U.S. patent application number 14/501477 was filed with the patent office on 2015-05-14 for patient interface assembly with conduits on each side of the head.
The applicant listed for this patent is KONINKLIJKE PHILIPS N.V.. Invention is credited to ELIAS G. DIACOPOULOS, JASON P. EATON, PETER CHI FAI HO, JEROME MATULA, JR., STEVEN B. RADNEY.
Application Number | 20150128952 14/501477 |
Document ID | / |
Family ID | 34863866 |
Filed Date | 2015-05-14 |
United States Patent
Application |
20150128952 |
Kind Code |
A1 |
MATULA, JR.; JEROME ; et
al. |
May 14, 2015 |
PATIENT INTERFACE ASSEMBLY WITH CONDUITS ON EACH SIDE OF THE
HEAD
Abstract
A patient interface assembly that includes a first conduit, a
second conduit, and a patient interface coupled to the first
conduit and the second conduit. The first and second conduits each
include a first end that is disposed proximate to a top of a head
of a user, and a second end that is disposed proximate to an airway
of such a user when the patient interface assembly is being worn by
the user. The first and second conduits also each include a central
portion that extends along the sides of a face between the user's
eye and an ear a head strap is coupled between the first and second
conduit, and a patient interface is coupled to the second ends of
the first and second conduits.
Inventors: |
MATULA, JR.; JEROME;
(APOLLO, PA) ; HO; PETER CHI FAI; (PITTSBURGH,
PA) ; EATON; JASON P.; (HUNKER, PA) ;
DIACOPOULOS; ELIAS G.; (EXPORT, PA) ; RADNEY; STEVEN
B.; (PITTSBURGH, PA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
KONINKLIJKE PHILIPS N.V. |
Eindhoven |
|
NL |
|
|
Family ID: |
34863866 |
Appl. No.: |
14/501477 |
Filed: |
September 30, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13361165 |
Jan 30, 2012 |
8857435 |
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14501477 |
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|
11516880 |
Sep 7, 2006 |
8118027 |
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13361165 |
|
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|
11048680 |
Feb 1, 2005 |
7178525 |
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11516880 |
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60542750 |
Feb 6, 2004 |
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Current U.S.
Class: |
128/206.21 |
Current CPC
Class: |
A61M 16/0683 20130101;
A61M 16/0622 20140204; A61M 16/0616 20140204; A61M 16/0655
20140204; A61M 16/0694 20140204; A61M 16/0883 20140204; A61M
16/0003 20140204; A61M 2016/0027 20130101; A61M 16/065 20140204;
A61M 2210/0618 20130101; A61M 16/0875 20130101; A62B 18/084
20130101; A61M 16/0666 20130101; A61M 16/0816 20130101 |
Class at
Publication: |
128/206.21 |
International
Class: |
A61M 16/06 20060101
A61M016/06; A61M 16/08 20060101 A61M016/08; A61M 16/00 20060101
A61M016/00 |
Claims
1. A patient interface assembly adapted to be coupled to a patient
circuit, the patient interface assembly comprising: a first conduit
having a first end, a central portion, and a second end, wherein
the first conduit is configured and arranged such that (a) the
first end of the first conduit is disposed proximate to a top of a
head of a user responsive to the patient interface assembly being
donned by such a user, (b) the second end of the first conduit is
disposed proximate to an airway of such a user responsive to the
patient interface assembly being donned by such a user, and (c) the
central portion of the first conduit extends along a first side of
a face of such a user and is disposed between an eye and an ear of
such of such a user on the first side of the face responsive to the
patient interface assembly being donned by such a user; a second
conduit having a first end, a central portion, and a second end
wherein the second conduit is configured and arranged such that (a)
the first end of the second conduit is disposed proximate to a top
of a head of a user responsive to the patient interface assembly
being donned by such a user, (b) the second end of the second
conduit is disposed proximate to an airway of such a user
responsive to the patient interface assembly being donned by such a
user, and (c) the central portion of the second conduit extends
along a second side of a face of such a user opposite the first
side and is disposed between an eye and an ear of such of such a
user on the second side of the face responsive to the patient
interface assembly being donned by such a user; a head strap
operatively coupled to the first conduit and the second conduit and
extending around a head of such a user responsive to the patient
interface assembly being donned by such a user; and a patient
interface operatively coupled to the second end of the first
conduit and the second end of the second conduit, and wherein the
first end of the first conduit and the first end of the second
conduit are operatively coupled to the patient circuit.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a Continuation of U.S. patent
application Ser. No. 13/361,165, filed Jan. 30, 2012, which is a
Continuation of U.S. patent application Ser. No. 11/516,880, filed
Sep. 7, 2006, which is a continuation of U.S. patent application
Ser. No. 11/048,680 filed Feb. 1, 2005, U.S. Pat. No. 7,178,525,
granted Feb. 20, 2007, which claims priority under 35 U.S.C.
.sctn.119(e) from provisional U.S. patent application No.
60/542,750, filed Feb. 6, 2004, the contents of which are
incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention generally relates to a patient
interface assembly for use in a pressure support system, and, in
particular, to a patient interface assembly that is supported under
at least a portion of the patient's mandible, and to a gas delivery
system that incorporates such a patient interface assembly.
[0004] 2. Description of the Related Art
[0005] There are numerous situations where it is necessary or
desirable to deliver a flow of breathing gas non-invasively to the
airway of a patient, i.e., without intubating the patient or
surgically inserting a tracheal tube in their esophagus. For
example, it is known to ventilate a patient using a technique known
as non-invasive ventilation. It is also known to deliver continuous
positive airway pressure (CPAP) or variable airway pressure, such
as a bi-level pressure that varies with the patient's respiratory
cycle or an auto-titrating pressure that varies with the monitored
condition of the patient. Typical pressure support therapies are
provided to treat a medical disorder, such as sleep apnea syndrome,
in particular, obstructive sleep apnea (OSA), or congestive heart
failure.
