Laryngeal endoscopy

Abstract

This laryngoscope is used for an endoscopic examination of swallowing and includes: an insertion part that is formed tubular and that is inserted into the human body; and a grasping part disposed on the proximal end side of the insertion part. The insertion part comprises: a distal end section having at least an objective lens; a first curved section that is located further toward the proximal end than the distal end section and that is curved in a direction perpendicular to the center axis of the insertion part; a second curved section that is located further toward the proximal end than the first curved section and that is curved about the center axis in a direction opposite to the first curved section; and a tubular, flexible tube section that is flexible and located further toward the proximal end than the second curved section. The grasping part comprises an operating section for deforming the first curved section and / or the second curved section into the curved shape.

Description

Technical Field

[0001] The present invention relates to a laryngeal endoscope used for swallowing endoscopy.

Background Art

[0002] Conventionally, as a method for examining the presence or absence of food residue in the larynx and the presence or absence of inflow into the trachea (hereinafter also referred to as aspiration) after swallowing food, swallowing endoscopy using a nasal endoscope (see, for example, Patent Document 1) is known. By this examination, the laryngeal region of the subject (specifically, the epiglottis, tracheal wall, vocal cords, esophageal inlet, etc.) is observed, and when the subject swallows food such as viscous food (jelly, etc.), the chewing state of the food, the presence or absence of residue, and the presence or absence of inflow into the trachea can be confirmed.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] By the way, the above nasal endoscope has a curved portion at the insertion site. In swallowing endoscopy, the endoscope is inserted from the nose, and the curved portion is curved near the laryngeal region, so that the tip of the endoscope is directed toward the larynx, vocal cords, or airway direction to visually recognize the corresponding location. FIG. 1 shows the positional relationship between the laryngeal region and the endoscope insertion portion ES when observing the laryngeal portion with such a conventional nasal endoscope. FIG. 1 schematically shows a cross section from the lower half of the human face to the throat, showing the nasal cavity NC, oral cavity MC, tongue S, epiglottis KG, trachea T, anterior tracheal wall TF, posterior tracheal wall TB, esophagus E, etc. The dotted line in the figure virtually shows the visual field of the endoscope.

[0005] As shown in Figure 1, the anterior tracheal wall TF of the trachea T ​​can be easily visualized depending on the orientation of the tip of the endoscope insertion section ES. However, in order to visualize the posterior tracheal wall TB, the tip of the endoscope must be inserted deep into the larynx (into the trachea), which requires inserting the endoscope along the epiglottis KG. However, if the endoscope comes into contact with the subject's epiglottis KG, a gag reflex will be triggered, making the examination impossible and causing significant discomfort to the subject. For this reason, in conventional transnasal endoscopy for swallowing examinations, the posterior tracheal wall TB cannot be visualized, and there is a risk of overlooking any residue in the posterior tracheal wall TB.

[0006] This invention was made in view of the above circumstances, and aims to provide an endoscope that can visualize the posterior tracheal wall during swallowing endoscopy. [Means for solving the problem]

[0007] To solve the above-mentioned problems, the present invention employs the following configuration. That is, the present invention is A laryngeal endoscope used for swallowing endoscopy, having an insertion portion formed in a tubular shape and inserted into the human body, and a gripping portion positioned at the proximal end of the insertion portion, The aforementioned insertion portion is At least a tip equipped with an objective lens, A first curved portion is located closer to the base end than the tip portion and curves in a direction perpendicular to the central axis of the insertion portion, A second curved portion is located closer to the base end than the first curved portion and curves in the opposite direction to the first curved portion with respect to the central axis, It comprises a flexible tubular section located closer to the base end than the second curved section, The gripping portion includes an operating portion for deforming at least one of the first curved portion and the second curved portion into the curved shape. This is a laryngeal endoscope characterized by the following features.

[0008] With the configuration described above, by inserting the tip of the endoscope near the larynx and adjusting its position so that the second curved section is curved toward the epiglottis and the first curved section is curved toward the posterior tracheal wall, it becomes possible to visualize the posterior tracheal wall without inserting the endoscope deep into the larynx (into the trachea). This prevents missing any residue in the posterior tracheal wall during swallowing endoscopy, allowing for more accurate swallowing endoscopy.

[0009] Furthermore, the first curved section may be formed in advance by curving it to a predetermined angle, and the operating unit may deform the second curved section into the curved shape. With such a configuration, the operating unit for curving the curved section (and the mechanism for curving connected thereto) can be made into one (one system), as in the conventional method, thus reducing the burden on the operator. In addition, the structure of the endoscope can be simplified.

