A method of treating snoring

 

(57) Abstract:

The present invention relates to the field of medicine and is intended for the treatment of snoring and sleep apnea. Conduct electrical stimulation of the muscles of the soft palate electric current in various modes through electrostimulator otological. The active electrode pacemaker otological "ESOT 1 is mounted on the midline of the soft palate on the small tab, and then in spots on the soft palate to the right and to the left of the previous one. Alternately electrostimulation is carried out in the described points of the soft palate rectangular pulse current 4 effects on each point, only 12 per session. The passive electrode is placed on the forearm. The parameters of the pulse current can be adjusted individually depending on the patient's sensitivity to the feeling of "tingling" in heaven: the frequency of 60-80 Hz, the amplitude of the current 10-600 µa in burst mode at 10 pulses per bundle, at a repetition frequency packs through 1 C, the duration of a series of irritation 30 s with an interval of 30 s, for the treatment of 10-12 sessions. The method allows to restore the functions of the soft palate due to the stimulation of his muscles. 1 Il.

The present invention relates to the field of medicine and nctive sleep apnea (CAC).

Snoring is now considered to be far from harmless phenomenon, sometimes life-threatening due to occur when it complications such as apnea. According to medical literature, the number of patients suffering from snoring, is extremely high, after the age of 30 years snores 5-7% of people. Therapeutic measures that can help reduce snoring, often ineffective or awkward.

Snoring is defined as "any resonant sounds generated in the upper airway during sleep", from other structures in education snoring participate Palatine arch, the root of the tongue, the tongue and the walls of the larynx. However, the main source of the sounds are thin edge of the soft palate (uvula). Thus, snoring is due to changes in the condition of the soft tissues of the upper respiratory tract and is the cause of many functions and body systems (respiratory, cardiovascular, nervous).

Features of snoring are not only inconvenience and damage from impacts related to the snoring (sleep fragmentation with subsequent insomnia, the risk of heart rhythm disturbances and the occurrence of myocardial ischemia and others), but also the trouble associated with the need wyslouch the STV nervous system.

Factors predisposing to the occurrence of sleep disorders and breathing during sleep, are: the curvature of nasal septum, hypertrophy of the turbinates, adenoids hypertrophy of the tonsils and uvula, large tongue, hypertrophy of the tongue, tumors, craniofacial anomalies, and overweight. All this requires strengthening of neuromuscular stimulation of the upper respiratory tract, which with the onset of sleep oppressed (O. Selivanova, I. Fischer, W. Mann. "Diagnosis and treatment of breathing disorders during sleep in limnologically centers of otolaryngologic clinics" // Russian rhinology, 2000, N 2, c. 30-34). Of particular importance currently attached to the status of the oropharynx in the form of sagging or thickening Palat. The lower part of the nasopharynx and oropharynx - the area in which comes the violation of the airway during sleep, when the rigidity of the walls of the respiratory tract and the width of the clearance is determined only by the muscle tone), so the reduction of muscle tone in the presence of negative pressure created in the trachea and bronchi, cause the losing of the walls of the pharynx. Although the decrease in muscle tone of the throat during sleep is a physiological nature, when the number of us, leading to losing the lumen of the pharynx. L. I. Zuckerberg, SL.Nersessian ("the State of upper respiratory tract in patients with the syndrome sleep apnea and methods of surgical treatment" // Bulletin of otorhinolaryngology, 1996, N 3, S. 42-43) note that the occurrence of snoring and apnea contributes to neurogenic failure, muscular pharynx and tongue.

A. F. Karas, Y. C. Minin in "Electron microscopic study of the muscle tissue of the soft palate snoring (journal of the ear, nose and throat diseases, 1991, No. 6, S. 32-36) showed the presence of damage of cellular elements of muscle tissue, atrophy of muscle cells, fibers, performing biomechanical function. These data are confirmed by other methods. In the work of C. J. Gapanovich et al. ("Electromyographic studies snoring" //Journal of Health Belarus, N8, S. 43-44) using the method of electromyography determining the bioelectrical activity of muscles of the soft palate and the uvula, proved that people suffering from snoring, significantly reduced muscle tone of the soft palate and the uvula, as well as reduced or absent pharyngeal reflex.

