Airway treatment device

Abstract

The invention relates to an airway treatment device (1) for treating airway muscles, lung function and / or mucus deposits in the lungs, nose and / or throat of a patient (2), comprising a hollow body (3) with at least one through channel (4, 5) arranged therein, a mouthpiece or nosepiece (6) inserted into the hollow body (3), which is connected to the patient (2) during treatment with the airway treatment device (1), and at least one vibration body (11, 12) arranged inside the hollow body (3), which is brought into oscillating vibration by the inhalation and / or exhalation of the patient (2), generating oscillating, resistance and / or threshold typical air pressure vibrations, wherein the individual resistance during inhalation and exhalation can be correctly adjusted individually for the patient and does not require modification or conversion of the airway treatment device (1). This is achieved by a retaining body (13) inserted into the hollow body (3), in which at least one opening (14) is machined, a freely vibrating tongue (15) being fastened to the retaining body (13) in the region of the opening (14), by means of which the opening (14) of the retaining body (13) is closed or regionally released depending on the air flow (7, 8) inside the hollow body (3), i.e. the end face (9) of the hollow body (3) opposite the mouthpiece (6) is open, a constriction (18) is inserted into the end face (9), at least two channel openings (20) are arranged in the side face (19) of the constriction, through which the air flow (7, 8) flows into the interior of the hollow body (3) or vice versa, the channel openings (20) of the constriction (18) have different cross sections as air channels for the air flow (7, 8), and the constriction (18) is rotatably supported in the hollow body (3) such that by twisting the constriction (18) one of the channel openings (20) can be selected or provided as an air channel.

Description

TECHNICAL FIELD

[0001] The invention relates to an airway treatment device for treating airway muscles, lung function and / or dissolving mucus in the patient's lung, nose and / or throat space. BACKGROUND

[0002] Such an airway treatment device is described, for example, in EP 3 251 718 B1. In the tube, a curved elastomer in the form of a hose is fastened on a mouthpiece. The tube is curved so that the hose has a curvature and thus a cross-section is reduced in the curvature area. As soon as the patient sucks in breathing air through the mouthpiece or presses it out, ambient air or breathing air is pulled or squeezed through the hose, causing the hose to vibrate. This vibration generates oscillating air pressure fluctuations in the patient's mouth, nose and / or lungs, which leads to airway muscle and mucus dissolution in these areas.

[0003] From EP 3 620 195 A1 it is known a ventilation device for the care of artificially ventilated patients, while releasing congestion in the bronchi, while releasing congestion in the bronchi and training the respiratory muscles. The device comprises an airway treatment device, for example of the type mentioned at the beginning.

[0004] For decades, such airway treatment devices have been proven in practice and have been successfully used to treat patients. However, it has been found to be disadvantageous that the service life of the used hoses is very short and is blocked after only a few breaths. In addition, aerosols, mucus or other bacteria or viruses are deposited in the hose, which have to be removed after each treatment. Therefore, after a few treatment processes, the hose can be laboriously removed from the tube and the mouthpiece and put into, for example, a microwave oven or other suitable medical device for sterilization in order to obtain such a pathogen solution.

[0005] As with any muscle tissue, respiratory muscle tissue can also be trained. In the context of muscle training, physicians distinguish between strength training and endurance training. Previously, devices for training respiratory muscles were either resistance (devices that generate resistance) or so-called threshold devices. With threshold devices, a spring valve opens and releases an opening when a certain pressure is overcome.

[0006] If a resistance respiratory muscle trainer is used, the constriction usually precedes the breathing portion.

[0007] To exercise a muscle, a certain resistance must be overcome. If comparable training is to be carried out, it is understood that this resistance must be the same for each training.

[0008] All devices on the market so far are primarily for inhalation or exhalation and only generate a static pressure (PIP = positive inspiratory pressure).

[0009] A respiratory training device that expands the bronchi in an inhalation oscillation, resistance (OPIP) and threshold driven manner and dissolves or liquefies mucus stuck therein has not yet been associated with respiratory muscle training.

[0010] Other airway therapy devices of this type can be found in, for example, US 10,004,872 B1, EP 0 262 239, US 2019 / 0201743 A1 or WO 2019 / 070804 A1. Common to the airway therapy devices described there is that a valve in the form of a vibrating plate or flap is arranged in the flow channel through which pressure fluctuations occur or are formed depending on the generated air pressure, that is to say the inhalation or exhalation pressure generated by the patient. The inhaled or exhaled air flows perpendicularly onto the surface of the flap or plate, which is lifted from the holding plate under the action of the prevailing pressure of the air, so that the air flows through the air gap between the flap and the holding plate top side.

