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WO2018143255A1 - Système d'évaluation de mobilité et procédé d'évaluation de mobilité - Google Patents

Système d'évaluation de mobilité et procédé d'évaluation de mobilité Download PDF

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Publication number
WO2018143255A1
WO2018143255A1 PCT/JP2018/003162 JP2018003162W WO2018143255A1 WO 2018143255 A1 WO2018143255 A1 WO 2018143255A1 JP 2018003162 W JP2018003162 W JP 2018003162W WO 2018143255 A1 WO2018143255 A1 WO 2018143255A1
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WIPO (PCT)
Prior art keywords
probe
mobility
actuator
voltage
ossicle
Prior art date
Application number
PCT/JP2018/003162
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English (en)
Japanese (ja)
Inventor
小池　卓二
加以 高桑
優花 入江
晶 神崎
世傑 徐
武展 肥後
林　正晃
Original Assignee
国立大学法人電気通信大学
学校法人慶應義塾
有限会社メカノトランスフォーマ
株式会社リーデンス
第一医科株式会社
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 JP2017135735A external-priority patent/JP7036309B2/ja
Application filed by 国立大学法人電気通信大学, 学校法人慶應義塾, 有限会社メカノトランスフォーマ, 株式会社リーデンス, 第一医科株式会社 filed Critical 国立大学法人電気通信大学
Publication of WO2018143255A1 publication Critical patent/WO2018143255A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/12—Audiometering

Definitions

  • the middle ear is an organ that converts sound waves incident on the ear canal into vibrations of the eardrum and efficiently transmits the mechanical vibrations to the inner ear cochlea through the ossicular chain.
  • the chain consists of the tibia, quinuta, and stapes and is held by the ligaments and muscle tendons to vibrate easily in the tympanic chamber. If these ligaments and muscle tendons become stuck due to aging or lesions, conduction hearing loss occurs, resulting in middle ear disease.
  • Patent Document 1 discloses an optical force detection element for a microsurgical instrument for evaluating the mobility of the ossicular chain in tympanoplasty as a method for quantitatively evaluating the ossicular mobility.
  • An optical force sensing element is disclosed having a sensitivity of 5 to 20 times higher than in the xy direction perpendicular to the axis.
  • an object of the present invention is to provide a user-friendly mobility evaluation system for quantitatively evaluating the mobility of the ossicles.
  • a mobility evaluation system is a mobility evaluation system that evaluates the mobility of the ossicle, and includes an excitation device that makes contact with the ossicle and applies vibration, an actuator that vibrates the excitation device, and an excitation device.
  • the reaction force applied to the actuator when the vibration device is brought into contact with the ossicle is measured, and based on the measurement result, the measurement probe including a force sensor that outputs a voltage, and the FFT output based on the voltage output from the measurement probe
  • An analysis unit that performs analysis to obtain a predetermined frequency component value, an evaluation unit that evaluates the mobility of the ossicle based on the predetermined frequency component value, and an output unit that outputs an evaluation result are provided.
  • the excitation device is an elongated rod-like probe, and the probe is removably supported by a fixed fulcrum and a force sensor at two points near the center of gravity and at the end.
  • the actuator gives a constant amplitude vibration around a fulcrum near the center of gravity of the probe
  • the force sensor includes a piezoelectric sensor and a charge amplifier, and the piezoelectric sensor applies the force applied to the probe by the probe.
  • the charge amplifier generates a charge signal
  • the charge amplifier converts the generated charge signal into a voltage and outputs the voltage.
  • the analysis unit includes an AD converter, and the AD converter converts the voltage into voltage information of the digital signal. Then, the voltage information may be subjected to FFT analysis.
  • the probe may be provided with a dent formed in the vicinity of the center of gravity, and the fulcrum may be provided with a spherically shaped magnet to be fitted and supported in the dent.
  • the measurement probe may include an elastic body that elastically contacts the probe.