[0006] Non-invasive ventilation and pressure support therapies
involve the placement of a patient interface device, which is
typically a nasal or nasal/oral mask having a rigid frame
supporting a mask cushion, on the face of a patient to interface
the ventilator or pressure support device with the airway of the
patient so that a flow of breathing gas can be delivered from the
pressure/flow generating device to the airway of the patient. It is
known to maintain such masks on the face of a patient by a headgear
situated on top of the patient's head having upper and lower
straps, each having opposite ends threaded through connecting
elements provided on the opposite sides and top of a mask.
[0007] Because such masks are typically worn for an extended period
of time, it is important the headgear maintain the mask in a tight
enough seal against a patient's face without discomfort. For
example, in providing CPAP to treat OSA, the patient normally wears
the patient interface device all night long while he or she sleeps.
One concern in such a situation is that the patient interface
device be supported on the user in a stable fashion so that the
mask does not shift on the patient as he or she moves during sleep.
Another concern is that the user does not perceive the mask to be
suffocating, i.e., minimize any claustrophobic effects the user may
perceive. If these concerns are not addressed, the patient may
avoid wearing the interface device, defeating the purpose of the
prescribed pressure support therapy. It is also important that the
interface device provide a tight enough seal against a patient's
face without discomfort.
[0008] U.S. Pat. No. 2,241,535 shows an apparatus for delivering
breathing gas to a patient including a nose piece having two tubes
extending from lower corners of the nose piece on either side of
the patient's mouth and joining together in a transverse tubular
member directly resting on the anterior portion of the patient's
chin. The transverse tubular member rests on or above the anterior
portion of the mandible. The term "mental protuberance" is used to
describe the protrusion of the anterior portion of the mandible
that constitutes the chin. While this term refers to a part of a
bone, it is used herein to define the entire structure of bone and
overlaying skin. Thus, the device taught by the '535 patent rests
just above the mental protuberance.
[0009] While the mask assembly shown in the '535 patent addresses
some of the above concerns, for example, by avoiding placing
portions of the interface near the patient's eyes, it does not
provide a stable platform that supports the nose piece. Thus, a
need still exists for a mask that more completely addresses these
concerns.
SUMMARY OF THE INVENTION
[0010] An exemplary embodiment of the present invention comprises a
patient interface assembly and a system and method for supplying a
flow of gas to a patient that incorporates such a patient interface
assembly.
[0011] The patient interface assembly according to the present
invention includes a first conduit, a second conduit, and a patient
interface coupled to the first conduit and the second conduit. The
first and second conduits each include a first end that is disposed
proximate to a top of a head of a user, and a second end that is
disposed proximate to an airway of such a user when the patient
interface assembly is being worn by the user. The first and second
conduits also each include a central portion that extends along the
sides of a face between the user's eye and an ear a head strap is
coupled between the first and second conduit, and a patient
interface is coupled to the second ends of the first and second
conduits.
[0012] These features and characteristics of the present invention,
as well as the methods of operation and functions of the related
elements of structure and the combination of parts and economies of
manufacture, will become more apparent upon consideration of the
following description and the appended claims with reference to the
accompanying drawings, all of which form a part of this
specification, wherein like reference numerals designate
corresponding parts in the various figures. It is to be expressly
understood, however, that the drawings are for the purpose of
illustration and description only and are not intended as a
definition of the limits of the invention. As used in the
specification and in the claims, the singular form of "a", "an",
and "the" include plural referents unless the context clearly
dictates otherwise.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] FIG. 1 is a front view of a first embodiment of a patient
interface assembly and schematically illustrates a gas delivery
system connected to such an interface assembly according to the
principles of the present invention;
[0014] FIG. 2 is a side of the patient interface assembly of FIG.
1;
[0015] FIG. 3 is a perspective view of the patient interface
assembly of FIG. 1;
[0016] FIG. 4 is a cross-sectional view of the patient interface
assembly of FIG. 1;
[0017] FIG. 5 is a cross-sectional view of FIG. 2;
[0018] FIG. 6 is a close-up cross-sectional view of the
coupling/rotation device of FIG. 4;
[0019] FIG. 7 is a front view of a second embodiment of a patient
interface assembly according to the principles of the present
invention;
[0020] FIG. 8 is a side view of the patient interface assembly of
FIG. 7;
[0021] FIGS. 9A and 9B through 18A-18B show various embodiments of
the patient interface portion of the patient interface assembly
according to the principles of the present invention;
[0022] FIG. 19 is a front perspective view of a third embodiment of
a patient interface assembly according to the principles of the
present invention;
[0023] FIG. 20 is a rear view of the patient interface assembly of
FIG. 19;
[0024] FIG. 21 is an exploded view of the patient interface
assembly of FIG. 19;
[0025] FIG. 22 is a further exploded view of the patient interface
assembly of FIG. 1 showing how a portion of this interface is
assembled;
[0026] FIG. 23 is an exploded perspective view showing the
connection of the patient circuit to the patient interface assembly
of FIG. 19;
[0027] FIG. 24 is an exploded view of the patient interface, i.e.,
patient contacting portion of the patient interface assembly of
FIG. 19;
[0028] FIG. 25 is a cross-sectional view of the patient contacting
portion shown in FIG. 19;
[0029] FIG. 26 is an exploded view showing the connection of the
patient interface and the connecting tubing for the patient
interface assembly of FIG. 19;
[0030] FIG. 27 is a rear perspective view illustrating another
embodiment of a patient interface suitable for use in the patient
interface assembly of FIG. 19;
[0031] FIGS. 28A and 28B are cross-sectional views of the patient
interface of FIG. 27;
[0032] FIG. 29 is an exploded view of the patient interface of FIG.