Snore treatment is usually medication, physiotherapy and other therapies, and so is Ty and patent literature identified various ways to treat snoring.

Known poluchilisi a method of treating snoring, in which the uvula, soft palate, Palatine arch subjected to the application of liquid nitrogen (RF Patent for invention N 2014016. Dorokhov C. D. "a Method for the treatment of snoring" //Bulletin of inventions No. 1, 1994, S. 25). The disadvantages of the method are: the trauma and pain intervention, the risk of postmanipulation soft tissue swelling of the throat, the need to implement the method in the hospital.

C. N. Gorbachev, Y. C. Minin perform surgical palatopharyngoplasty to eliminate obstacles to air flow, resulting achieve reduction or elimination of snoring ("Efficiency palatopharyngoplasty in the treatment of snoring and obstructive sleep apnea" //In the book: 3rd Congress of otolaryngologists of the Republic of Belarus: Abstracts, Minsk, 1992, S. 134-136).

L. I. Zuckerberg, S. A. Nersessian for the treatment of patients with snoring are wwwlivingelectrocom using a surgical laser that helps to reduce bleeding and the current State of ENT organs in patients with the syndrome sleep apnea and methods of surgical treatment". Bulletin of otorhinolaryngology, 1996, N 3, S. 42-43). The disadvantages of these methods should volumetric removal of healthy tissues of the soft palate, the formation of reactive edema of the pharynx in the postoperative period, the complexity of the techniques of surgical intervention using expensive equipment (surgical laser).

Common method of therapy is the creation of a continuous positive airway pressure proposed by C. E. Sullivan ("Reversal of obstructiv sleep apnoea by continuous positive airway pressure applied through the nares" // Lancet, 1961, V. 1, p. 861-865), and the air in the respiratory tract serves through fixed on the face mask. The created increased pressure prevents spadats respiratory and snoring stops. In our country this technique is used only in very few specialized centers. The disadvantages of the method are as follows: efficiency only at the moment of impact, the need for constant use of "masks", a negative attitude towards this practice most patients, the ability of a number of complications (morning stuffy or runny nose, dry mouth, conjunctivitis, and others).

The closest in its essence, and is taken as a prototype is the method proposed by A. N. Nasedkina described in the application for the invention RF N 98117650/14 "Method of treatment of snore"(BIPM, 2000, No. 18, S. 56), for the treatment and implementation in 3-4 areas with radiation of YAG-Nd laser with a wavelength of 1.06 μm, energy 1-2 j, a series of pulses of 200 - 250 μs, a frequency of 5-15 Hz, or by the emission of a semiconductor laser with a wavelength of 0,81 μm, energy 3 - 7.5 j, the pulse time 100 - 250 µs, frequency, 4-20 Hz.

The disadvantages of the prototype are:

1. trauma to the destruction of the soft tissues of the sky;

2. violation of the anatomical structures of the soft palate with damage to the muscles of the soft palate

3. the need for hospitalization of the patient;

4. the formation of reactive edema of the pharynx in the postoperative period;

5. forcibly changing the functions of the soft palate;

6. the complexity of the techniques of surgical intervention using expensive equipment - surgical laser.

The aim of the invention is to restore the functions of the soft palate due to the stimulation of his muscles.

This goal is achieved by conducting sessions electric stimulation to the area of the soft palate using pacemaker otological "ESOT 1" (Manufacturer: OOO "Santim" research Institute for Neurocybernetics, , Rostov-on-don), leading to stimulation of nerve cells and increased tone of the muscles of the soft palate. This helps to maintain a constant clearance of the upper respiratory tract and eliminate or reduce snoring in BP is RA otological set on the middle line of the soft palate on the small tongue, and then at the points of the soft palate on the right and left paracentral; turn by electrical stimulation of the soft palate rectangular electric pulses (4 effects on each point, a total of 12 impacts per session). The passive electrode placed on the forearm. The parameters of the pulse current adjust individually depending on the patient's sensitivity to the feeling of "tingling" in heaven (the frequency of 60-80 Hz, the amplitude of the current from 5 to 600 µa, burst mode at 10 pulses per bundle at a repetition frequency packs through 1 C, the duration of a series of irritation 30, the interval between the series - 30). In the course of treatment is 10 to 12 sessions.