[0011] A disadvantage of this airway therapy device is that the inhaled or exhaled air acts perpendicularly onto the flap, because this does not cause the flap to vibrate. This can only be released or closed. This corresponds to the known valve function. This arrangement and the associated air flow do not lead to a flap vibration.

[0012] Furthermore, for the already known airway therapy devices, the amount of air inhaled or pressed into the channel of the respective hollow body cannot be individually adjusted to suit the patient. Rather, a constant, predetermined amount of air enters the channel of the hollow body or is pressed out of it. The volume fraction of the inhaled or pressed-out air corresponds to the lung volume of the respective patient. However, since a large number of different patients and their diseases or training purposes require treatment with the aid of an airway therapy device, the setting options of the known airway therapy devices are very limited. SUMMARY

[0013] It was therefore an object of the present invention to further develop an airway therapy device of the type mentioned at the outset, so that an oscillating, resistance and / or threshold typical air pressure vibration is produced, in which the individual resistance during inhalation and exhalation can be correctly individually adjusted for the patient and without the need for a retrofit or conversion of the airway therapy device. The training load can also be individually adapted depending on the length, weight, stiffness and position of the flap and the design or arrangement of the hollow chamber.

[0014] The object and other advantageous refinements of the application are achieved in that a holding body is inserted into the hollow body, in which holding body at least one opening is incorporated, a freely vibrating and from a metal material made tongue is fastened on the holding body in the region of the opening, by which tongue, depending on the air flow inside the hollow body, the opening of the holding body is closed or regionally released, i.e. the end face of the hollow body opposite the mouthpiece is open, a constriction is inserted into the end face, in the side face of which constriction at least two passage openings are provided through which the ambient air flows into the interior of the hollow body or vice versa, the passage openings of the constriction have different cross sections as air passages for the air flow, and the constriction is rotatably supported in the hollow body, so that by twisting the constriction one of the passage openings can be selected or set as air passage, it should be achieved that the adjustment of the pressure conditions inside the hollow body, which can be individually adjusted for each patient, is possible. This mechanism thus generates various forms of oscillating pressure fluctuations, which have an influence on bronchodilation, have a stabilizing effect and dissolve mucus. Such an airway treatment device can thus be used for individual medical respiratory muscle training purposes, in which oscillating, resistance or threshold driven bronchodilation is provided when inhaling and / or exhaling breathing air.

[0015] The subject of the application uses the tongues to generate acoustically perceptible oscillations, which, due to their different frequencies, allow the inhalation to be distinguished from the exhalation. Depending on the conditions and the position, different levels of specified pressure or flow are required in order to set the tongues in vibration. The pressure or flow at which the tongues start to vibrate can be changed and adjusted by connecting different constrictions. When the required pressure or flow is reached, a sound is emitted. When using the device as a muscle trainer, the occurrence of this tone indicates that the adjustable training "minimum resistance" has been reached.

[0016] The different tones generated are important for the evaluation or guidance during the treatment or training with regard to their volume, their duration and their time relationship to the exhalation.

[0017] In particular, if the vibrating body is formed by a holding body having a cuboid box profile on which openings for the passage of air are incorporated in two lateral side walls extending parallel to the vertical direction, the tongues can be generated to oscillate by the inhalation or exhalation activity of the patient only, without the influence of the generally present gravity. Furthermore, the air does not flow vertically onto the tongues, but sweeps between the free end of the tongues and the top and bottom side of the holding body in the region of the openings, whereby vibrations are generated at the free end of the tongues, by which tongues the desired and required oscillations of the air pressure in the hollow body are generated.

[0018] These vibrations also generate acoustics, as the respective tongue is considered a sound body. This vibration of the tongue and the associated sound can help the patient to identify the inhalation and exhalation behavior. If the sound generated is too deep, too high or too low in volume, the patient will immediately realize that, during inhalation or exhalation, these respiratory activities have not achieved the intended therapeutic or training purposes, so that he can immediately adjust or change his lung activities.

[0019] In addition, the inhaled ambient air can be variably changed by the incorporated passage openings in the constriction, as the cross-sectional area size of the respective passage openings on the constriction is different and the constriction is rotatably supported in the hollow body, so that the patient can individually adjust the respective inhaled or exhaled air quantity by twisting the constriction even when using the airway therapy device. The generated vibrations and the associated sound on the tongue also allow the patient to immediately check to what extent the selected settings achieve the desired therapeutic or training purposes.