[0010] Furthermore, the laryngeal endoscope may have a first operating unit for deforming the first curved section into the curved shape, and a second operating unit for deforming the second curved section into the curved shape. With such a configuration, since the two curved sections can be operated separately, a series of operations such as insertion of the endoscope and positioning to the examination site can be flexibly performed in accordance with the shape of the subject's nasal cavity, larynx, etc., thereby reducing the burden on the subject.

[0011] Furthermore, the first curved portion may be formed to be deformable by bending at an angle of ±20 degrees or more and ±50 degrees or less with respect to the central axis, and the second curved portion may be formed to be deformable by bending at an angle of ±130 degrees or less with respect to the central axis in the opposite direction to the first curved portion. With such a configuration, it is suitable for observing the posterior tracheal wall by curving the second curved portion toward the epiglottis and curving the first curved portion toward the posterior tracheal wall.

[0012] Furthermore, the first curved portion may be shorter than the second curved portion, and the length of the first curved portion may be 3 mm or more and 13 mm or less, while the length of the second curved portion may be 10 mm or more and 30 mm or less. Such a configuration is suitable for observing the posterior tracheal wall without contacting the epiglottis with the endoscope.

[0013] Furthermore, in the present invention, the above means can be used in combination as much as possible. [Effects of the Invention]

[0014] According to the present invention, it is possible to provide an endoscope that allows visualization of the posterior tracheal wall during swallowing endoscopy. [Brief explanation of the drawing]

[0015] [Figure 1] Figure 1 illustrates the arrangement of the insertion part and the field of view when observing the vicinity of the larynx using a conventional endoscope. [Figure 2] Figure 2A is a front view showing a schematic configuration of a laryngeal endoscope according to Embodiment 1 of the present invention. Figure 2B is a top view showing a schematic configuration of a laryngeal endoscope according to Embodiment 1 of the present invention. [Figure 3] Figure 3A is the first diagram illustrating the configuration of the curved portion of the laryngeal endoscope according to Embodiment 1 of the present invention. Figure 3B is the second diagram illustrating the configuration of the curved portion of the laryngeal endoscope according to Embodiment 1 of the present invention. Figure 3C is the third diagram illustrating the configuration of the curved portion of the laryngeal endoscope according to Embodiment 1 of the present invention. Figure 3D is the fourth diagram illustrating the configuration of the curved portion of the laryngeal endoscope according to Embodiment 1 of the present invention. [Figure 4] Figure 4 is a diagram illustrating the arrangement of the insertion part and the field of view when observing the vicinity of the larynx using the laryngeal endoscope according to Embodiment 1. [Figure 5] Figure 5 is a diagram illustrating the schematic configuration of a laryngeal endoscope according to Embodiment 2 of the present invention. [Modes for carrying out the invention]

[0016] Hereinafter, specific embodiments of the present invention will be described based on the drawings. However, dimensions, materials, shapes, relative arrangements, etc. of the components described in this embodiment are not intended to limit the scope of the present invention only to them unless otherwise specified.

[0017] <Embodiment 1> (Structure of the endoscope) FIG. 2 is a diagram showing an outline of the structure of the laryngeal endoscope 1 according to this embodiment. FIG. 2A is a front view of the laryngeal endoscope 1, and FIG. 2B is a top view of the laryngeal endoscope 1. As shown in FIGS. 2A and 2B, the laryngeal endoscope 1 generally has a configuration including an insertion portion 11 and a gripping portion 12. The insertion portion 11 is formed in a tubular shape and is a portion inserted into the human body. It includes a distal end portion 110 provided with an objective lens and a light guide (both not shown), a first bending portion 111 located on the proximal side (i.e., the gripping portion side) of the distal end portion 110, a second bending portion 112 located on the proximal side of the first bending portion 111, and a flexible tube portion 113 located on the proximal side of the second bending portion 112.

[0018] Although the insertion portion 11 as a whole has a flexible configuration, each part constituting the insertion portion 11 may be made of different materials. For example, the distal end portion 110 may be formed of stainless steel, the first bending portion 111 and the second bending portion 112 may be formed of fluorine rubber, and the flexible tube portion 113 may be formed of polyurethane resin or the like.

[0019] Also, inside the insertion portion 11, although not shown in any figure, an image guide fiber (optical glass fiber), a light guide fiber, a first bending mechanism for bending the first bending portion 111, and a second bending mechanism for bending the second bending portion 112 are incorporated.

[0020] For the first bending mechanism and the second bending mechanism, any desired known technique can be adopted and they can have any configuration. For example, a structure can be adopted in which a plurality of annular members connected rotatably are connected by two wires, and by pulling one of the wires and relaxing the other, it bends to the side of the pulled wire.

[0021] The gripping section 12 has a roughly rectangular housing and includes a first bending section operating lever 121, a second bending section operating knob 122, a light source connection section 123, and an eyepiece lens 124.

