301-2, The pull wire 2 is loosened or tensioned to adjust the magnitude of the pulling force of the pull wire 2.
  • the worm-worm type retractor for implantable tongue pulling device of the invention has the advantages of compact structure, small volume and convenient adjustment.
  • the worm and worm structure of the worm-type retractor of the present invention for implantable tongue-and-left traction device may have other combinations of turbines and worms.
  • the worm gear structure formed by one worm 301-1 and one turbine 301-2 has a smaller volume advantage.
  • the control switch 301 contains only one turbine 301- 2 and 1 worm 301-1.
  • the turbine 301-2 can be driven such that the traction line fixture 302 coupled to the turbine 301-2 rotates, tensioning or relaxing the pull line 2, and adjusting the station The magnitude of the pulling force of the traction wire 2.
  • Example 2 Mosaic Twin Turbine Retractor for Implantable Tongue Pulling Device of the Invention
  • the difference between this embodiment and the embodiment 1 is that, in the embodiment, the turbine 301-1 of the retractor 3 and the worm 301-2 are mounted on the front side of the mandible 5. In the groove, compared with the first embodiment, the appearance of the maxillofacial surface of the patient after surgery does not change significantly.
  • the control switch 301 includes a turbine 301-2 and a worm 301-1; when the worm 301-1 rotates along a right-handed spiral, the turbine 301-2 rotates in a clockwise direction, tensioning the traction wire 2, so that the pulling force is increased; when the worm 301-1 is rotated in the reverse direction, the turbine 301-2 rotates in the counterclockwise direction, and the traction line 2 is relaxed. , so that the pulling force is reduced.
  • the housing 304 further includes an upper cover 304-6; and the upper cover 304-6 is provided with a positioning hole 304-6-1.
  • the positioning hole 304-6-1 matches the size of the end 302-3 of the traction wire fixing device 302, refer to FIG.
  • the lower cover 304-1 is provided with a through hole 304-1-1 through which the fixing screw 10 passes, with reference to FIG.
  • the inner cover 304-2 is provided with a through hole 3042-1 for passing the traction wire fixing device 302, a mounting hole 304-2-2 through which the fixing screw 10 passes, and positioning the traction wire fixing device 302. Positioning end 304-2-3.
  • the positioning end 304-2-3 is provided with a through hole 304-2-31 through which the traction wire 2 passes and a positioning hole 304-2-32 for positioning the traction wire fixing device 302.
  • a pull wire fixing device 302 connected to the turbine 301-2 protrudes from the through hole 304-2-1 on the inner cover 304-2 and is mounted on the mounting groove of the positioning end 304-2-3.
  • the pull wire fixture 302 is positioned through the locating holes 304-2-32, with reference to Figures 11-16.
  • the retractor 3 is made of a medical material. It is proved that the retractor 3 has good biocompatibility after being implanted into the human body.
  • control switch 301 composed of the turbine 301-2 and the worm 301-1 is first installed in the mounting groove 304-4 of the housing 304. Then, the inner cover 304-2 is covered, and the pull wire fixing device 302 connected to the turbine 301-2 is extended from the through hole 304-2-1 on the inner cover 304-2. Installed in the mounting groove 304-2-33 of the positioning end 304-2-3, and the positioning of the traction wire fixing device 302 through the positioning hole 304-2-32.
  • the positioning hole 304-6-1 on the upper cover 304-6 is aligned with the end 302-3 of the traction wire fixing device 302, and the upper cover 304-6 is covered, and the upper cover 304 is The positioning plate 304-6-2 at the lower end of the -6 is inserted into the upper cover mounting groove 304-2-4 on the inner cover 304-2, and the assembly of the retractor 3 can be completed.
  • a small incision is made through the oral cavity at the back of the tongue, and the traction plate 1 is implanted in the tongue 9 of the proximal pharynx. Then, at the middle of the mandible 5, a mounting groove having a width of about 8 mm and a depth of about 8 mm is opened, and the fixing screw 10 similar to the bone nail structure is passed through the through hole 304-1-1 on the lower cover 304-1.
  • the mounting hole 304-2-2 on the inner cover 304-2 fixes the retractor 3 on the mandible 5, at this time, the traction wire fixing device connected to the turbine 301-2
  • the positioning end 304-2-3 of the inner cover 304-2 and the inner cover 304-2 are embedded in a mounting groove in front of the mandible 5, and the other portion of the retractor 3 is suspended from the lower portion of the mandible 5.
  • the traction wire 2 is then passed through the tongue 9 with a special instrument and guided from the traction plate 1 implanted in the tongue 9 of the tongue back to the vicinity of the small incision of the mandible 5.