27;
[0033] FIG. 30 is a front perspective view of a fourth embodiment
of a patient interface assembly according to the principles of the
present invention;
[0034] FIG. 31 is an exploded view of the patient interface
assembly of FIG. 30;
[0035] FIG. 32 is a front perspective view of a fifth embodiment of
a patient interface assembly according to the principles of the
present invention;
[0036] FIG. 33 is a side view of the patient interface assembly of
FIG. 32 shown attached to a patient;
[0037] FIG. 34 is a front perspective view of a sixth embodiment of
a patient interface assembly according to the principles of the
present invention shown on a patient;
[0038] FIG. 35 is a front perspective view of a seventh embodiment
of a patient interface assembly according to the principles of the
present invention;
[0039] FIG. 36 is a front perspective view of the chin support
portion of the patient interface assembly of FIG. 35;
[0040] FIG. 37 is a front perspective view of an eighth embodiment
of a patient interface assembly according to the principles of the
present invention;
[0041] FIG. 38 is a front view of a ninth embodiment of a patient
interface assembly according to the principles of the present
invention;
[0042] FIG. 39 is a side view of the patient interface assembly of
FIG. 38;
[0043] FIG. 40 is a front view of a tenth embodiment of a patient
interface assembly according to the principles of the present
invention;
[0044] FIG. 41 is a side view of the patient interface assembly of
FIG. 40;
[0045] FIG. 42 is a side view of an eleventh embodiment of a
patient interface assembly according to the principles of the
present invention;
[0046] FIG. 43 is a front view of a twelfth embodiment of a patient
interface assembly according to the principles of the present
invention;
[0047] FIG. 44 is a side view of the patient interface assembly of
FIG. 43;
[0048] FIG. 45 is a front view of a thirteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0049] FIG. 46 is a side view of the patient interface assembly of
FIG. 45;
[0050] FIG. 47 is a front view of a fourteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0051] FIG. 48 is a side view of the patient interface assembly of
FIG. 47;
[0052] FIG. 49 is a side view of a fifteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0053] FIG. 50 is a side view of a sixteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0054] FIG. 51 is a front view of a seventeenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0055] FIG. 52 is a side view of the patient interface assembly of
FIG. 51;
[0056] FIG. 53 is a side view of an eighteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0057] FIG. 54 is a side view of a nineteenth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0058] FIG. 55 is a front view of a twentieth embodiment of a
patient interface assembly according to the principles of the
present invention;
[0059] FIG. 56 is a side view of the patient interface assembly of
FIG. 55;
[0060] FIG. 57 is a front view of a twenty-first embodiment of a
patient interface assembly according to the principles of the
present invention;
[0061] FIG. 58 is a side view of the patient interface assembly of
FIG. 57;
[0062] FIG. 59 is a side perspective view of a twenty-second
embodiment of a patient interface assembly according to the
principles of the present invention;
[0063] FIG. 60 is a rear view of the patient interface assembly of
FIG. 59;
[0064] FIG. 61 is a side perspective view of a twenty-third
embodiment of a patient interface assembly according to the
principles of the present invention; and
[0065] FIG. 62 is a side perspective view of a twenty-forth
embodiment of a patient interface assembly according to the
principles of the present invention.
DETAILED DESCRIPTION OF THE EXEMPLARY EMBODIMENTS
[0066] A patient interface assembly 10 according to a first
embodiment of the present invention is shown in FIGS. 1-6 and
includes a patient interface 12 fluidly and rotatably coupled to a
chin support 14. Patient interface assembly 10 communicates a flow
of breathing gas between a patient's airway and a pressure
generating system 16, such as a ventilator, CPAP device, or
variable pressure device, e.g. an auto-titrating device,
proportional assist ventilation (PAV) device, proportional positive
airway pressure (PPAP) device, C-Flex device, Bi-Flex device, or a
BiPAP.RTM. device manufactured and distributed by Respironics, Inc.
of Murrysville, Pa., in which the pressure provided to the patient
varies with the patient's respiratory cycle so that a higher
pressure is delivered during inspiration than during expiration, or
other pressure support device.
[0067] Chin support 14 is preferably formed from a hollow chambered
support made from a flexible plastic compound and extends from
either side of patient interface 12 curving downwardly in front of
the patient's cheeks around the outside of the patient's mouth to a
position beneath the patient's chin. Specifically, chin support 14
extends to a position beneath or rearward the mental protuberance
of the chin. Chin support 14 closely follows the contour of the
patient's face and directly contacts the skin of the patient. Chin
support 14 further includes a swivel port 18 located near the
position beneath or rearward the mental protuberance of the chin
for fluid and rotatably connection with a conduit 20, which is
connected to the pressure generating device 16.
[0068] While it was noted above that the chin support can be made
from a flexible plastic compound, it is to be understood that the
present invention contemplates using other materials to form the
chin support. That is, any semi-rigid or rigid material, whether
plastic or not, can be used as the chin support. For example, chin
support 14 can be formed from silicone. If necessary, the silicone
can be reinforced using any conventional stiffening material to
increase stiffness where needed.
[0069] Conduit 20 is typically a flexible conduit and is typically
referred to as a patient circuit. The combination of the pressure
generating device, the patient circuit, and the patient interface
assembly, define a pressure support system that provides gas to a
patient. The present invention contemplates that the pressure
support system of the present invention includes any features,
elements, or functions, typically present in a conventional
pressure support system. For example, conduit 20 can be either a
single-limb circuit or a dual-limb circuit. Accessories, such as a
humidifier, pressure sensor, flow sensor, temperature sensor,
humidity sensor, bacteria filter, etc. can be used in conjunction
with the patient interface assembly and pressure support system of
the present invention.