  • the actuator may vibrate the probe at 5 Hz or more
  • the predetermined frequency component value may be a value of a frequency component of 5 Hz or more of each waveform in the voltage information.
  • the mobility evaluation system according to the present invention is installed in the cochlear window or in the vicinity of the cochlear window, and detects the cochlear microphone potential when the vibration is applied to the ossicles by the vibration device, and the detected cochlear microphone potential.
  • the output unit may display the measured cochlear microphone potential.
  • the mobility evaluation method is a mobility evaluation method for evaluating the mobility of the ossicle, and is a process for applying vibration to the ossicle by bringing the tip of the probe vibrated by the actuator into contact with the ossicle.
  • the voltage measurement step that outputs the voltage based on the measurement result, and the voltage output from the measurement probe based on the measurement result.
  • An analysis step for performing a FFT analysis to obtain a predetermined frequency component value an evaluation step for evaluating the mobility of the ossicle based on the predetermined frequency component value, and an output step for outputting the evaluation result.
  • a mobility evaluation system is a mobility evaluation system that evaluates the mobility of the ossicle, and includes an excitation device that makes contact with the ossicle and applies vibration, an actuator that vibrates the excitation device, and an excitation device.
  • the reaction force applied to the actuator when the vibration device is brought into contact with the ossicle is measured, and based on the measurement result, the measurement probe including a force sensor that outputs a voltage, and the FFT output based on the voltage output from the measurement probe Analyzing to obtain a predetermined frequency component value by analyzing, mobility evaluation unit comprising an evaluation unit for evaluating the mobility of the ossicle based on the predetermined frequency component value, and an output unit for outputting the evaluation result System.
  • a predetermined frequency component value can be obtained when quantitatively evaluating the mobility of the ossicles, so that it is possible to provide a mobility evaluation system that can reduce the effects of camera shake when used as a handpiece. , Improve usability.
  • the mobility evaluation system and the mobility evaluation method according to the present invention can improve usability in quantifying the mobility of the ossicles.
  • the mobility evaluation system 700 includes a measurement probe 100, an information processing device 300, a display device 400 (400a, 400b), an amplifier 500, and an electrode 600.
  • a display device 400 400a, 400b
  • an amplifier 500 500
  • an electrode 600 an electrode 600.
  • two display devices 400a and 400b are shown for ease of explanation, but one display device 400 or 400 or more may be present.
  • display devices are collectively referred to as a display device 400 unless there is a particular need for distinction.
  • the display 400 and the audio output unit 340 of the information processing apparatus 300 described later output the evaluation results of the mobility of the ossicles and the measurement results of the cochlear microphone potential (display, audio output, etc.). Collectively referred to as an output section.
  • the output unit outputs the evaluation result of the evaluation unit.
  • the measurement probe 100 measures the reaction force applied to the actuator when the vibrating device is brought into contact with the ossicle, the vibration device that makes contact with the ossicle and vibrates, the actuator that vibrates the vibration device, and the vibration device. And a force sensor that outputs a voltage based on the measurement result.
  • the measurement probe 100 is an elongated rod-like probe, and the probe is supported by a fixed fulcrum and a force sensor at two points near the center of gravity and at the end, and an actuator Provides a vibration having a constant amplitude around a fulcrum near the center of gravity of the probe, the force sensor includes a piezoelectric sensor and a charge amplifier, and the piezoelectric sensor applies the force applied to the probe by the actuator.
  • the charge signal may be generated by being applied by a needle, and the charge amplifier may convert the generated charge signal into a voltage and output the voltage.
  • the information processing device 300 is connected to the measurement probe 100, the display device 400, the amplifier 500, or the like by wire or wirelessly, and receives information processing requests from these peripheral devices and peripheral devices to perform information processing. Done. Any computer device such as a server that provides the result of the processing may be used, or a hardware device dedicated to the measurement probe 100 may be used.
  • the display device 400 may be any device as long as it is connected to the information processing device 300 and displays the display information output from the information processing device 300 on the screen.