  • the upper cover 304-6 of the housing 304 is removed, and the pull wire 2 is mounted and fixed to the pull wire fixing device 302 connected to the turbine 301-2.
  • the through hole 302-1 and the wire groove 302-2 of the pull wire fixing device 302 can firmly connect the pull wire 2 to the pull wire fixing device 302.
  • one end of the pull wire 2 is connected to the traction plate 1, and the other end is connected to the pull wire fixing device 302 of the retractor 3.
  • the positioning hole 304-6-1 on the upper cover 304-6 is aligned with the end 302-3 of the traction wire fixing device 302, and the upper cover 304-6 is covered, and the upper cover is attached.
  • the positioning plate 304-6-2 at the lower end of the 304-6 is inserted into the upper cover mounting groove 304-2-4 on the inner cover 304-2, and the upper cover 304-6 is reinstalled on the housing 304. , suture the incision, That is, the clinical implantation of the worm-type reamer for the implantable tongue pulling device of the present invention is completed.
  • a special screwdriver 4 whose head shape matches the shape of the adjusting hole 301-1-1 is selected, and after the special screwdriver 4 is pierced through the skin of the mandible, The head of the special screwdriver 4 is inserted into the adjustment hole 301-3-1, and the special screwdriver 4 is rotated, thereby rotating the worm 301-1 of the control switch 301, and by rotating the turbine 301-2, The pull wire 2 is loosened or tensioned to adjust the magnitude of the pulling force of the pull wire 2.
  • the turbine 301-2 rotates in a clockwise direction, tensioning the traction wire 2, so that the pulling force is increased; when the worm 301-1 is rotated in the reverse direction, The turbine 301-2 rotates in the counterclockwise direction, loosening the pull wire 2, so that the pulling force is reduced.
  • the product volume is smaller, and the trauma during the surgery is smaller.
  • the mounting groove is opened in the middle of the front side of the mandible 5, the positioning end 304-2-3 of the inner cover 304-2 and the traction wire fixing device 302 installed inside are embedded in the mandible 5 In the front mounting groove, the height of the implant under the mandible is reduced as much as possible, and therefore, the patient's maxillofacial appearance is not significantly affected.