The proposed method is tested in the ENT clinic RSMU 13 ball and has shown positive results.

Before and after of the treatment to control for the objective evaluation of its results without prior notification of the patient was conducted sound of snoring on tape for the first 2 hours of sleep and subsequent acoustic analysis of snoring. When comparing the results of examination of patients before and after treatment was observed positive dynamics: reducing power of snoring after treatment when listening to the magician and spectral components, the decrease in the intensity of the acoustic signal in 2-3 times, the shift of the spectrum towards lower frequencies. Data received by biografii muscles of the soft palate before and after treatment indicated a increase in muscle tone of the soft palate after treatment both at rest and during functional loading. If electrical stimulation of bioelectric activity of the muscles of the soft palate was characterized by the amplitude of the action potential 25-50 UV alone and 100-250 mV under load, after a course of treatment, these figures were: 50-60 mV and 250-550 µv, respectively. The proposed treatment caused a lasting effect, leading to eliminate or reduce snoring.

An example showing the capabilities of the proposed method are the results of patient treatment R., 24 years old (case history N 24364/2211). Suffers from snoring for about 10 years. At the time of hospitalization the patient with a comprehensive survey: if pharyngoscopy detected thickening and increase in small tongue, the laxity of the soft palate, constricting the lumen of the pharynx, lower pharyngeal reflex. These biografii at rest and during functional loading showed a decrease in muscle activity of the soft palate: the average amplitude of the action potential alone coopoosamy patient in the first 2 hours of sleep and subsequent acoustic analysis of sound signals testified variance of the fundamental frequency of snoring in the low and mid range 250-1000 Hz, as well as a considerable intensity of spectral components. The data obtained was the indication for carrying out of sessions of electrical stimulation of the muscles of the soft palate. Active electrode apparatus "ESOT 1" was installed in the midline of the soft palate on the small tongue, the passive electrode was fixed on the forearm. After this was carried out by electrical stimulation of the soft palate rectangular electric pulses, initially described in point, then turn in points (paracentral) the soft palate to the right and to the left of the middle line (4 effects on each point). Supplied pulse current, selected according to the sensitivity of the patient to feel "tingling", corresponded to a frequency of 80 Hz, the amplitude of 600 μa, burst mode at 10 pulses per bundle, repetition frequency packs through 1 C, the duration of a series of irritation 30, the interval between a series of 30 C. the Course of treatment consisted of 10 sessions.

After treatment were recording snoring on tape (also without alerting the patient). Acoustic analysis of snoring before and after treatment showed a positive trend: decreasing the strength of snoring after treatment when listening to tape recordings and visual analysis of its acoustically increase in muscle tone of the soft palate after electrostimulation, the value of which was characterized by increased amplitude of the bioelectric activity at rest to 55 µv, with a load of up to 400 µv.

Thus, in the treatment of snoring method of electrical stimulation in a patient with P. significantly reduced the intensity of snoring.

The drawing shows the acoustic curves before and after treatment. After electrostimulation marked the shift of the spectrum of the fundamental tone at 400-700 Hz, the decrease in the intensity of the acoustic signal.

During the treatment the patient received a good functional result: increased tone of the muscles of the soft palate, a significant decrease in snoring.

The inventive method has the following advantages:

1. healing factor affects the most important element in the pathogenesis of snoring - the tone of the muscles of the soft palate;

2. reducing the morbidity method, preserving the integrity of the anatomical structures of the soft palate;

3. the possibility of treatment, both in hospital and outpatient settings;

4. provides persistent therapeutic effect, causing the elimination or reduction of intensity of snoring during sleep;

5. allows selection of appropriate parameters of the treatment process which requires special training of the doctor.

A method of treating snoring, providing external influence on the soft palate, characterized in that exercise, electrical stimulation using pacemaker otological "ASOT-1" muscles of the soft palate in the midline and paracentral points one-by-4 effects on each point of the rectangular pulse current frequency of 60 - 80 Hz, the amplitude of the current 10 - 600 µa in burst mode at 10 pulses per bundle, at a repetition frequency packs through 1 C, the duration of a series of irritation 30 s with an interval of 30 s, for a treatment course of 10 to 12 sessions.

 

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