[0020] Different constrictions are provided which can be quickly and easily attached.

[0021] As the airway resistance is defined as the pressure change divided by the flow change, the patient must be able to recognize that the desired pressure has been reached, otherwise different flow rates with the same constriction would result in different pressures and thus in different training loads.

[0022] The sound tongue vibration starts depending on its stiffness and mass. In the case of a defined flow, the same sound tongue has the same vibration start. Different diameters of the constrictions result in different pressures at the same flow. When the tongue starts to vibrate, the sound tongue in combination with the constrictions of defined diameters results in a reproducible, defined pressure integral. This can be perceived acoustically and thus recorded. The respiratory muscles have to counteract this pressure integral. It is defined and trained in a reproducible way.

[0023] The force required to make the tongue vibrate and sound depends on the stiffness and length of the tongue and the installation angle. If this force is known, the resistance reached with a given constriction can be determined exactly. Since the stiffness of the tongue does not change, the pressure at which it starts to vibrate is always the same. Therefore, the "critical pressure" and thus the resistance to be overcome can be determined exactly for all constrictions.

[0024] In addition to changing the installation angle, selecting different constrictions can also result in different pressures at which the tongue starts to vibrate or the passage openings of the constrictions open.

[0025] The pressure fluctuations resulting from the vibration of the tongue cause the bronchi to dilate, the bronchial mucus to detach from the walls due to its thixotropy and to liquefy.

[0026] When using a tapping tongue as a "pressure generator and indicator" without a stenosis, the vibration produces a pressure pattern that corresponds to a dynamic PEP (zero to peak; peak to zero), i.e. the pressure rises from 0 to a maximum value in order to just immediately fall back to 0. In addition to the length of the sound tongue, its shape also determines the specific pressure pattern. The longer and heavier or the stiffer the tongue, the higher the initial pressure. The tongue must have enough space in the structure in order to be able to maintain the release distance so that the tongue vibrates.

[0027] The longer the tongue, the more space it needs. Therefore, long and heavy sound tongues are combined into a dynamic pressure form. The pressure form thus produced is required to move the bronchial mucus in order to shear and liquefy it.

[0028] If a sound-emitting tongue is used instead of a tapping tongue, the emission of sound also indicates that a certain pressure has been reached, the pressure fluctuation pattern here corresponding to a combined PEP. The pressure fluctuation forms a permanent positive pressure.

[0029] By using two different vibration bodies, it is also possible to distinguish between inhalation and exhalation purely acoustically. The differences can be recorded, evaluated and documented using an application program with regard to frequency, length and OPIP or OPEP application (different harmonics).

[0030] An additional variable stenosis can be placed between the mouthpiece and the guide tongue tube.

[0031] By virtue of the arrangement of the differently designed vibration bodies in the hollow body according to the invention, which is also used in the hose system of, for example, an inhalation device or a breathing machine, it is thus possible to take into account various situations of the patient. In the case of artificially ventilated patients, the airway treatment device described according to the invention can be switched on and off in the ventilation circuit. This makes it possible to dissolve and liquefy the bronchial mucus and to facilitate the training of the respiratory muscles. BRIEF DESCRIPTION OF DRAWINGS

[0032] Eight embodiment variants of the airway treatment device are shown in the drawings, which will be explained in detail below. In each of the drawings:

[0033] Figure 1 A side view of a first embodiment of the airway treatment device is shown, which consists of a hollow body and a mouthpiece fastened thereon, through which the patient inhales breathing air from the ambient air, wherein the free end of the hollow body has a stenosis, wherein three channel openings with different opening cross sections are combined and reduced in size, wherein a first vibration body is arranged in the through channel of the hollow body;

[0034] Figure 2a An enlarged view of the first vibration body in the form of a holding plate in the raised state according to Figure 1 is shown, wherein a rectangular opening is combined, which is covered by a tongue;

[0035] Figure 2b A holding plate according to Figure 2b is shown, wherein the tongue is lowered, through which the outlet opening is closed;

[0036] Figure 2c An extension of the opening is shown, wherein the tongue passes through the opening in both directions;

[0037] Figure 3a A second embodiment of the airway treatment device during inhalation is shown, which can be used for inhalation and exhalation, having two hollow bodies which communicate with one another, whose respective free end faces are closed by a narrow portion, and having three oscillation bodies arranged in the interior of the hollow bodies in the form of holding plates with tongues or valves;