  • the display device 400 displays, for example, the evaluation result of the ossicular mobility evaluated by the information processing device 300.
  • the display device 400 may display the measured cochlear microphone potential using the electrode 600 and the amplifier 500.
  • the amplifier 500 may be an amplifier device such as a differential amplifier that amplifies a weak signal such as a cochlear microphone potential measured by the electrode 600.
  • the electrode 600 may be a silver electrode that can be installed near the cochlear window or near the cochlear window and can measure the cochlear microphone potential (CM).
  • CM cochlear microphone potential
  • the mobility evaluation system 700 uses the reaction force applied to the measurement probe 100 as voltage information when the tip of the measurement probe 100 is vibrated and brought into contact with the ossicle 800 that is the measurement target.
  • the information processing apparatus 300 evaluates the mobility of the ossicle based on the transmitted voltage.
  • the mobility evaluation system 700 may display the evaluation result on the display device 400b using a graph or the like as shown in FIG. 1, or may notify the voice by the voice output function of the information processing device 300. .
  • the operator can confirm the quantitative evaluation of the mobility of the ossicles before and during the operation, and determine the surgical procedure, etc. It can be done efficiently.
  • the mobility evaluation system 700 is installed in the vicinity of the cochlear window or the cochlear window, and an electrode for detecting the cochlear microphone potential when the ossicle is vibrated by the vibration device, An amplifier for amplifying and measuring the detected cochlear microphone potential may be provided, and the output unit may display the measured cochlear microphone potential.
  • FIG. 2 is a block diagram illustrating an example of a functional configuration of the information processing apparatus 300.
  • the information processing apparatus 300 includes a communication unit 310, an I / O unit 320, a control unit 330, an audio output unit 340, a storage unit 350, and the like.
  • the communication unit 310 has a function of performing communication (transmission and reception of various messages) with peripheral devices and other information processing devices under the control of the control unit 330 via the network. Specifically, for example, the communication unit 310 transmits a message transmitted from each unit to another device, receives a message from the other device, and receives the message according to the control of the control unit 330 via the network. Communicate the message to other parts.
  • the communication may be either wired or wireless, and any communication protocol may be used as long as mutual communication can be performed. Further, the communication may be subjected to an encryption process in order to ensure security.
  • the “message” here includes text, images (photos, illustrations), sound, moving images, and the like, and information attached thereto (information about dates, positions, etc. attached to the text, images, sounds, and moving images).
  • the I / O unit 320 has a function of connecting to other devices, other devices or media by wireless or wired in accordance with the control of the control unit 330.
  • the I / O unit 320 includes WiFi (Wireless Fidelity), HDMI (registered trademark) (High-Definition Multimedia Interface), USB (Universal Serial Bus), power connector, I2C (Inter-Integrated Circuit), and the like.
  • WiFi Wireless Fidelity
  • HDMI registered trademark
  • USB Universal Serial Bus
  • power connector I2C (Inter-Integrated Circuit), and the like.
  • I2C Inter-Integrated Circuit
  • the control unit 330 is a processor having a function of controlling each unit.
  • the control unit 330 includes an analysis unit (not shown) and an evaluation unit (not shown).
  • the control unit 330 may receive, for example, a command output from a program or the like stored in the storage unit 350, and may control each unit to operate based on the command. Further, the control unit 330 may generate display information to be displayed on the display device 400 based on, for example, the evaluation result of the mobility of the ossicles and the measurement result of the cochlear microphone potential.
  • the analysis unit performs an FFT analysis based on the voltage output from the measurement probe 100 to obtain a predetermined frequency component value.
  • FFT analysis refers to analysis by fast Fourier transform (Fast Fourier Transform), which can be obtained by analyzing component values for each frequency.
  • the analysis unit may include, for example, an AD converter, and the AD converter may convert the voltage output from the measurement probe 100 into voltage information of a digital signal, and the voltage information may be subjected to FFT analysis.