  • postoperative treatment can be achieved.
  • the appearance of the patient has substantially no effect, and the patient of the present embodiment is more aesthetically pleasing than the first embodiment.

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Abstract

一种用于植入型舌牵拉装置的蜗轮蜗杆型牵拉器(3)，含有能调节牵引线(2)拉力大小的控制开关(301)、能固定牵引线(2)的牵引线固定装置(302)及壳体(304)。控制开关(301)和牵引线固定装置(302)安装在壳体(304)内，控制开关(301)为蜗轮蜗杆结构，由蜗杆(301-1)及蜗轮(301-2)组成。由于控制开关(301)采用了蜗轮蜗杆结构，通过旋转蜗杆(301-1)，可以驱动蜗轮(301-2)，从而使得与蜗轮(301-2)相连接的牵引线固定装置(302)转动，拉紧或松弛牵引线(2)，从而调节牵引线(2)的拉力大小，具有结构紧凑、体积小、调节方便的优点。

Description

用于植入型舌牵拉装置的涡轮蜗杆型牵拉器 技术领域
本发明涉及用于植入型舌牵拉装置的涡轮蜗杆型牵拉器，特别是在用于治疗鼾症和阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea/Hypopnea Syndrome,以下简称：OSAHS)的植入型舌牵拉装置的牵拉器。
背景技术
阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是由于睡眠时上气道的软组织出现塌陷、堵塞而引起的一种以打鼾、呼吸暂停和低通气为临床特征的睡眠呼吸障碍性疾病。
对于OSAHS的发病机理，一般认为有多因素共同作用。除了上气道解剖结构狭窄外，主要原因是由于睡眠时维持上气道开放的扩咽肌松弛，出现软组织塌陷，而导致的阻塞。阻塞部位多位于腭咽平面或舌咽平面。
研究表明：20％-25％的OSAHS患者是由于单纯的腭咽平面的软组织塌陷导致，15％-20％的OSAHS患者是单纯的舌咽平面的软组织塌陷导致，50％-70％的OSAHS患者同时有腭咽平面和舌咽平面的软组织塌陷，即混合型OSAHS患者。
为了治疗舌后坠而导致的舌咽平面软组织塌陷形成的OSAHS，本发明人在中国专利申请CN102198010A中公开了一种植入式的舌根牵引装置，该发明在临床上获得了较好的疗效，特别适合于因舌根塌陷而导致的中度或重度OSAHS患者的手术治疗。
本专利申请是对该专利申请中的植入型舌牵拉装置的牵拉器的进一步改进和完善。
发明内容
用于植入型舌牵拉装置的涡轮蜗杆型牵拉器，所述牵拉器3含有能调节牵引线2拉力大小的控制开关301、能固定牵引线2的牵引线固定装置302及壳体304；控制开关301 和牵引线固定装置302安装在壳体304内；其特征在于：
所述控制开关301为涡轮蜗杆结构，由蜗杆301-1及涡轮301-2组成；旋转所述蜗杆301-1，可以驱动所述涡轮301-2沿顺时针方向或逆时针方向旋转；所述涡轮301-2上设有所述牵引线固定装置302；
进一步，所述壳体304含内盖304-2；所述控制开关301通过内盖304-2安装在壳体304上，与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出。这种将所述牵引线固定装置302暴露在外，而涡轮蜗杆内置的技术方案，一方面便于安装牵拉线2，另一方面，由于内盖304-2保护作用，涡轮蜗杆结构安装在所述壳体304与所述内盖304-2之间的安装槽内，避免了牵引线2因滑脱、移位，被涡轮蜗杆结构铰断的风险。
所述壳体304含下盖304-1，所述控制开关301、及所述牵引线固定装置302安装在下盖304-1内。
所述控制开关301至少含1个涡轮301-2和至少1个蜗杆301-1。
所述控制开关301含2个涡轮301-2和1个蜗杆301-1；当所述蜗杆301-1沿右手螺旋转动时，右侧涡轮沿顺时针方向旋转，左侧涡轮沿逆时针方向旋转，拉紧牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，右侧涡轮沿逆时针方向旋转，左侧涡轮沿顺时针方向旋转，松弛牵引线2，使得牵拉力减小。
所述蜗杆301-1设有调节孔301-1-1，所述调节孔301-1-1是非圆形。所述调节孔301-1-1通常采用多边形孔，如，三角形孔、四方形孔、五边形孔、或六边形孔。插入专用螺丝刀，即可以旋转所述蜗杆301-1。