[0038] Figure 3b An airway treatment device according to Figure 3a during exhalation is shown;

[0039] Figure 4 A third embodiment of the airway treatment device is shown, wherein the oscillation bodies are arranged at an angle to the respective axis of symmetry of the hollow bodies or extend orthogonally thereto;

[0040] Figure 5 An airway treatment device according to Figure 1 is shown, to which sensors and microphones are connected on the oscillation bodies, which communicate with an external device;

[0041] Figure 6a A fourth embodiment of the airway treatment device is shown, in which a partition wall is provided in the hollow body, by which the hollow body is divided into two through passages, through which the breathing air flows during inhalation, at least one of the two oscillation bodies being mounted in each through passage;

[0042] Figure 6b An airway treatment device according to Figure 6a is shown, through which the exhaled air is pushed back into the environment through a second through passage;

[0043] Figure 7 A fifth embodiment of the airway treatment device is shown in a further development of the embodiments according to Figure 6a and 6b , wherein two oscillation bodies are provided in the respective through passage;

[0044] Figure 8 A sixth embodiment of the airway treatment device is shown, wherein the two oscillation bodies arranged in the respective through passage of the airway treatment device according to Figure 6a are arranged orthogonally or obliquely;

[0045] Figure 9 An airway treatment device according toFigure 1 top view of a seventh embodiment of an airway therapy device according to

[0046] Figure 10 shows an airway therapy device according to Figure 9

[0047] Figure 11a shows a constriction with different size designs of the air cross section area inserted into the hollow body of an airway therapy device according to Figures 1 to 10

[0048] Figure 11b shows a second alternative of a constriction according to Figure 11a

[0049] Figures 12a to 12c shows a partial cross section of a holding body according to Figure 9 and 10 with different vibration characteristics of the tongue leaf attached thereto;

[0050] Figure 13 shows an air flow diagram of different constrictions and tongue leaves of one of the airway therapy devices according to Figures 1 to 10

[0051] Figure 14 shows one of the airway therapy devices according to Figures 1 to 10 with a Y-shaped adapter by which the open end face of the hollow body is divided into two air inlet or outlet openings; and

[0052] Figure 15 shows one of the airway therapy devices according to Figures 1 to 10 in nasal application with a face mask connected thereto. DETAILED DESCRIPTION

[0053] Figure 1 shows an airway therapy device 1 with which a patient 2 can improve his respiratory muscles to dissolve mucus in the bronchi and / or to improve his lung function. The airway therapy device 1 comprises a hollow body 3 which is designed, for example, as a tube. A mouthpiece 6 is arranged on one of the free end portions of the hollow body 3 and can be connected to the patient 2 so that the patient 2 can inhale ambient air 10 through the mouthpiece 6 by means of his respiratory muscles.

[0054] ​​​​The end face of the hollow body 3 opposite the mouthpiece 6 is closed with a narrow portion 18. In the side face 19 of the narrow portion 18 three channel openings 20 of different diameters or cross-sectional areas are incorporated. As soon as the patient 2 sucks in ambient air 10 through the mouthpiece 6, the ambient air flows through the channel openings 20 into the interior of the hollow body 3, which thus serves as a first through channel 4 for the inhaled ambient air 10. The arising air flow in the interior of the hollow body 3 is identified by the reference signs 7 and 8, wherein reference sign 7 denotes the ambient air to be inhaled and reference sign 8 denotes the air exhaled by the patient. Due to the number and diameters of the channel openings 20, the patient 2 already needs to increase the breathing force to completely suck in the ambient air 7 into the first through channel 4.

[0055] Since the inhaled air should establish a vibrating or oscillating pressure as far as possible, the first vibrating body 11 is arranged directly before the mouthpiece 6 in the first through channel 4.

[0056] According to Figure 2a , the first vibrating body 11 comprises a plate-like holding body 13, wherein a rectangular opening 14 is incorporated. In the unactuated state, the opening 14 is partially closed by a tongue 15. The free end of the tongue 15 is fastened on the holding body 13 by two screws 22. The outer contour of the holding body 13 here adapts to the inner contour of the first through channel 4 of the hollow body 3, so that the inhaled ambient air 7 can only flow through the opening 14 in the direction of the mouthpiece 6, since the side faces of the holding body 13 lie air-tightly against the inner walls of the first through channel 4. Thus, as soon as the patient 2 sucks in ambient air 7 through the mouthpiece 6, the tongue 15 vibrates in the direction of the mouthpiece 6. Thus, by the inhalation pressure exerted by the patient 2, the tongue 15 is lifted on the free end face opposite the screws 22 and the outlet opening 14 is released in certain areas.