[0022] The first curved section operating lever 121 is connected to the first curved mechanism, and by sliding the first curved section operating lever 121 back and forth, the first curved mechanism can be operated and the first curved section 111 can be curved. In addition, the second curved section operating knob 122 is connected to the second curved mechanism, and by rotating the second curved section operating knob 122, the second curved mechanism can be operated and the second curved section 112 can be curved.

[0023] As shown in Figure 2, the first curved section operating lever 121 and the second curved section operating knob 122 are each provided on different sides of the gripping section 12 housing. This allows, for example, when gripping the gripping section 12 with the right hand, the first curved section operating lever 121 to be operated with the thumb and the second curved section operating knob 122 to be operated with the index finger (or middle finger). In other words, it becomes possible to grip the gripping section 12 and operate the first curved section operating lever 121 and the second curved section operating knob 122 with just one hand. Furthermore, this configuration, combined with the fact that one operating part is an operating lever and the other is an operating knob, helps to prevent operational errors such as accidentally bending the second curved section 112 when intending to bend the first curved section 111.

[0024] The light source connection section 123 is connected to a light source device (not shown) by a light guide cord (not shown) or the like. The light source connection section 123 and the light guide on the tip section 110 are connected by a light guide fiber, so that the light emitted from the light source device is transmitted to the light guide on the tip section 110 via the light guide fiber. This makes it possible to illuminate the observation area.

[0025] The eyepiece 124 is connected to the objective lens at the front end 110 via an image guide fiber, and the image formed on the objective lens is transmitted to the eyepiece 124 via the image guide fiber.

[0026] (Regarding the characteristics of the curved section) Figure 3 illustrates the curvature of the first curved section 111 and the second curved section 112 of the laryngeal endoscope 1 according to this embodiment. Figure 3A shows the vicinity of the tip 110 of the laryngeal endoscope 1 when neither the first curved section 111 nor the second curved section 112 is curved. The dashed line in the figure indicates the central axis A1 of the tubular insertion section 11. As shown in Figures 2 and 3, the first curved section 111 is formed to be shorter than the second curved section 112. Specifically, the length of the first curved section 111 can be 3 mm to 13 mm, preferably 6 mm to 10 mm, and the length of the second curved section 112 can be 10 mm to 30 mm, preferably 15 mm to 25 mm.

[0027] Figure 3B shows the first curved section 111 in a curved state. As shown in Figure 3B, the first curved section 111 is curved in a direction perpendicular to the central axis A1 of the insertion section 11 (in the direction of the white arrow in the figure). The first curved section 111 is configured to bend at an angle of ±20 degrees to ±50 degrees with respect to the central axis A1.

[0028] Figure 3C shows the second curved section 112 in a curved state. As shown in Figure 3C, the second curved section 112 is curved in the opposite direction to the curvature direction of the first curved section 111 (direction of the black arrow) with respect to the central axis A1 of the insertion section 11. The second curved section 112 is configured to bend at an angle of ±130 degrees or less with respect to the central axis A1 in the opposite direction to the first curved section 111. However, similar to the first curved section 111, it may also be configured to bend at an angle of ±20 degrees or more and ±50 degrees or less with respect to the central axis A1.

[0029] Figure 3D shows the vicinity of the tip 110 of the laryngeal endoscope 1 with both the first curved section 111 and the second curved section 112 curved. As shown in Figure 3D, when both the first curved section 111 and the second curved section 112 are curved, the entire curved section forms a roughly S-shaped line.

[0030] Figure 4 shows the state in which the insertion section 11 of the laryngoscope 1 has been inserted to the vicinity of the larynx, and both the first curved section 111 and the second curved section 112 have been curved. As shown in Figure 4, according to the laryngoscope 1 of this embodiment, by inserting the insertion section 11 to the vicinity of the larynx, curving the second curved section 112 toward the epiglottis KG direction, and curving the first curved section 111 toward the posterior tracheal wall TB direction, it becomes possible to bring the posterior tracheal wall TB into view. In other words, in swallowing endoscopy, it is possible to prevent missing any residue in the posterior tracheal wall TB, and to perform swallowing endoscopy with higher accuracy.

[0031] <Embodiment 2> In the laryngeal endoscope 1 according to Embodiment 1 described above, both the first bending section 111 and the second bending section 112 were variable in shape, and their bending mechanisms were operated by an operating unit to change their curved shape. However, the present invention is not necessarily applicable only to such embodiments. Other embodiments of the present invention will be described below.

[0032] Figure 5 is a schematic front view showing the structure of a laryngeal endoscope 2 according to a second embodiment of the present invention. As shown in Figure 5, the laryngeal endoscope 2, like the laryngeal endoscope 1, has a configuration that generally includes an insertion section 21 and a gripping section 22. Furthermore, the insertion section 21 is also generally the same as the laryngeal endoscope 1 according to Embodiment 1 in that it comprises a tip section 210, a first curved section 211, a second curved section 212, and a flexible tube section 213. However, it differs from the insertion section 11 of the laryngeal endoscope 1 in that the first curved section 211 is formed in a pre-curved shape.