牵引线固定装置302含固定所述牵拉线2的通孔302-1和线槽302-2，所述通孔302-1的中心线与所述线槽302-2立体交叉。通常所述通孔302-1的中心线可垂直于所述线槽302-2。
所述壳体304含下颌前固定板304-3；所述下颌前固定板304-3上设有让固定螺钉10通过的通孔304-3-1及槽孔304-3-2；所述槽孔304-3-2将所述下颌前固定板304-3分成左右两侧。由于设有所述槽孔304-3-2，所述下颌前固定板304-3可以适应不同的下颌形状，具有良好的形状调节效果，方便用固定螺钉10将所述下颌前固定板304-3固定在下颌骨5上，从而将所述牵拉器3固定在下颌骨5上。
组装时，先将所述涡轮301-2和所述蜗杆301-1组成的所述控制开关301安装在所述壳体304的安装槽304-4内。然后，盖上所述内盖304-2，将与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出。最后，用所述螺钉304-5 将所述下盖304-1固定在所述壳体304上，即完成了所述牵拉器3的组装。
临床使用时，局麻下，先经口腔，在舌背部切小切口，将所述牵引板1植入在近舌咽部的舌体9内。然后在下颌骨5的下部开一约6mm小切口，将所述牵拉器3的下颌前固定板304-3用类似骨钉结构的所述固定螺钉10固定在所述下颌骨5上，即将所述牵拉器3固定在下颌骨5上；这时，所述下颌前固定板304-3在下颌骨5的前面，所述牵拉器3的主体，安装有涡轮蜗杆结构的壳体304，悬吊在下颌骨5的下部。再用专用器械将牵引线2经过舌体9内，从植入在舌背部的舌体9内的牵引板1上引导至下颌骨5小切口附近。
拆下所述壳体304的下盖304-1，将所述牵引线2安装固定在与涡轮301-2连接的所述牵引线固定装置302。所述牵引线固定装置302的通孔302-1和线槽302-2能将所述牵引线2牢固地连接在所述牵引线固定装置302上。这时，在舌体9内，所述牵引线2的一端连接在所述牵引板1上，另一端连接在所述牵拉器3的牵引线固定装置302上。
最后，将所述下盖304-1通过所述螺钉304-5重新安装在所述壳体304上，缝合切口，即完成了本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器的临床植入。
当需要调整所述牵引线2的拉力大小时，选择头部形状与所述调节孔301-1-1的形状相匹配的专用螺丝刀4，将所述专用螺丝刀4刺穿下颌骨皮肤后，将所述专用螺丝刀4的头部插入所述调节孔301-1-1内，旋转所述专用螺丝刀4，从而旋转所述控制开关301的蜗杆301-1，通过带动所述涡轮301-2旋转，使得所述牵引线2松弛或拉紧，从而调整所述牵引线2拉力的大小。当所述蜗杆301-1沿右手螺旋转动时，右侧涡轮沿顺时针方向旋转，左侧涡轮沿逆时针方向旋转，拉紧所述牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，右侧涡轮沿逆时针方向旋转，左侧涡轮沿顺时针方向旋转，松弛牵引线2，使得牵拉力减小。
所述控制开关301含1个涡轮301-2和1个蜗杆301-1；当所述蜗杆301-1沿右手螺旋转动时，所述涡轮301-2沿顺时针方向旋转，拉紧牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，所述涡轮301-2沿逆时钟方向旋转，松弛牵引线2，使得牵拉力减小。
所述壳体304含上盖304-6；所述上盖304-6上设有定位孔304-6-1。所述定位孔304-6-1与所述牵引线固定装置302的端部302-3的尺寸匹配。
所述下盖304-1上设有让固定螺钉10通过的通孔304-1-1。
所述内盖304-2上还设有让固定螺钉10通过的安装孔304-2-2和定位所述牵引线固定装置302的定位端304-2-3；所述定位端304-2-3上设有让所述牵引线2通过的通孔304-2-31和定位所述牵引线固定装置302的定位孔304-2-32；连接在所述涡轮301-2上 的牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出后安装在所述定位端304-2-3的安装槽304-2-33内，并通过所述定位孔304-2-32对所述牵引线固定装置302进行定位。
组装时，将先将所述涡轮301-2和所述蜗杆301-1组成的所述控制开关301安装在所述壳体304的安装槽304-4内，将所述蜗杆301-1的调节孔301-1-1对准所述下盖304-1的调节通孔304-1-2。然后，盖上所述内盖304-2，将与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出后安装在所述定位端304-2-3的安装槽304-2-33内，并通过所述定位孔304-2-32对所述牵引线固定装置302进行定位。然后将所述上盖304-6上的定位孔304-6-1对准所述牵引线固定装置302的端部302-3，盖上所述上盖304-6，将所述上盖304-6下端的定位板304-6-2插入所述内盖304-2上的上盖安装槽304-2-4内，即可完成所述牵拉器3的组装。
