Head-stabilized medical apparatus, system and methodology

Abstract

Structure and methodology involving mountable and head-wearable frame structure which is positionally stabilized, during use, relative a human subject's head, and which carries a selection of positionally anchored data sensors, and stimuli deliverers, that are relevant to the diagnosis and treatment of vestibular disorders. Special configurations are provided for two types of stimulators, one for sound application and air-pressure modification, and the other for the introduction of fluids to the ear. Stabilization enables tight and accurate correlation of data which is quickly analyzable by a connected, properly algorithmed computer, which can also be used for feedback control in a designed “expert” system. The invention enables, among other things, practical and significant differentiation between physiological and pathological nystagmus.

Description

[0001] This application is a Divisional of U.S. patent application Ser. No. 10 / 715,871, entitled HEAD-STABILIZED MEDICAL APPARATUS, SYSTEM AND METHODOLOGY, filed 17 Nov. 2003, the disclosure of which is herein incorporated by reference in its entirety.[0002] This invention was made with government support under PHS 398 / 2590 awarded by the National Institutes of Health. The government has certain rights in the invention.BACKGROUND AND SUMMARY OF THE INVENTION [0003] The present invention involves a head-stabilized method and apparatus designed for the diagnosis and treatment of vestibular disorders involving symptoms of dizziness, vertigo and / or imbalance. It also relates to the structures of certain special devices that are particularly suited for use with this method and apparatus, and to certain procedural approaches that the structure and method of the invention make advantageous. [0004] In a manner of speaking, the invention recognizes, and centers attention on, the discovered s...

AI Technical Summary

Benefits of technology

The system enables more accurate and efficient diagnosis and treatment of vestibular disorders by distinguishing between normal and abnormal nystagmus and integrating data from multiple sources, reducing the need for separate devices and improving treatment outcomes.

Problems solved by technology

Dysfunction of the semicircular canals results mainly in symptoms of vertigo.

However, these standardized test positions do not employ the ideal anatomical positions for obtaining useful information.

Inasmuch as nystagmus occurring in a particular test position will be dependent upon numerous factors, such as (a) the rapidity and method of the just-mentioned maneuver, (b) the time lapse after a test position is reached until the data-acquisition run is commenced, and (c) the exact angles of the test positions, etc, the usual ENG / VNG test battery, as now generally carried out, is not optimally effective and accurate.

Abnormal conditions adversely affecting the otolithic organs cause mainly symptoms and signs of imbalance.

This imbalance of otolithic origin results from either unstable neural input from an otolithic organ, or organs, or a bilateral deficit.

Central compensation generally takes place adequately over time for the reduced form if it is unilateral and becomes stable, but compensation is delayed or not forthcoming in response to the distorted form because of its persistent instability.

A problem with analyzing adverse postural effects for this purpose is that test subjects are usually acutely aware of their recent postural misperceptions that have resulted in abnormal sway or fall in a particular direction, and can quickly compensate for these misperceptions to some degree when presented with the same apparent stimulus.

This tendency to compensate results in limited repeatability, and thus, questionable reliability of such a test using postural control as a measure.

Aberrant receptivity of the labyrinth to sound or intralabyrinthine pressure change can occur in either the semicircular canals, thereby adversely impacting the VOR system and producing nystagmus, or in the otolithic organs, thereby adversely impacting the VSR system and producing abnormal postural effects and altered gravitational perception.

In the present state-of-the-art, quantitative information on the status of both the VOR and the VSR requires two separate devices, taking up more space in the vestibular laboratory and adding to expense.

In addition, several valuable existing tests have not been utilized significantly outside of research laboratories because of the expense involved in the equipment to perform each test separately.

However, for the more complicated cases, optimal performance of these maneuvers requires ongoing, real time observation and analysis of nystagmus.

In addition, and as mentioned above, the nystagmus patterns that subjects may display in response to maneuvers may be rapidly changing and complex, yet immediate interpretation is often required, and this requirement becomes more acute when the need for a change in strategy is indicated (e.g. a conversion of the causative particles from the posterior to the horizontal canal, or the development of a jamming of the particles).

Very challenging, there is the need for the operator, during an entire sequence of maneuvers, to envision the 3-D orientation, with respect to space and gravity, of the semicircular canals inside the head, as well as the apparent position of the particles within those canals.

This multi-level observation requirement is quite difficult because of the constant changing orientation in space of the subject during maneuvers.

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