[0070] Patient interface 12 is fluidly and rotatably connected to
chin support 14 by a rotatable coupling 22 provided on either side
of patient interface 12. See FIGS. 4 and 6. In an exemplary
embodiment of the present invention, rotatable coupling 22 is a
two-piece relatively hard plastic device, which also provides
rigidity. Rotatable coupling 22 comprises a hollow cylindrical
piece 24 having a flange 26 on one end. Flange 26 is receivable
within a flange receiving coupling 28 defined in patient interface
12. A rotatable flange 30 is coupled to the other end of
cylindrical piece 24 and is receivable within a flange receiving
coupling 32 in chin support 14. A relatively small flange 33 is
provided in cylindrical piece 24 to retain rotatable flange 30 on
the cylindrical piece such that they are rotatable relative to each
other. In this manner, each end of chin support 14 coupled to
patient interface 12 is also rotatable relative to the patient
interface.
[0071] Swivel port 18, shown in FIG. 5, includes a flange receiving
coupling 34 for receiving a flange 36 from the conduit 20 or a
coupling piece for rotatable coupling between the conduit 20 and
chin support 14. It is to be understood that other configurations
and techniques for rotatably coupling chin support 14 to patient
interface 12 and conduit 20 are contemplated by the present
invention. For example, the flange and flange coupling technique
used to attach chin support 14 to conduit 20 can be used in place
of coupling 22 between the chin support and the patient interface,
and vice versa.
[0072] The present invention also contemplates that either or both
of these couplings can be non-rotatable couplings. However, in a
preferred embodiment, each of these couplings are rotatable and
allow the patient interface to be adjustable in discrete or an
infinite number of positions relative to the chin support. An
example of a coupling that provides discrete positioning of the
patient interface relative to the chin support is discussed
below.
[0073] Patient interface assembly 10 is held in place on the
patient's head by an adjustable head strap 38, which is attachable
to connection pieces 40 on chin support 14 on either side of the
patient interface 12. It is to be understood that other connection
pieces and other head straps can be provided in addition to or in
place of those shown to secure the interface to the patient.
[0074] The modular design of patient interface assembly 10 allows a
variety of patient interfaces 12 to be used to couple the patient
interface assembly to the airway of the patient. Examples of other
such patient interfaces include nares interfaces, nasal masks, and
nasal/oral masks. FIGS. 1-6 show a nares interface being used with
the patient interface assembly. In this embodiment, as best shown
in FIG. 3, patient interface 12 includes a substantially
cylindrical support piece 46 supporting a pair of spaced nares
elements 42. Each nares element 42 has an opening 44 for
communicating with the nasal passages of the patient with an
interior of cylindrical support piece 46 and, hence, an interior of
chin support 14. In addition, each end of the cylindrical support
piece 46 includes the flange receiving coupling 28 as discussed
above.
[0075] A second embodiment of a patient interface assembly 47 is
shown in FIGS. 7-8. This second embodiment is generally similar to
the first embodiment except that a nasal mask 48 is used as the
patient interface instead of a nares interface. Nasal mask 48
includes a shell, seal, or cushion that covers at least a portion
of the nose of the patient. The lower corners of the mask are
connected to chin support 14 in any conventional manner, including
the rotatable coupling techniques discussed above. Head strap 38 is
attached to patient interface assembly 47 using an additional
attachment piece 50 connected to both chin support 14 and nasal
mask 48. Preferably, the attachment pieces are pivotally or
moveably connected to the chin support and the nasal mask so they
can move or flex to fit comfortably on the patient. Attachment
piece 50 can be either rigid, semi-rigid, or flexible.
[0076] Alternate embodiments of the patient interface suitable for
use in the patient interface assembly are shown in FIGS. 9A and 9B
through 18A-18B. The patient interface illustrated in each of these
embodiments attaches to the chin support as discussed above. For
example, each patient interface embodiment includes a pair of
flange receiving couplings for receiving flanges from a pair of
rotatable couplings as discussed above so that each patient
interface is capable of rotating relative to the chin support.
[0077] Patient interface 60 shown in FIGS. 9A and 9B includes a
conduit 62 and a pair of nares pillows 64. Conduit 62 is preferably
a rigid structure, made from plastic, for example, and nares
pillows 64 are soft structures, made from gel, foam, silicone, or a
soft rubber, for example. Nares pillows 64 are removable attached
to openings 65 defined in conduit 62. For this purpose, small
flanges are provided on the ends of the nares pillows that insert
into the conduit.
[0078] The end of the nares pillows that contact the patient are
mushroom-shaped so that the relatively large flange 66 is provided
to contact the patient's nose area surrounding the nares. Flange 66
remains outside the patient. A channel 68 is defined through the
nares pillows to communicate gas between the airway of the patient
and the interior of the conduit.
[0079] Patient interface 70 shown in FIGS. 10A and 10B uses conduit
62 but has a different configuration for a pair of nares pillows
72. Nares pillows 72 are generally balloon or bulbous-shaped so
that a rounded end 74 of the nares pillows rests on the underside
of the user's nose around each nare. As with the previous
embodiment, a flange 76 is provided as the opposite end of each
nares pillow to coupled the nares pillow to the conduit. A channel
78 is defined through the nares pillows to communicate gas between
the airway of the patient and the interior of the conduit.
[0080] Patient interface 80 shown in FIG. 11A includes a conduit 82
and a pair of prongs 84 that extend from the conduit. Prongs 84 are
preferably integrally molded with conduit 82. For example, the
present invention contemplates that the entire patient interface 80
is a single piece of molded silicone. Prongs 84 insert into the
user's nares and extend from the conduit such that the prongs are
angled toward one another. In the embodiment illustrated in FIG.