临床使用时，局麻下，先经口腔，在舌背部切小切口，将所述牵引板1植入在近舌咽部的舌体9内。然后在下颌骨5的下部正中处开一宽约6mm，深约6mm的安装槽，用类似骨钉结构的所述固定螺钉10经所述下盖304-1上的通孔孔304-1-1和所述内盖304-2上的安装孔304-2-2将所述牵拉器3固定在所述下颌骨5上，这时，连接在所述涡轮301-2上的牵引线固定装置302和所述内盖304-2的定位端304-2-3镶嵌在下颌骨5前面的安装槽内，所述牵拉器3的其它部分悬吊在下颌骨5的下部。再用专用器械将牵引线2经过舌体9内，从植入在舌背部的舌体9内的牵引板1上引导至下颌骨5小切口附近。
拆下所述壳体304的上盖304-6，将所述牵引线2安装固定在与涡轮301-2连接的所述牵引线固定装置302上。所述牵引线固定装置302的通孔302-1和线槽302-2能将所述牵引线2牢固地连接在所述牵引线固定装置302上。这时，在舌体9内，所述牵引线2的一端连接在所述牵引板1上，另一端连接在所述牵拉器3的牵引线固定装置302上。
最后，将所述上盖304-6上的定位孔304-6-1对准所述牵引线固定装置302的端部302-3，盖上所述上盖304-6，将所述上盖304-6下端的定位板304-6-2插入所述内盖304-2上的上盖安装槽304-2-4内，将所述上盖304-6重新安装在所述壳体304上，缝合切口，即完成了本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器的临床植入。
当需要调整所述牵引线2的拉力大小时，选择头部形状与所述调节孔301-1-1的形状相匹配的专用螺丝刀4，将所述专用螺丝刀4刺穿下颌骨皮肤后，将所述专用螺丝刀4的头部经所述下盖304-1上的调节通孔304-1-2插入所述调节孔301-1-1内，旋转所述专用螺丝刀4，从而旋转所述控制开关301的蜗杆301-1，通过带动所述涡轮301-2旋转，使得所述牵引线2松弛或拉紧，从而调整所述牵引线2拉力的大小。当所述蜗杆301-1沿右 手螺旋转动时，所述涡轮301-2沿逆时针方向旋转，拉紧牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，所述涡轮301-2沿顺时针方向旋转，松弛牵引线2，使得牵拉力减小。
所述牵拉器3采用医用材料制造。从而保证所述牵拉器3植入人体后具有良好的生物相容性。
本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器，含有能调节牵引线2拉力大小的控制开关301、能固定牵引线2的牵引线固定装置302及壳体304；控制开关301和牵引线固定装置302安装在壳体304内，所述控制开关301为涡轮蜗杆结构，由蜗杆301-1及涡轮301-2组成。由于所述控制开关301采用了涡轮蜗杆结构，通过旋转所述蜗杆301-1，可以驱动所述涡轮301-2，从而使得与所述涡轮301-2相连接的所述牵引线固定装置302转动，拉紧或松弛牵引线2，而调节所述牵引线2的拉力大小，具有结构紧凑、体积小、调节方便的优点。
附图说明
图1是本发明之双涡轮的牵拉器的立体结构示意图。
图2是图1的正视图。
图3是图2的A-A剖视图。
图4是本发明之双涡轮的牵拉器的下盖打开后的结构示意图。
图5是图1的爆炸图。
图6是本发明之单涡轮的牵拉器的结构示意图。
图7是图6的爆炸图。
图8是本发明之牵拉器的工作原理图。
图9是镶嵌式本发明之单涡轮的牵拉器的结构示意图。
图10是图9仰视时的结构示意图
图11是图9的俯视图。
图12是图11的B-B剖视图。
图13是图12的C-C剖视图。
图14是牵拉器的上盖打开后正视时的结构示意图。
图15是图14的后视图。
图16是图9的爆炸图。
图17是镶嵌式本发明之单涡轮的牵拉器的工作原理图。
上述图中：
1为牵引板，2为牵引线，3为牵拉器，4为专用螺丝刀，5为下颌骨，9为舌体，10为固定螺钉。
301为控制开关，302为牵引线固定装置，304为壳体。
301-1为蜗杆，301-2为涡轮。
302-1为固定固定牵引线的通孔，302-2为线槽，302-3为牵引线固定装置的端部。
304-1为下盖，304-2为内盖，304-3为下颌前固定板，304-4为安装槽，304-5为螺钉，304-6为上盖。
301-1-1为蜗杆上的调节孔；304-1-1为下盖上让螺钉通过的通孔，304-1-2为让螺丝刀穿过的调节通孔，304-2-1为内盖上让牵引线固定装置通过的通孔，304-2-2为内盖上让螺钉通过的安装孔，304-2-3为定位牵引线固定装置的定位端，304-2-4为上盖安装槽；304-2-31为让牵引线通过的通孔，304-2-32为牵引线固定装置的定位孔，304-2-33为安装牵引线固定装置的安装槽；304-3-1为固定板上让固定螺钉通过的通孔，304-3-2为下颌前固定板上的槽孔；304-6-1为定位孔，304-6-2为定位板。
具体实施方式
实施例1：本发明之用于植入型舌牵拉装置的双涡轮牵拉器