[0057] According to Figure 2b , as soon as the patient 2 has completed the inhalation process, the tongue 15 springs back to the upper side of the holding body 13 and the opening 14 is thus completely closed, so that it is air-tightly sealed. Thus, the vibrating or oscillating air pressure fluctuations generated by the tongue 15 depend on the bending stiffness of the tongue 15 and the mass of the tongue 15, respectively, and on the diameter dimensions of the narrow portion 18 and the opening 14.

[0058] Figure 2c It is shown that the opening 14 can be lengthened, so that the length of the tongue 15 is smaller than the length of the opening 14. This means that there is an air gap between the free end of the tongue 15 and the inner side of the opening 14 and that the tongue 15 can vibrate or dive in both directions through the opening 14. Thus, the tongue 15 vibrates through the opening 14 and thus according to Figure 1 the airway treatment device 1 according to

[0059] Figure 3a and3b A different configuration of the airway treatment device 1 is shown, which now has two hollow bodies 3 connected to each other, whose respective axes of symmetry (identified by the reference 3') are perpendicular to each other. The respective free end faces of the two hollow bodies 3 are closed by a constriction 18. Two oscillating bodies 11 and 12 are arranged in the first through channel 4.

[0060] The first oscillating body 11 comprises a holding body 13 with an opening 14, which according to Figure 2a and 2b is closed or partially released by a tongue 15. Furthermore, a second oscillating body 12 is arranged in the first through channel 4, whose first end face is pivotably connected to the hollow body 3 by a rotary joint 16. When the patient 2 sucks in ambient air 7 through the constriction 18 into the first through channel 4, the opposite free end of the second oscillating body 12 can be lifted from a stop 30 formed on the inside of the hollow body 3 and is identified by the reference 17. The second oscillating body 12 serves as a kind of valve.

[0061] The tongue 15 of the first oscillating body 11 protrudes from the opening 14. A negative pressure Pu is generated in the first through channel 4. Due to the connection of the two through channels 4 and 5 to each other, a negative pressure Pu is generated in the second through channel 5, whereby the tongue 15 of the first oscillating body 11 is pressed onto the holding body 13 in order to close the opening 14. That is, the tongue 15 is arranged on the side of the holding body 13 facing away from the first through channel 4, so that the negative pressure Pu pulls the tongue 15 onto the holding body 13.

[0062] When exhaling according to Figure 3b , both oscillating bodies 11 and 12 are closed in the first through channel 4, since the valve presses against the stop 30 when exhaling through the breathing air 8; the opening 14 is also closed, since the tongue 15 is pressed onto the holding body 13 and thus rests on the holding body due to the pre-stress present of the tongue 15. The exhaled breathing air 8 thus flows through the suction mouth 6 into the first through channel 4 and then into the second through channel 5, so that the breathing air 8 hits the tongue 15 of the first oscillating body 11 arranged in the second through channel 5 and the tongue 15 lifts or presses in certain areas from the opening 14. The breathing air 8 then flows through the passage opening 20 of the constriction 18 arranged in the free end face of the second hollow body 3 into the environment.

[0063] The airway treatment device 1 according to Figure 3a and 3b can thus be used both for inhalation and for exhalation. The two different constrictions 18 for inhalation and exhalation, which can be selected, allow the training load of these two breathing operations to be set individually and separately.

[0064] Different types of arrangements of the first oscillating body 11 in the two hollow bodies 3 are shown in Figure 4 . According to Figure 3a and3b The first oscillation body 11 is arranged perpendicular to the symmetry axis 3' of the respective hollow body 3 and in Figure 4 The first oscillation body 11 is shown in Fig. 3 arranged at a predetermined angle, i.e. tilted to the respective symmetry axis 3'.

[0065] According to Figure 5 The first oscillation body 11 serves both as an acoustic transmission device and as an electronic transmission device. Thus, for example, a loudspeaker 25 or an electric sensor 24 is provided in association with the tongue 15. The loudspeaker 25 transmits tones so that the patient 2 can acoustically perceive whether the respiratory muscles cause the tongue 15 to vibrate sufficiently and for how long the oscillation resistance lasts, i.e. can withstand the specified training load, when using the breathing trainer (inhalation) or the airway treatment device (exhalation) 1.