11A, each prong includes a cutout defined in the wall of the prong
so that an opening 86 defined in each prong is configured like a
relatively large ellipsoid. Patient interface 80' shown in FIG. 11B
is configured similar to that shown in FIG. 11A, except that the
walls of prongs 84' do not include such a cutout. As a result,
opening 88' in prongs 84' that communicate with the interior or
conduit 82' are much smaller ellipsoids and are provided mainly at
the distal ends of the prongs.
[0081] Patient interfaces 90 shown in FIG. 12A is similar to that
discussed above with respect to FIGS. 11A and 11B except for the
configuration for the prongs. In the embodiment illustrated in FIG.
12A, each prong 92 attached to conduit 82 includes a flange 94
disposed around the perimeter of the prong at a location along the
length of the prong. Flange 94 preferably is integrally molded with
the prong and has a shape that is generally similar to that of the
prong. The purpose of the flange is to facilitate sealing the prong
against the user's nostril. An opening 96 is defined in the distal
end of each prong to communicate gas with the interior of conduit
82.
[0082] Patient interface 90' shown in FIG. 12B is configured
similar to that shown in FIG. 12A, except that the walls of prongs
92' are much shorter and need not be angled toward one another. In
addition, flange 94' disposed on each prong is much larger than the
flange in FIG. 12A, to the provide a larger sealing area.
[0083] While a single flange having a generally circular shape is
shown in FIGS. 12A and 12B, it is to be understood that the present
invention contemplates providing multiple flanges on each prong.
The present invention also contemplates that the flanges can be
shaped and sized to better match the contours of the human nostril.
Indeed, the shapes of the prongs can also be contoured to better
match the contours of the human nostril rather than use a standard
generally cylindrical shape as shown in these figures.
[0084] FIGS. 13A and 13B illustrate patient interfaces 100 and
100', respectively, that are a type of nares pillows patient
interface. Patient interface 100 includes a conduit 102. In place
of a pair of nasal prongs or pillows, a pair of nostrils engaging
portions 104 are formed directly into the conduit. The nostril
engaging portions are a pair of bulbous regions defined in the
conduit with a valley region 106 is provided between the nostrils
engaging portions. The primary difference between the patient
interfaces shown in FIGS. 13A and 13B reside in the depth of the
valley between the bulbous regions. As in the previous embodiments,
openings 108 are defined in the nostrils engaging portions 104 to
communicate gas between the patient's nares and the interior of the
conduit.
[0085] FIGS. 14A and 14B are front and rear views, respectively, of
yet another patient interface 110 suitable for use with the patient
interface assembly of FIG. 1. Patient interface 110 includes a flap
portion 112 having an opening 114 defined therein and end portions
116 that coupled to chin support 14. The flap portion fits under
the user's nose during use so that both nares are provided in
opening 114. In the illustrated embodiment, opening 114 is shaped,
and flap portion 112 is contoured, to generally match the underside
of a human nose. This is done to improve comfort and fit.
Preferably, the flap portion and the end portion are formed from a
unitary material, such as silicone.
[0086] FIGS. 15A and 15B are front and rear views, respectively, of
another embodiment of a patient interface 120 suitable for use with
the patient interface assembly of FIG. 1. Patient interface 120 is
similar to patient interface 110 in FIGS. 14A and 14B except that
instead of a single, relatively large opening in which both nares
are located, patient interface 120 includes a pair of openings 122
to communicate gas between the patient's nares and the interior of
the patient interface. A sealing surface 124 is provided over a
flap portion 126 disposed on a conduit portion 127. Openings 122
are provided in sealing surface 124. In a preferred embodiment,
protrusions 128 are provided on sealing surface 124 and openings
122 are provided at an apex of the protrusions. The protrusions are
shaped so as to correspond generally with a shape of a human
nostril at the nares so that a good seal is formed at each nare
when the patient interface is positioned at the nose. As with the
previous embodiments, flap portion 126, sealing surface 124, and
end portions 128, which coupled to the chin support, are preferably
formed from a unitary material, such as silicone.
[0087] FIGS. 16A and 16B show a patient interface 120' that is
similar to patient interface 120 except for the general shape and
size of protrusions 128' and opening 122'. In addition, patient
interface 120' lacks a flap portion (item no. 126 in FIGS. 15A and
15B) that otherwise encircles the user's nose.
[0088] FIGS. 17A and 17B show a still further embodiment of a
patient interface 130 suitable for use with the patient interface
assembly of FIG. 1. Patient interface 130 is similar to the Monarch
style interface manufactured by Respironics, Inc. of Murrysville,
Pa., and disclosed in U.S. Pat. No. 5,724,965. Patient interface
130 includes a patient contacting portion 132, which is also
referred to as a cushion or seal, that surrounds the nares. An
opening 134 is provided in the cushion to communicate gas between
the patient's airway and the interior of the patient interface.
Patient contacting portion 132 is coupled to a support 136, which
includes end portions 138 that couple the patient interface to the
chin support. Patient contacting portion 132 and support 136 are
angled to correspond to the underside of a patient's nose. Patient
contacting portion 132 is also preferably removably coupled to
support 136. It is to be understood that other variations for the
patient interface, such as those taught by in U.S. Pat. No.
5,724,965, which include providing separate openings for each
nostril, are contemplated by the present invention.
[0089] FIGS. 18A and 18B show yet another embodiment of a patient
interface 140 suitable for use with the patient interface assembly
of FIG. 1. Patient interface 140 is similar to patient interface 48
of FIGS. 7 and 8. Patient interface 140 is a nasal mask 48 type of
interface in that it encapsulates a least a portion of the nose. It
includes a shell, seal, or cushion 142 that covers at least a
portion of the nose of the patient with an opening 144 defined
therein into which the nose is inserted. Lower corners 146 are
connected to the chin support in any conventional manner, including
the rotatable coupling techniques discussed above. In this
exemplary embodiment, the entire patient interface assembly is
formed from a unitary material, such as silicone or rubber.