  • the AD converter an AD conversion circuit built in the information processing apparatus 300 may be used, or an external AD converter may be used.
  • the measurement probe 100 is assumed to be used as a handpiece that is held and measured by a surgeon during the operation, and at that time, it is necessary to consider the influence of camera shake.
  • the predetermined frequency component value may be 5 Hz or more. More preferably, in consideration of the audible range, the vibration frequency of the vibration applied to the ossicles by the measurement probe 100 may be 20 Hz, which is the lower limit of the audible range.
  • the analysis unit may obtain a component value of voltage information equal to the vibration excitation frequency (input frequency to the actuator 116) of the vibration applied to the probe 103 by the actuator 116 as the predetermined frequency component value.
  • the excitation frequency of the actuator is 20 Hz
  • the value of the 20 Hz frequency component of each waveform in the voltage information may be obtained as the predetermined frequency component value.
  • raising the frequency to the audible range may cause cochlear injury and the like, but the influence of camera shake can be reduced without raising the frequency to the audible range.
  • the influence of camera shake can be excluded from the voltage output from the measurement probe 100 by the FFT analysis by the analysis unit, the measurement probe 100 can be measured with the hand held by the operator and can be easily measured during the operation. it can.
  • the result of measuring the mobility of the calibrator imitating the stapes 122 and the ligament 121 supporting the bone with the measurement probe 100 Will be described.
  • the 20 Hz component of the FFT analysis result increases.
  • the mobility of the ossicle is quantified by the increased amount.
  • the frequency component seen at 5 Hz or less is due to camera shake, it can be clearly distinguished from the 20 Hz component. Therefore, even in hand-held measurement using the measurement probe 100, the mobility evaluation system according to the present invention has the effect of camera shake. It is possible to evaluate the ossicular mobility with almost no exposure.
  • the evaluation unit evaluates the mobility (compliance) of the ossicle based on a predetermined frequency component value. Specifically, for example, the evaluation unit fixes the ossicle based on a 20 Hz component value equal to the excitation frequency of vibration such as rotational vibration given to the ossicle by the measurement probe 100 (equal to the input frequency to the actuator 116). Evaluate the degree.
  • the evaluation unit evaluates as normal if the compliance of the 20 Hz component value is within the range of the reciprocal of the spring constant (compliance) of the system composed of the otic bone and ligament of the normal ear, and if out of the range, It may be evaluated as abnormal (the ear ossicles are fixed). Thereby, it can be quantitatively shown that the ossicle is less likely to vibrate.
  • the mobility (compliance) C of the ossicle is a displacement [unit: m] that the actuator 116 gives to the ossicle, and a reaction force P [unit] when the actuator 116 gives the displacement to the ossicle. : N] and the following equation (1).
  • the sound output unit 340 has a function of outputting sound according to the control of the control unit 330.
  • the audio output unit 340 notifies the evaluation result.
  • the audio output unit 340 may be a speaker built in the information processing apparatus 300 or an external audio output device.
  • the storage unit 350 has a function of storing various programs, data, and parameters necessary for the information processing apparatus 300 to operate in accordance with the control of the control unit 330.
  • the storage unit 350 specifically, for example, a main storage device composed of ROM and RAM, an auxiliary storage device composed of a nonvolatile memory, HDD (Hard Disc Drive), SSD (Solid State Drive), flash memory And various other recording media.
  • the storage unit 350 may store the voltage output from the measurement probe 100 under the control of the control unit 330 as voltage information of a digital signal converted into a digital signal via an AD converter (not shown).
  • Measurement probe measures ossicular reaction force.
  • the measurement probe 100 includes a probe 103 and an attachment 120 as an example.
  • the attachment 120 includes, for example, an actuator 116, a piezoelectric sensor 117, a strain gauge 118, and a probe fixing magnet 119.
  • FIG. 3 shows a state where the probe 103 is attached to the attachment 120.
  • the stapes 122 and ligaments 121 constituting the ossicle are modeled and described.