[0066] The sensor 24 communicates with an external device 26, for example via a WLAN connection. The device 26 can record the duration of use, the frequency of use of the tongue 15 and the number of respiratory exercises of the patient 2 so that these can be read out and evaluated by a doctor, for example, after a certain period of time.

[0067] If two different tongues 15 are installed, it is possible to directly distinguish and record the training of the inhalation muscles, including the respective training load, and the duration during exhalation, including the resistance and threshold-driven treatment level. Conventional cell phones can also make these recordings via an APP, making the loudspeaker and microphone superfluous.

[0068] In Figure 6a and 6b The breathing trainer or airway treatment device 1 comprises a hollow body 3 in which a partition wall 27 is formed to form two through passages 4 and 5 separated from one another in an air-tight manner. The respective free end face of the hollow body 3 is partially closed by a constriction 18. One of the first oscillation bodies 11 is arranged in each of the through passages 4 and 5. According to Figure 6a As soon as the patient sucks in ambient air 7 through the first through passage 4, the first oscillation body 11 arranged in the first through passage 4 opens because the tongue 15 is pressed in the direction of the mouthpiece 6 due to the sucked-in ambient air 7. The tongue 15 is arranged on the upper side of the holding body 13 facing the mouthpiece 6.

[0069] According to Figure 6b As soon as the patient 2 exhales, the tongue 15 opens in the second through passage 5 because the breathing air 8 first presses the tongue 15 of the first oscillation body 11 in the first through passage 4 onto the holding body 13 and thus, the first through passage 4 closes and the breathing air 8 presses the tongue 15 of the first oscillation body 11 arranged in the second through passage 5. The tongue 15 is arranged on the upper side of the holding body 13 facing away from the mouthpiece 6.

[0070] Figure 7The combination of the first oscillation body 11 and the second oscillation body 12 is shown, which are inserted with the tongue 15. The first through-passage 4 is opened during inhalation by means of the first oscillation body 11 and the second oscillation body 12 and during exhalation they are closed by the breathing air 8, so that the breathing air 8 presses the first oscillation body 11 in the second through-passage 5.

[0071] The combination of the inhaler / nebulizer 36 and the second oscillation body 12 can be used. The first through-passage 4 is opened during inhalation by the second oscillation body 12 and during exhalation by the breathing air 8, so that the breathing air 8 presses the first oscillation body 11 in the second through-passage 5.

[0072] Figure 8 The first through-passage 4 is shown closed by the first oscillation body 11 and the second through-passage 5 is closed by the second oscillation body 12. Optionally, these combinations can be exchanged accordingly and the orientation of the oscillation bodies 11 and 12 with respect to the symmetry axis 3' of the hollow body 3 can extend perpendicularly or at an angle thereto.

[0073] In Figure 9 and 10 alternative design variants of the airway treatment device 1 are shown. In this case, the first oscillation body 11 is initially composed of a holding body 13, which is configured T-shaped in cross-section. The free end of the holding body 13 is fastened on the inside of the hollow body 3, wherein an opening 14 is surrounded thereby. This opening 14 is accordingly opposite or leads to the mouthpiece or nosepiece 6, so that the air flow 7, 8 passes through these openings essentially perpendicularly.

[0074] Furthermore, the airway treatment device 1 is equipped with a cuboid box profile as a component of the holding body 13. The cuboid box profile accordingly encloses the hollow chamber which communicates with or leads to the openings 14. Two opposite sides of the box profile have two openings 14, on the outside and the inside of which the tongues 15 are attached. In use of the airway treatment device 1, the two sides of the holding body 13 extend parallel to the vertical direction, so that the self-weight force of the tongues 15 does not influence their vibration behavior; rather, the vibration behavior of the tongues 15 is influenced only by the air bridge generated, by the air fluctuations due to the passage openings 20 provided in the constriction 18 and due to the material properties of the tongues 15 and the geometry in the openings 14. The tongues 15 thus move in a vertical plane and can be correspondingly vibrated or oscillated both when the patient 2 inhales and exhales. The flow properties in the interior of the hollow body 3 and in the region of the openings 14 and the tongues 15 are indicated schematically by the reference numerals 10, 7 and 8. Thus, when the patient 2 inhales, ambient air 10 is sucked through one of the passage openings 20 of the constriction 18 into the first through passage 4 of the hollow body 3 and the tongues 15 attached on the inside vibrate, so that the inhaled ambient air 7 flows through the openings 14 and through the air gap between the tongues 15 and the holding body 13 facing the openings 14 towards the patient 2 and can be inhaled by the patient. When exhaling, the breathing air 8 flows into the interior of the box profile of the holding body 13 and presses the sound tongues 15 attached on the inside, so that their openings 14 close; while the tongues 15 hinged on the outside vibrate outwards and the breathing air 8 enters through the air gap thus released into the first through passage 4 of the hollow body 3 and flows to the outside through the passage openings 20 of the constriction 18.