[0090] FIGS. 19-26 illustrate a third embodiment of a patient
interface assembly 160 according to the principles of the present
invention. Patient interface 160 includes a patient interface 162
fluidly and rotatably coupled to a chin support 164, which is
similar to chin support 14 discussed above with respect to FIGS.
1-5. Chin support 164 includes a patient contacting portion 166 and
an exterior portion 168 that define a hollow tube suitable for
communicating a flow of gas from a patient circuit coupling port
170 to patient interface 162. Patient contacting portion 166 is
preferably formed from a soft substance, such as silicon, and/or
includes a soft, patient contacting substance disposed thereon to
maximize the comfort of the contact between the patient and the
patient interface assembly.
[0091] For example, the present invention contemplates providing a
removeable foam or fabric slip-on cover (not shown) that is
provided over patient contacting portion 166. Such a slip-cover
would provide benefits such as: (1) allow that patient's skin under
the patient contacting portion to "breathe", (2) absorb moisture
from the patient, and (3) maintain the cleanliness of the chin
support over an extended period of time, especially if the
slip-cover is periodically replaced with a new one or washed.
[0092] Chin support 164 is configured such that the patient's chin
is received within opening 172 and the portion of the chin support
proximate to port 170 is disposed under and supported against the
mandible. This configuration provides a relatively secure mounting
of the patient interface assembly on the patient. The relatively
wide area of patient contacting portion 166 also enhances the
stability of the interface on the patient.
[0093] Chin support 164 also includes connection pieces 174 to
which a headgear attachment member 176 attaches. In a preferred
exemplary embodiment, connection pieces 174 are provided on each
leg of chin support 164 and are formed integrally with the chin
support. It is to be understood, however, that connection pieces
174 can be separate structures that attach to the chin support in
any conventional manner.
[0094] In the illustrated exemplary embodiment, a plurality of
attachment openings 178 are provided in each attachment piece, and
headgear attachment member 176 attaches to one of these openings by
fitting a flange 180 provided on the headgear attachment member
into the attachment opening. This configuration allows the headgear
attachment member to swivel or rotate relative to the connection
piece, as indicated by arrow A in FIG. 19. The multiple attachment
openings provide adjustability in the location to which the
headgear attaches to the chin support via the headgear attachment
members. Slots are provided in each headgear attachment member 176
into which the headgear strap inserts. The present invention also
contemplates proving openings in headgear attachment member 176 and
multiple protrusions or flanges on the connection that fit into the
opening on the headgear attachment member.
[0095] Patient circuit coupling port 170 is adapted to receive a
patient circuit coupling 184 that attaches to a conventional
conduit or patient circuit (not shown) to communicate a flow of gas
from the pressure generating system to the interior of chin support
164. In use, patient circuit coupling port 170 is located near the
position beneath or rearward the mental protuberance of the chin.
Patient circuit coupling 184 includes a sleeve 186 and an elbow
188. Sleeve 186 preferably rotatably attaches to a first end of
elbow 188 as indicated by arrow B in FIG. 23. The patient circuit
attaches to sleeve 188. A second end of elbow 188 inserts into an
opening in 190 of port 170.
[0096] An attachment mechanism is provided to couple the elbow
patient circuit coupling port 170. In a preferred embodiment of the
present invention, this attachment mechanism allows the elbow to
rotate or swivel relative to chin support 164, as indicated by
arrow C in FIG. 19, while also providing a quick attaching and
detaching capability between the elbow and the chin support. This
allows the patient to detach the entire patient interface assembly
from the pressure generating system. This is important, for
example, when a patient needs to get out of bed in the middle of
the night for a short period of time and does not want to remove
the entire patient interface assembly from their head, which may
require readjusting the headgear.
[0097] The illustrated exemplary embodiment provides the rotating
and removable coupling between the elbow and the chin support by
providing a pair of attaching arms 192 attached to elbow 188 via an
attachment support located generally in the middle of each arm.
Attaching arms include a prong (not shown) at a first end 193 that
inserts into a channel 194 provided in patient circuit coupling
port 170. Channel 194 extends around the perimeter of port 170 that
the elbow can rotate over a 360.degree. range of angles relative to
the chin support by allowing the prongs to slide along the channel.
Of course a smaller range of rotation can be provided depending on
the length of the channel.
[0098] Attaching arms 192 are biased such that the prongs remain
engaged in channel 194 when the elbow is attached to the chin
support. This biasing can be done by means of the materials used to
construct the arms and/or by means of a dedicated bias mechanism,
such as spring, coupled to the arms. Depressing on an end 196 of
the arm deflects the prong outward from the axis of the elbow, so
that the prong detaches from the channel. Attaching the prong into
the channel is accomplished in a similar manner. It can be
appreciated that other techniques can be used to provide these
features of the present invention.
[0099] As in the embodiment shown in FIGS. 1-5, patient interface
162 is coupled to chin support 164 such that the patient interface
is rotatable relative to the chin support, as indicated by arrow D
in FIG. 19. Patient interface 162 includes a relatively rigid shell
198 that supports a cushion 200. Shell 198 is preferably formed
from rigid plastic, such as polycarbonate and includes end portions
199 that include a conduit 201 defined therethrough to communicate
a flow of gas from chin support 164 to patient interface 162. A
channel 202 is formed in shell 198 that receives an edge 204 of
cushion 200 in a tongue-and-groove fashion. Cushion 200 includes a
flap 205 that attaches to shell 198. It is to be understood that
the present invention contemplates that other techniques, such as a
retaining ring or locking tabs, can be used to attach the cushion
to the shell.