  • the measurement probe 100 causes the actuator 116 to vibrate when the probe 103 is vibrated at 20 Hz by the actuator 116 and the tip of the probe is brought into contact with the stapes 122 constituting the ossicle to be measured.
  • the reaction force applied to the sensor is measured by the piezoelectric sensor 117, and a voltage is output.
  • the displacement applied to the ossicles should be as small as possible from the viewpoint of protection of the cochlea
  • the displacement applied by the actuator 116 of the measurement probe 100 is set to 40 ⁇ m or less, and the actual voltage is applied. Amplify using a charge amplifier or the like (not shown) and output a voltage proportional to the measured reaction force.
  • the displacement of the actuator 116 is measured by the strain gauge 118.
  • FIG. 4 is an exploded perspective view showing an example of the configuration of the measurement probe 100.
  • the configuration of the measurement probe 100 according to the second embodiment includes, as an example, an upper cover 101, a lower cover B102, a probe 103, a lock knob 104, a cord bush 105, a lower cover A106, and a leaf spring 107.
  • the probe 103 is formed in an elongated rod shape.
  • the probe 103 may be an otologic probe or the like, and is supported by these components by being placed on a fulcrum bracket 109 as a fixed fulcrum and a piezoelectric sensor 117 attached to the actuator 116. And attached.
  • the probe 103 which is an otologic probe normally used during surgery, is placed on the fulcrum bracket 109 and the piezoelectric sensor 117 attached to the actuator 116 (that is, the probe 103 is attached to the attachment). Therefore, it is possible to provide an easy-to-use measurement probe that can be easily attached and can measure the quantitative reaction force of the ossicle.
  • the tip of the probe 103 directly touches the ossicle, the probe 103 can be easily replaced and hygiene can be improved with such simple attachment.
  • the probe 103 may be formed with a depression (concave portion) in the vicinity of the center of gravity.
  • the probe 103 may be provided with a concave or concave digging portion such as a spherical shape or a circular shape in the vicinity of its center of gravity in order to be supported by a fulcrum bracket 109 or the like.
  • a convex protrusion may be provided.
  • the probe 103 when the probe 103 is removed from the measurement probe 100 and used, it also serves as an indicator for positioning the operator's handle. When the operator holds the probe 103 with his / her hand, it is visually confirmed. Since the position near the center of gravity of the probe 103 can be easily specified without any problem, a convenient probe can be provided.
  • a 6 mm rectangular protrusion or the like may be provided, and the uneven portions may be fitted together.
  • the probe 103 when the probe 103 is placed on the fulcrum bracket 109, when the probe 103 is horizontal with respect to the longitudinal direction, clearances (for example, on the both sides between the concave portion of the probe 103 and the convex portion of the fulcrum bracket 109, for example, The probe 103 may be disposed on the fulcrum fitting 109 so that a gap of 0.05 mm on one side is formed.
  • the measurement probe 100 may include an elastic body that elastically contacts the probe 103.
  • the elastic body may be any material as long as it is in contact with the probe 103 and imparts an elastic resistance force.
  • a leaf spring may be considered.
  • the leaf spring 107 may be elastically in contact with the probe 103 and give an elastic resistance force.
  • the leaf springs 107a and 107b are screwed to the upper cover 101 by tapping screws 108a and 108b.
  • the probe is fixed. It may be attached so as to contact 103.
  • the piezoelectric sensor 117 is disposed so as to be sandwiched between the probe 103 and the actuator 116, and measures the reaction force applied to the actuator 116 by the probe 103 that vibrates and rotates. The measured reaction force is transmitted to the charge amplifier 112, and the charge amplifier 112 converts the reaction force into a voltage and outputs the voltage. Specifically, the piezoelectric sensor 117 generates a charge signal when the force applied by the actuator 116 to the probe 103 is applied by the probe 103. At this time, the charge amplifier 112 converts the generated charge signal into a voltage and outputs the voltage.