[0075] In Figure 11a and 11b two different embodiments of one of the common constrictions 18 with differently dimensioned passage openings 20 are shown. The respective constrictions 18 are rotatably supported in the hollow body 3 and their side 19 has four differently designed passage openings 20, which can be positioned by rotating the constrictions 18 relative to the hollow body 3, so that the respective inlet opening is reduced or enlarged. The respective selection of the cross-sectional area of the respective passage openings 20 thus means that the patient 20 has to suck the ambient air 10 into the first through passage 4 of the hollow body 3 with more or less suction pressure or has to press the breathing air 8 from the first through passage 4 to the outside. The cross-sectional area of the respectively provided passage openings 20 also has a considerable influence on the vibration behavior of the respective tongues 15, since the vibration behavior of the respective tongues 15 changes with higher internal pressure in the first through passage 4.

[0076] In Figure 12a , 12bThe vibrational behavior of the tongue 15 is shown and illustrated in Figures 12c and 12c. First, the deflection of the tongue 15 differs because the distance Δh between the lower side of the tongue 15 and the upper side of the retainer 13 has different magnitudes. This distance variation is indicated by reference numerals 32, 32', and 32”. These distance variations 32, 32', or 32” initially depend on the material used for the tongue 15, which is made of flexible metal. The vibrational behavior of the tongue 15 varies with the material properties. Furthermore, the vibrational behavior of the tongue 15 may also be affected by the geometry of the opening 14 and the thickness of the tongue 15.

[0077] It is also shown that, through a specific pairing of materials, geometry, and pressure conditions within the first through channel 4 or the hollow body 3, the vibrational behavior of the tongue 15 generates an acoustically perceptible sequence of tones. Using this acoustics, the patient 2 can accurately determine whether their breathing behavior meets the desired training or therapeutic objectives. If the sound is weak or produces a discordant sound, the patient 2 identifies the incorrect breathing behavior from the primary sound and thus modifies the stenosis 18, the retainer 13, or the inserted tongue 15.

[0078] exist Figure 13 The diagram schematically illustrates three different vibration behaviors. The acoustic characteristics of the airway therapy device 1 are thus represented by the predetermined internal pressure in the first through-channel 4 and the flow through the opening 14, which influence and determine the vibration characteristics of the tongue 15. Figure 12a , 12b The distance 32, 32', or 32” changes with 12c, thereby creating a flow rate of inhaled ambient air 7 or breathing air 8. Therefore, the larger this distance 32, 32', or 32”, the more air volume flows through the opening 14, or creates overpressure or negative pressure in the first through channel 4, or is necessary for the tongue 15 to vibrate. Here, in conjunction with the corresponding upstream narrow section 18, the minimum flow rate, negative pressure, or overpressure required for tone formation can be precisely set.

[0079] Figure 13 The graph illustrates the relationship between these adjustment possibilities. Enter time on the horizontal axis and the corresponding pressure on the horizontal axis, with 1V corresponding to the pressure of 20 cm H2O. The measurements shown here as an example were performed under negative pressure. However, this also applies to overpressure that occurs during exhalation. These measurements of the maximum or widest cross-sectional area of ​​the channel opening 20 with a small release distance 32 and a narrow section 18 show significant oscillations in the vibrational behavior of the tongue 15, exhibiting significant pressure fluctuations even at low pressures. Under high pressures, these pressure fluctuations are significantly more pronounced and even move at a high pressure level of -1V. However, if the minimum cross-sectional area of ​​the channel opening 20 on the narrow section 18 is selected or set, the vibrational behavior does not change and is determined by the dimensions and the stiffness of the material used for the tongue 15.

[0080] The combination of different release distances 32, 32' or 32" is used to create a negative pressure and / or overpressure during inhalation and exhalation, the stiffness and length of the tongue tab 15 and the set cross-sectional area of the passage opening 20 of the respective constriction 18 thus precisely define the required pressure, which is necessary at the start of the vibration and thus for training the respiratory muscles and dissolving bronchial secretions. This vibration behavior can also be acoustically perceived by the patient 2 and the sensor 23 or 24 attached to the tongue tab 15. This selection of the setting possibilities can thus be determined individually for each patient 2 in order to optimally influence the parameters required for the treatment.