[0100] Cushion 200 is configured to contact a portion of the
patient, such as the area of the face surrounding the nose, so that
a portion of the patient, such as the nose, is received within the
cavity defined within the shell and cushion. Cushion 200 is formed
from any material suitable for this purpose, such as silicone,
foam, rubber, gel, or any other conventional cushion material or
combination of materials. Cushion 200 is generally triangular
shaped having an apex 206 that rests on the center of the patient's
nose. The end of the cushion opposite the apex includes a cutout
208 that rests on an area of the patient under the nose.
[0101] An exhaust port piece 210 is connected on each side of
patient interface 162. Exhaust port piece 210 is preferably formed
from rigid plastic, such as polycarbonate. A plurality of exhaust
ports or openings are provided in the exhaust port pieces so as to
allow an exhaust flow of gas exit the patient interface assembly.
As shown in FIG. 26, exhaust pieces 210 preferably include an
engaging tab 212 that inserts into a channel 214 defined in shell
198. A plurality of teeth 214 are provided in channel 216 to engage
tab 212 in a ratchet-like fashion, so that the position of the
patient interface can set in one of a number of discrete positions
relative to the chin support.
[0102] As shown in FIG. 22, the present invention contemplates
forming chin support 164 by joining two halves: patient contacting
portion 166, and an exterior portion 168. A channel 218 is provided
in exterior portion 168 and a protrusion (not shown) is provided
along edge 220 of patient contacting portion 166 that inserts into
channel 218. The two halves can be joined in a permanent fashion
using any conventional technique, such as an adhesive, weld,
friction, or combination. End portions 222 of patient contacting
portion 166 attach to exhaust port piece 210 such that edge 220 of
patient contacting portion 166 align with a receiving channel 224
provided on exhaust port pieces 210. Thus, the rear side of the
exhaust port piece is defined by end portion 222 of patient
contacting portion 166. A cavity 226 is formed by the two halves of
the chin support that carries gas from circuit coupling port 170 to
patient interface 162.
[0103] It should be noted that the present invention contemplates
that the two halves of the chin support need not have the same
structural properties or characteristics. That is, patient
contacting portion 166 and exterior portion 168 can be formed from
different materials or from the same material but having different
properties, such as different degrees of softness or hardness. For
example, the exterior portion and patient contact portion can both
be soft, one soft and one relatively hard, or both relatively hard.
In the latter case, an additional slip-cover or other material can
be provided over the patient contacting portion, either removably
or permanently, to optimize patient comfort. In an exemplary
embodiment of the present invention, exterior portion 168 is a
relatively rigid to support exhaust port piece 210 and/or patient
interface 162 and patient circuit coupling 184 and patient
contacting portion 166 is a relatively soft piece to provide a
comfortable surface that contacts the patient and gives a little to
contour to the surface of the patient. It should also be noted that
patient circuit coupling 184 and patient contacting portion 166
need not provide exactly one-half of the entire chin support.
Rather, one piece of these pair of pieces can define a larger
portion of the chin support than the other.
[0104] FIGS. 27-29 illustrate a patient interface assembly 160'
that is similar to patient interface 160 except for the
configuration for a patient interface 230 that attaches to chin
support 164'. Therefore, the description of patient interface
assembly 160' will focus the configuration of patient interface
230.
[0105] As perhaps best shown in FIGS. 28A-29, patient interface 230
includes a cushion 232 attached to a shell 234. In the illustrated
exemplary embodiment, cushion 232 is attached to shell 234 by means
of a channel 236 defined in the shell into which an edge of the
cushion inserts. The edge of the cushion is fixed in the channel in
any conventional manner, such as via friction, an adhesive,
two-shot molding of the cushion of the shell, or any other
conventional technique.
[0106] Cushion 232 is configured to contact a portion of the
patient, such as the area of the face surrounding the nose, so that
a portion of the patient, such as the nose, is received within a
cavity 238 defined within the shell and cushion. Cushion 232 is
formed from any material suitable for this purpose, such as
silicone, foam, rubber, gel, or any other conventional cushion
material or combination of materials. Cushion 232 is generally
triangular shaped having an apex 240 that rests on the center of
the patient's nose and is formed in a concave shape that overlies
the nose of the patient.
[0107] An opening 242 is defined in the cushion. The patient's nose
inserts into opening 242. The end of the cushion opposite apex 240
includes a cutout 244 that rests on an area of the patient under
the nose. It can be appreciated that the concave shape of the
cushion provides a folded-back feature, generally indicated at 246,
at cutout 244 where the cushion is folded back on itself. This
feature is believed to provide an increased comfort where the
cushion contacts the patient as well as a good seal to prevent
leakage of the gas at the patient-cushion interface.
[0108] It should again be noted that one advantage of the patient
interface assembly illustrated in FIGS. 19-29 is that different
patient interfaces can be used on the same chin support structure.
This allows a health care provide to stock a common chin support,
thereby avoiding inventory costs, while offering the patient a
large selection of patient interface devices that can be mounted on
the chin support, thereby maximizing interface design options for
the patient. Another interesting aspect of the patient interface
assembly shown in FIGS. 19-29 is that it can be reversed and worn
by the patient such that the portion of the chin support that would
otherwise rest below the mandible, rests on the user's forehead.
This is made possible, should the user desire this configuration,
by the ability to rotate the patient interface 180 degrees relative
to the patient circuit.
[0109] FIGS. 30-31 illustrate a fourth embodiment of a patient
interface assembly 250 according to the principles of the present
invention. Patient interface assembly 250 includes a patient
interface 252 coupled to a chin support 254. Patient interface 252
corresponds to any of the patient interfaces discussed herein and
is preferably rotatably coupled to chin support 254 at exhaust port
pieces 256 that include a plurality of openings that allow a flow
of gas to be exhausted from the patient interface assembly.