[0033] Furthermore, the gripping section 22 of the laryngeal endoscope 2 is equipped with a second bending section operating knob 222 and an eyepiece lens 224, and the light source connection section is located in the same position as the laryngeal endoscope 1, although it is not shown in the figure. However, it differs from the laryngeal endoscope 1 in that it does not have a configuration equivalent to the first bending section operating lever.

[0034] In other words, in the laryngeal endoscope 2 according to this embodiment, the first curved section 211 is formed in a pre-curved state, and only the second curved section 212 is configured to bend variably by operating the second curved section operating knob 222. The second curved section 212 can be bent in at least the opposite direction to the curvature of the first curved section 211. As a result, by bending only the second curved section 212, a roughly S-shaped form can be created for the entire curved section, providing a laryngeal endoscope that allows visualization of the posterior tracheal wall.

[0035] As described above, the laryngeal endoscope 2 according to this embodiment allows for the operation unit and bending mechanism for bending the curved section to be combined into a single unit (single system), as in the conventional design, thereby reducing the burden on the operator. Furthermore, by consolidating the bending mechanism into a single system, it is possible to reduce the diameter of the insertion section and enhance the functionality of the optical system (each fiber).

[0036] <Other> The above examples are merely illustrative illustrations of the present invention, and the present invention is not limited to the specific forms described above. The present invention can be modified and combined in various ways within the scope of its technical concept.

[0037] For example, instead of the eyepiece in each of the above examples, an imaging means and an image display means may be connected to the laryngoscope, and the endoscopic examination may be performed while checking the image on the image display means. Alternatively, the image guide fiber inside the insertion section may be omitted, and an image sensor (CCD, CMOS, etc.) may be placed at the tip.

[0038] Furthermore, in the above examples, the light emitted from the light source device was transmitted to the light guide at the tip via a light guide fiber. However, instead of this configuration, an LED for illumination may be placed at the tip.

[0039] Furthermore, in the above embodiment, the first curved section operating lever 121 and the second curved section operating knob 122 were provided on different surfaces of the gripping section 12 housing, but this configuration is not necessarily required. For example, the operating knobs could be provided twice on the same surface of the housing, or both the first curved section 111 and the second curved section 112 could be operated by the operating knobs connected to them. [Explanation of Symbols]

[0040] 1, 2... Laryngeal endoscopy 11, 21... Insertion part 110, 210...Tip 111, 211...first curved part 112, 212...Second curved part 113, 213...Flexible tube section 12, 22...Gripping part 121... First curved section operating lever 122, 222... Second curved section operation knob 123...Light source connection section 91... Endoscope insertion section NC...nasal cavity MC...oral cavity S...tongue KG...epiglottis T... Trachea TF... Anterior tracheal wall TB...posterior tracheal wall E...Esophageal E A1... Insertion part central axis

Claims

1. A laryngeal endoscope used for swallowing endoscopy, having an insertion portion formed in a tubular shape and inserted into the human body, and a gripping portion positioned at the proximal end of the insertion portion, The aforementioned insertion portion is At least a tip equipped with an objective lens, A first curved portion is located closer to the base end than the tip portion and curves in a direction perpendicular to the central axis of the insertion portion, A second curved portion is located closer to the base end than the first curved portion and curves in the opposite direction to the first curved portion with respect to the central axis, It comprises a flexible tubular section located closer to the base end than the second curved section, The gripping portion includes an operating portion for deforming at least one of the first curved portion and the second curved portion into the curved shape. A laryngeal endoscope characterized by the following features.

2. The first curved portion is formed in advance by being curved at a predetermined angle. The operating unit deforms the second curved portion into the curved shape. The laryngeal endoscope according to claim 1, characterized in that

3. A first operating section for deforming the first curved section into the curved shape, The second curved portion has a second operating portion for deforming it into the curved shape, The laryngeal endoscope according to claim 1, characterized in that

4. The first curved portion is formed to be deformable by bending at an angle of ±20 degrees or more and 50 degrees or less with respect to the central axis. The second curved portion is formed to be deformable by bending at an angle of ±130 degrees or less in the direction opposite to that of the first curved portion with respect to the central axis. The laryngeal endoscope according to claim 3, characterized in that

5. The first curved portion is formed to be shorter than the second curved portion. A laryngeal endoscope according to any one of claims 1 to 4, characterized in that

6. The length of the first curved portion is 3 mm or more and 13 mm or less, and the length of the second curved portion is 10 mm or more and 30 mm or less. The laryngeal endoscope according to claim 5, characterized in that it is the laryngeal endoscope according to claim 5.

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