参考图1至图5，本实施例中，所述牵拉器3含有能调节牵引线2拉力大小的控制开关301、能固定牵引线2的牵引线固定装置302及壳体304。所述控制开关301和所述牵引线固定装置302安装在所述壳体304内。
所述控制开关301为涡轮蜗杆结构，由蜗杆301-1及涡轮301-2组成。旋转所述蜗杆301-1，可以驱动所述涡轮301-2沿顺时针方向或逆时针方向旋转。所述涡轮301-2上设有所述牵引线固定装置302。
所述壳体304含内盖304-2，所述控制开关301通过内盖304-2安装在壳体304上，与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出。这种将所述牵引线固定装置302暴露在外，而涡轮蜗杆内置的技术方案，一方面便于安装牵拉线2；另一方面，由于所述内盖304-2保护作用，涡轮蜗杆结构安装在所述壳体304与所述内盖304-2之间的安装槽内，避免了所述牵引线2因滑脱、移位，被涡轮蜗 杆结构铰断的风险。
所述壳体304含下盖304-1，所述控制开关301、及所述牵引线固定装置302安装在下盖304-1内。
所述控制开关301至少含1个涡轮301-2和至少1个蜗杆301-1。
本实施例中，所述控制开关301含2个涡轮301-2和1个蜗杆301-1；当所述蜗杆301-1沿右手螺旋转动时，右侧涡轮沿顺时针方向旋转，左侧涡轮沿逆时针方向旋转，拉紧所述牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，右侧涡轮沿逆时针方向旋转，左侧涡轮沿顺时针方向旋转，松弛牵引线2，使得牵拉力减小。
所述蜗杆301-1设有调节孔301-1-1，所述调节孔301-1-1是非圆形。所述调节孔301-1-1通常采用多边形孔，如，三角形孔、四方形孔、五边形孔、或六边形孔。插入专用螺丝刀，即可以旋转所述蜗杆301-1。
牵引线固定装置302含固定所述牵拉线2的通孔302-1和线槽302-2，所述通孔302-1的中心线与所述线槽302-2立体交叉。通常所述通孔302-1的中心线垂直于所述线槽302-2。
所述壳体304含下颌前固定板304-3；所述下颌前固定板304-3上设有让固定螺钉10通过的通孔304-3-1及槽孔304-3-2；所述槽孔304-3-2将所述下颌前固定板304-3分成左右两侧。通过调整所述槽孔304-3-2的宽度，可以使得所述下颌前固定板304-3可以适应不同的下颌形状，具有良好的形状调节效果，方便将所述牵拉器固定在下颌骨5上。
所述牵拉器3采用医用材料制造。
组装时，先将所述控制开关301安装在所述壳体304的安装槽304-4内，将与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出，盖上所述内盖304-2，再用所述螺钉304-5将所述下盖304-1固定在所述壳体304上，即完成了所述牵拉器3的组装。
参考图8，临床使用时，局麻下，先经口腔，在舌背部切小切口，将所述牵引板1植入在近舌咽部的舌体9内。然后在下颌骨5的下部开一约6mm小切口，将所述牵拉器3的下颌前固定板304-3用类似骨钉结构的所述固定螺钉10固定在所述下颌骨5上，即将所述牵拉器3固定在下颌骨5上；这时，所述下颌前固定板304-3在下颌骨5的前面，所述牵拉器3的主体，安装有涡轮蜗杆结构的壳体304，悬吊在下颌骨5的下部。再用专用器械将所述牵引线2经过舌体9内，从植入在舌背部的舌体9内的牵引板1上引导至下颌骨5小切口附近。
拆下所述壳体304的下盖304-1，将所述牵引线2安装固定在与涡轮301-2连接的所 述牵引线固定装置302上。所述牵引线固定装置302的通孔302-1和线槽302-2能将所述牵引线2牢固地连接在所述牵引线固定装置302上。这时，在舌体9内，所述牵引线2的一端连接在所述牵引板1上，另一端连接在所述牵拉器3的牵引线固定装置302上。
最后，将所述下盖304-1通过所述螺钉304-5重新安装在所述壳体304上，缝合切口，即完成了本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器的临床植入。
当需要调整所述牵引线2的拉力大小时，选择头部形状与所述调节孔301-1-1的形状相匹配的专用螺丝刀4，将所述专用螺丝刀4刺穿下颌骨皮肤后，将所述专用螺丝刀4的头部插入所述调节孔301-1-1内，旋转所述专用螺丝刀4，从而旋转所述控制开关301的蜗杆301-1，通过带动所述涡轮301-2旋转，使得所述牵引线2松弛或拉紧，从而调整所述牵引线2拉力的大小。当所述蜗杆301-1沿右手螺旋转动时，右侧涡轮沿顺时针方向旋转，左侧涡轮沿逆时针方向旋转，拉紧所述牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，右侧涡轮沿逆时针方向旋转，左侧涡轮沿顺时针方向旋转，松弛牵引线2，使得牵拉力减小。
本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器，具有结构紧凑、体积小、调节方便的优点。
在本实施例中，只举例说明了1个蜗杆301-1与2个涡轮301-2形成的涡轮蜗杆结构的本发明之牵拉器的结构。但本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器的涡轮蜗杆结构含有的的涡轮、蜗杆的数量还可以有其他的多种组合。