[0081] Figure 14 A design refinement of the airway treatment device according to Figure 9 and 10 is shown. Here the adapter 37 can be introduced into the free end of the hollow body 3 as a switch for the inhalation ambient air 10 and the breathing air 8. The adapter 37 has a Y shape, so that it has two openings facing the environment, into each of which one of the constrictions 18 can be inserted. The pressure conditions in the first through passage 4 during the inhalation or exhalation process can thus also be set differently by correspondingly selecting or setting the cross-sectional area of the passage opening 20 on the respective constriction 18, which is smaller or larger.

[0082] Figure 15 The application case of a nasal airway treatment device 1 is shown. In this case, the mouthpiece 6 of the airway treatment device leads to a mask 38, which is placed in a conventional and known manner onto the outside of the nose of a patient 20. The patient 20 can thus also use the airway treatment device 1 according to the invention to dissolve mucus in the nasal cavity.

[0083] The tongue tab 15 can be made of a curved elastic material. It is essential that the tongue tab 15 vibrates and thus generates its oscillating acoustically perceptible vibrations. The material used can thus consist of metal, hard plastic or a fabric made of these materials.

Claims

1. Airway treatment device (1) for treating airway muscles, lung function and / or mucus deposits in the lungs, nose and / or throat of a patient (2), which airway treatment device consists of - a hollow body (3) in which at least one through channel (4, 5) is provided, - a mouthpiece or nosepiece (6) inserted into the hollow body (3) which is connected to the patient (2) during the treatment by the airway treatment device (1), and - at least one vibration body (11, 12) arranged inside the hollow body (3) which is brought into oscillating vibration by the inhalation and / or exhalation of the patient (2), characterized in that a holding body (13) is inserted into the hollow body (3) in which at least one opening (14) is incorporated, in the region of which opening (14) a freely vibrating tongue (15) is fastened on the holding body (13) for generating an acoustic oscillation which is audible to the human ear and which enables the differentiation between inhalation and exhalation by means of the frequency difference, by means of which tongue, depending on the air flow (7, 8) inside the hollow body (3), the opening (14) of the holding body (13) is closed or regionally released, i.e. the end face of the hollow body (3) opposite the mouthpiece (6) is open, into which end face a narrowing (18) is inserted, in the side face (19) of which narrowing at least two channel openings (20) are provided through which the air flow (7, 8) flows into the interior of the hollow body (3) or vice versa, the channel openings (20) of the narrowing (18) have different cross sections as air channels for the air flow (7, 8), and the narrowing (18) is rotatably supported in the hollow body (3) in such a way that by twisting the narrowing (18) one of the channel openings (20) can be selected or provided as an air channel.

2. Airway treatment device according to claim 1, characterized in that the narrowing (18) has a wall (21) through which the passage to the hollow body (3) in the direction of its symmetry axis (3') is closed, and the outer contour of the narrowing (18) is adapted to the inner contour of the hollow body (3).

3. Airway treatment device according to one of claims 1 or 2, characterized in that the channel openings (20) can be closed by means of plugs (23).

4. Airway treatment device according to claim 1 or 2, characterized in that one side of the tongue (15) lies against the surface of the hollow body (3) or is raised from the surface of the hollow body (3), or the tongue (15) allows an oscillating inflow and / or outflow of air through the opening (14).

5. Airway treatment device according to claim 1 or 2, characterized in that the first and second vibration bodies (11, 12) are arranged in the direction of breathing and / or counter to the direction of breathing.

6. Airway treatment device according to claim 1 or 2, characterized in that The hollow body (3) is designed as a box profile through which a cuboid hollow chamber is enclosed, a sensor (24) and / or a microphone (25) are connected to at least one of the vibration bodies (11, 12) for transmitting acoustic or electrical signals to an external device (26), the vibration bodies (11, 12) serve as acoustically perceptible sound generators for checking the correct or desired use of the airway treatment device (1), and the openings are provided in the end faces of the housing which extend parallel in the valve.

7. Airway treatment device according to claim 1 or 2, characterized in that The tongue (15) is made of a curved elastic material.

8. Airway treatment device according to claim 7, characterized in that The tongue (15) is made of metal and / or hard plastic.

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