  • the piezoelectric sensor 117 may be a piezoelectric sensor (piezo-type piezoelectric ceramic), a laminated piezoelectric sensor, or the like.
  • the sensor holding part 134 is a member that holds (adheres) the sensor main body part 133.
  • the sensor holding unit 134 may hold one or more round grooves (four round grooves in the example of FIG. 9) to hold the signal line (code) from the sensor main body 133.
  • the charge amplifier 112 is connected to cords 113 and 123, and the cords 113 and 123 are connected to an external device (such as the information processing device 300) through the cord bush 105.
  • the cord bush 105 may be attached to the lower cover A106 using a fixing means such as a hexagon nut fixing rib. With such a configuration, the cord bush 105 can be easily attached.
  • the charge amplifier 112 may be configured separately into (1) an OP amplifier unit that performs analog operation and amplification, and (2) a power supply unit that supplies power to the actuator.
  • a line (signal line) for connecting to the OP amplifier unit for outputting an analog signal and (2) a line (power line) for connecting to the power supply unit and supplying power to the actuator 116 are separated. May be formed.
  • FIG. 5 is a perspective view showing an example of the configuration of the measurement probe 100.
  • FIG. 5 shows a state where the measurement probe 100 according to the second embodiment is used with each component attached as described above.
  • 5A is a perspective view of the measurement probe 100 according to the second embodiment when viewed obliquely from the cord bush 105 side
  • FIG. 5B is a perspective view of the measurement probe 100 according to the second embodiment of the probe 103. It is the perspective view seen diagonally from the front end side.
  • the measurement probe 100 according to the second embodiment includes a lower cover B102 and a lower cover so that an operator can easily grasp the measurement probe 100 by holding the lower cover B102 and the lower cover A106.
  • A106 has a shape that conforms to the shape of a human hand. By setting it as such a structure, the measurement probe 100 can be made into a handpiece, and the measurement probe 100 which is easy to use can be provided.
  • the piezoelectric sensor 117 generates a charge signal by applying the force applied to the probe 103 by the actuator 116 by the force applied when the end of the probe 103 moves up and down.
  • the actuator 116 can give the probe 103 vibration such as rotational vibration having a constant amplitude centered on a fulcrum near the center of gravity.
  • FIG. 8 is a flowchart illustrating an example of processing executed by the mobility evaluation system 700.
  • the present invention is not limited to this, and it is also used when evaluating the cured state of a part of a living body in a fine space. it can. For example, it can also be used when detecting the presence or absence of cancer in the surrounding area by vibrating the stomach wall with an endoscope.

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Abstract

La présente invention concerne un système d'évaluation de mobilité pour évaluer la mobilité des osselets, qui est pourvu de : une sonde de mesure comprenant un excitateur de vibration qui entre en contact avec les osselets et transmet une vibration, un actionneur qui amène l'excitateur de vibration à vibrer, et un capteur de force qui mesure la force réactive sur l'actionneur lorsque l'excitateur de vibration entre en contact avec les osselets, et qui délivre une tension sur la base du résultat de mesure ; une unité d'analyse qui effectue une analyse FFT sur la base de la tension délivrée par la sonde de mesure et qui calcule une valeur de composante de fréquence prescrite ; une unité d'évaluation qui évalue la mobilité des osselets sur la base de la valeur de composante de fréquence prescrite ; et une unité de sortie qui délivre en sortie le résultat d'évaluation.
PCT/JP2018/003162 2017-01-31 2018-01-31 Système d'évaluation de mobilité et procédé d'évaluation de mobilité WO2018143255A1 (fr)

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JP2017016331 2017-01-31
JP2017-016331 2017-01-31
JP2017-135735 2017-07-11
JP2017135735A JP7036309B2 (ja) 2017-01-31 2017-07-11 可動性評価システム

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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006121070A (ja) * 2004-10-23 2006-05-11 John Macken 磁石連結装置及びその方法

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006121070A (ja) * 2004-10-23 2006-05-11 John Macken 磁石連結装置及びその方法

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