1个蜗杆301-1与1个涡轮301-2形成的涡轮蜗杆结构具有体积更小的优势，参考图6和图7，在这个实施例中，所述控制开关301仅含1个涡轮301-2和1个蜗杆301-1。通过旋转所述蜗杆301-1，可以驱动所述涡轮301-2，从而使得与所述涡轮301-2相连接的所述牵引线固定装置302转动，拉紧或松弛牵引线2，而调节所述牵引线2的拉力大小。
实施例2：镶嵌式本发明之用于植入型舌牵拉装置的双涡轮牵拉器
参考图9至图17，本实施例与实施例1的区别在于，本实施例中，所述牵拉器3的涡轮301-1和蜗杆301-2镶嵌在所述下颌骨5前侧的安装槽内，本实施例与实施例1相比，患者手术后的颌面外观不会产生明显变化。
参考图9至图16，本实施例中，所述所述控制开关301含1个涡轮301-2和1个蜗杆301-1；当所述蜗杆301-1沿右手螺旋转动时，所述涡轮301-2沿顺时针方向旋转，拉紧牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，所述涡轮301-2沿逆时钟方向旋转，松弛牵引线2，使得牵拉力减小。
本实施例中，所述壳体304还含上盖304-6；所述上盖304-6上设有定位孔304-6-1。所述定位孔304-6-1与所述牵引线固定装置302的端部302-3的尺寸匹配，参考图9
所述下盖304-1上设有让固定螺钉10通过的通孔304-1-1，参考图10。
所述内盖304-2上设有让所述牵引线固定装置302通过的通孔304-2-1、让固定螺钉10通过的安装孔304-2-2和定位所述牵引线固定装置302的定位端304-2-3。所述定位端304-2-3上设有让所述牵引线2通过的通孔304-2-31和定位所述牵引线固定装置302的定位孔304-2-32。连接在所述涡轮301-2上的牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出后安装在所述定位端304-2-3的安装槽304-2-33内，并通过所述定位孔304-2-32对所述牵引线固定装置302进行定位，参考图11至图16。
所述牵拉器3采用医用材料制造。证所述牵拉器3植入人体后具有良好的生物相容性。
组装时，将先将所述涡轮301-2和所述蜗杆301-1组成的所述控制开关301安装在所述壳体304的安装槽304-4内。然后，盖上所述内盖304-2，将与所述涡轮301-2连接的所述牵引线固定装置302从所述内盖304-2上的通孔304-2-1中伸出后安装在所述定位端304-2-3的安装槽304-2-33内，并通过所述定位孔304-2-32对所述牵引线固定装置302进行定位。然后将所述上盖304-6上的定位孔304-6-1对准所述牵引线固定装置302的端部302-3，盖上所述上盖304-6，将所述上盖304-6下端的定位板304-6-2插入所述内盖304-2上的上盖安装槽304-2-4内，即可完成所述牵拉器3的组装。
参考图17，临床使用时，局麻下，先经口腔，在舌背部切小切口，将所述牵引板1植入在近舌咽部的舌体9内。然后在下颌骨5的中部处开一宽约8mm，深约8mm的安装槽，用类似骨钉结构的所述固定螺钉10经所述下盖304-1上的通孔孔304-1-1和所述内盖304-2上的安装孔304-2-2将所述牵拉器3固定在所述下颌骨5上，这时，连接在所述涡轮301-2上的牵引线固定装置302和所述内盖304-2的定位端304-2-3镶嵌在下颌骨5前面的安装槽内，所述牵拉器3的其它部分悬吊在下颌骨5的下部。再用专用器械将牵引线2经过舌体9内，从植入在舌背部的舌体9内的牵引板1上引导至下颌骨5小切口附近。
拆下所述壳体304的上盖304-6，将所述牵引线2安装固定在与涡轮301-2连接的所述牵引线固定装置302上。所述牵引线固定装置302的通孔302-1和线槽302-2能将所述牵引线2牢固地连接在所述牵引线固定装置302上。这时，在舌体9内，所述牵引线2的一端连接在所述牵引板1上，另一端连接在所述牵拉器3的牵引线固定装置302上。
最后，将所述上盖304-6上的定位孔304-6-1对准所述牵引线固定装置302的端部302-3，盖上所述上盖304-6，将所述上盖304-6下端的定位板304-6-2插入所述内盖304-2上的上盖安装槽304-2-4内，将所述上盖304-6重新安装在所述壳体304上，缝合切口， 即完成了本发明之用于植入型舌牵拉装置的涡轮蜗杆型牵拉器的临床植入。
当需要调整所述牵引线2的拉力大小时，选择头部形状与所述调节孔301-1-1的形状相匹配的专用螺丝刀4，将所述专用螺丝刀4刺穿下颌骨皮肤后，将所述专用螺丝刀4的头部插入所述调节孔301-1-1内，旋转所述专用螺丝刀4，从而旋转所述控制开关301的蜗杆301-1，通过带动所述涡轮301-2旋转，使得所述牵引线2松弛或拉紧，从而调整所述牵引线2拉力的大小。当所述蜗杆301-1沿右手螺旋转动时，所述涡轮301-2沿顺时针方向旋转，拉紧牵引线2，使得牵拉力增加；当所述蜗杆301-1沿反向旋转时，所述涡轮301-2沿逆时钟方向旋转，松弛牵引线2，使得牵拉力减小。
本实施例中，由于只有1个所述蜗杆301-1和1个所述涡轮301-2，产品体积更小，手术过程创伤更小。而且，由于在所述下颌骨5的前侧正中开设安装槽，使得所述内盖304-2的定位端304-2-3以及安装在内部的所述牵引线固定装置302一起镶嵌在下颌骨5前面的安装槽内，尽量降低了下颌骨下植入物的高度，因此，不会对患者的颌面外观造成明显影响，通过调整所述下盖304-1的尺寸，可以实现术后对患者的容貌基本不产生影响，与实施例1相比，本实施例的患者术后更加美观。
应该注意，本文中公开和说明的结构可以用其它效果相同的结构代替，同时本发明所介绍的实施例并非实现本发明的唯一结构。虽然本发明的优先实施例已在本文中予以介绍和说明，但本领域内的技术人员都清楚知道这些实施例不过是举例说明而己，本领域内的技术人员可以做出无数的变化、改进和代替，而不会脱离本发明，因此，应按照本发明所附的权利要求书的精神和范围来的界定本发明的保护范围。

Claims (13)

  1. 用于植入型舌牵拉装置的涡轮蜗杆型牵拉器，所述牵拉器(3)含有能调节牵引线(2)拉力大小的控制开关(301)、能固定牵引线(2)的牵引线固定装置(302)及壳体(304)；控制开关(301)和牵引线固定装置(302)安装在壳体(304)内；其特征在于：
    所述控制开关(301)为涡轮蜗杆结构，由蜗杆(301-1)及涡轮(301-2)组成；旋转所述蜗杆(301-1)，可以驱动所述涡轮(301-2)沿顺时针方向或逆时针方向旋转；所述涡轮(301-2)上设有所述牵引线固定装置(302)。
  2. 根据权利要求1所述牵拉器，其特征在于：所述壳体(304)含内盖(304-2)；所述控制开关(301)通过内盖(304-2)安装在壳体(304)上，与所述涡轮(301-2)连接的所述牵引线固定装置(302)从所述内盖(304-2)上的通孔(304-2-1)中伸出。
  3. 根据权利要求1所述牵拉器，其特征在于：所述壳体(304)含下盖(304-1)，所述控制开关(301)、及所述牵引线固定装置(302)安装在下盖(304-1)内。
  4. 根据权利要求1所述牵拉器，其特征在于：所述控制开关(301)至少含1个涡轮(301-2)和至少1个蜗杆(301-1)。
  5. 根据权利要求4所述牵拉器，其特征在于：所述控制开关(301)含2个涡轮(301-2)和1个蜗杆(301-1)；当所述蜗杆(301-1)沿右手螺旋转动时，右侧涡轮沿顺时针方向旋转，左侧涡轮沿逆时针方向旋转，拉紧牵引线(2)，使得牵拉力增加；当所述蜗杆(301-1)沿反向旋转时，右侧涡轮沿逆时针方向旋转，左侧涡轮沿顺时针方向旋转，松弛牵引线(2)，使得牵拉力减小。
  6. 根据权利要求1所述牵拉器，其特征在于：所述蜗杆(301-1)设有调节孔(301-1-1)，所述调节孔(301-1-1)是非圆形。
  7. 根据权利要求1所述牵拉器，其特征在于：牵引线固定装置(302)含固定牵拉线(2)的通孔(302-1)和线槽(302-2)，所述通孔(302-1)的中心线与所述线槽(302-2)立体交叉。
  8. 根据权利要求1所述牵拉器，其特征在于：所述壳体(304)含下颌前固定板(304-3)；所述下颌前固定板(304-3)上设有让固定螺钉(10)通过的通孔(304-3-1)及槽孔(304-3-2)；所述槽孔(304-3-2)将所述下颌前固定板(304-3)分成左右两侧。
  9. 根据权利要求4所述牵拉器，其特征在于：所述控制开关(301)含1个涡轮(301-2)和1个蜗杆(301-1)；当所述蜗杆(301-1)沿右手螺旋转动时，所述涡轮(301-2)沿顺 时针方向旋转，拉紧牵引线(2)，使得牵拉力增加；当所述蜗杆(301-1)沿反向旋转时，所述涡轮(301-2)沿逆时钟方向旋转，松弛牵引线(2)，使得牵拉力减小。
  10. 根据权利要求1所述牵拉器，其特征在于：所述壳体(304)含上盖(304-6)；所述上盖(304-6)上设有定位孔(304-6-1)。
  11. 根据权利要求3所述牵拉器，其特征在于：所述下盖(304-1)上设有让固定螺钉(10)通过的通孔(304-1-1)。
  12. 根据权利要求2所述牵拉器，其特征在于：所述内盖(304-2)上还设有让固定螺钉(10)通过的安装孔(304-2-2)和定位所述牵引线固定装置(302)的定位端(304-2-3)；所述定位端(304-2-3)上设有让所述牵引线(2)通过的通孔(304-2-31)和定位所述牵引线固定装置(302)的定位孔(304-2-32)；连接在所述涡轮(301-2)上的牵引线固定装置(302)从所述内盖(304-2)上的通孔(304-2-1)中伸出后安装在所述定位端(304-2-3)的安装槽(304-2-33)内，并通过所述定位孔(304-2-32)对所述牵引线固定装置(302)进行定位。
  13. 根据权利要求1所述牵拉器，其特征在于：所述牵拉器(3)采用医用材料制造。
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