[0110] Chin support 254 includes a support member 258 to which the
other elements of the chin support, such as the exhaust port
pieces, are mounted. Support member 258 is preferably rigid or
semi-rigid so that it can support the components of the patient
interface assembly. The patient contacting side of support member
258 is preferably formed from a soft substance, such as silicon, or
includes a soft, patient contacting substance disposed thereon to
maximize the comfort of the contact between the patient and the
patient interface assembly.
[0111] Conduits 260 couple exhaust port pieces 256 to a patient
circuit coupling portion 262 that is formed in support member 258.
In a preferred embodiment, conduits 260 are detachably coupled to
the remaining components of the patient interface assembly. Patient
circuit coupling portion 262 couples the conduits to a patient
circuit 20 via a patient circuit coupling port 264 such that the
patient circuit can rotate relative to the chin support.
[0112] A fifth embodiment of a patient interface assembly 270
according to the principles of the present invention is shown in
FIGS. 32 and 33. Patient interface assembly includes a patient
interface 272 and a chin support assembly 274. Patient interface
272 includes a cushion 276 and a cushion support 278. Cushion
support 278 includes a cushion mounting portion 280 to which the
cushion is attached, and a hollow arm 282 that includes a patient
circuit coupling port 284 that attaches to patient circuit 20. In
the illustrated embodiment, an elbow coupling 286 connects the
patient circuit to port 280. In an exemplary embodiment, elbow
coupling 286 is rotatably attached to port 284. It is to be
understood that the present invention contemplates connecting the
patent circuit to arm 282 using any suitable coupling technique.
Gas from the pressure generating system is provided to a cavity
defined by cushion 276 via patient circuit 20, elbow coupling 286,
and through the hollow interior of hollow arm 282.
[0113] An exhaust element 288 is also provided on arm 282. Exhaust
element 288 includes a plurality of openings to exhaust gas from
the patient interface assembly to ambient atmosphere. Headgear
mounting elements 290 are provided on cushion mounting portion 280
of cushion support 278. In the illustrated exemplary embodiment,
headgear mounting elements 290 are sockets to receive a ball
portion attached to a headgear strap 292 in a ball-and-socket
configuration. Such a ball-and-socket configuration is disclosed,
for example, in pending published U.S. application Ser. No.
10/629,366 (publication no. US 2004-0025883 A1) the contents of
which are incorporated herein by reference. It is to be understood
that any conventional configuration for attaching the headgear
strap to the cushion support 278 are contemplated by the present
invention.
[0114] In the illustrated embodiment, cushion 276 is a nasal mask
type interface and rests against the underside of the patient's
nose. It is held in place by a headgear, generally indicated at
294. Cushion 276 is formed from any suitable material, such as
foam, silicone, rubber, gel, or any combination thereof, and is
preferably detachable from cushion support 278 so that it can be
cleaned, or so that different sizes of cushions can be used on one
size of cushion support. Chin support assembly 274, according to
the illustrated exemplary embodiment, is generally T-shaped and
includes a chin support arm 293 and a chin support bracket 295.
Chin support bracket 295 is a substantially rigid member that
supports a chin pad 296. Chin support assembly 274 includes
headgear mounting elements 298 provided on chin support bracket 295
that are similar to headgear mounting elements 290, so that
headgear straps 292 can be selectively attached to the chin support
assembly. It is to be understood that the present invention
contemplates using any conventional connection assembly for
attaching the headgear straps 292 to the chin support assembly.
Chin pad can have any suitable configuration and be formed from any
material suitable for contacting the user.
[0115] Chin support arm 293 is adjustably coupled to arm 282 so
that chin support assembly 274 is adjustable relative to cushion
support 278. Arms 282 and 293 are preferably arc-shaped so that the
chin support assembly takes place along an axis or curve, as
indicated by arrow E, to allow the patient interface device to be
adjusted to accommodate patients of different sizes, shapes, and
comfort desires. This adjustment feature allows a patient to adjust
the patient interface device in such a way as to minimize leakage
and pressure on certain areas of the face. The attachment of chin
support arm 293 to arm 282 is accomplished in any conventional
manner, and controlling the relative position of the two arms can
be achieved using any one of a variety of techniques. For example,
the present invention contemplates providing a sliding friction
engagement between arms 282 and 293. Of course, a ratchet-like
mechanism can be used to control the relative positions between
these arms. In addition, a locking pin or screw can be used to set
the relative position of these two arms.
[0116] Chin support bracket 295 is adjustably connected to an end
portion of chin support arm 293 via a slide-and-rotate arrangement.
That is, chin support bracket 295 can both slide and rotate with
respect to chin support arm 293. It can be appreciated that this
configuration for the chin support bracket provides three
independent positional adjustments for the chin support bracket
relative to cushion support 278. First, the chin support bracket is
capable of moving in a lengthwise direction, as indicated by arrow
E. Second, the chin support bracket moves in a sliding direction,
as indicated by arrow F. Finally, chin support bracket 295 pivots
about an axis, as indicated by arrow G.
[0117] The present invention contemplates the headgear that can be
used with the patient interface device can be any suitable
headgear, i.e., any conventional headgear used in the patient
interface field. For example, a typical headgear assembly comprises
a headpiece 299 that overlies a portion of the patient's crania and
with a pair of lower and a pair of upper headgear straps 292
extending therefrom to adjustably connect the headgear to the
mask.
[0118] A sixth embodiment of a patient interface assembly 300,
which is a variation of patient interface assembly 270 is shown in
FIG. 34. Patient interface assembly 300 includes a patient
interface 302 and a chin support assembly 304. In this embodiment,
patient interface 302 includes a shell 306 that supports a cushion
308. Cushion 308 is a generally triangular shaped cushion that
encompasses the user's nose, mouth, or both. The cushion is formed
from any conventional material and is attached to shell 306 in any
conventional manner. Shell 306 includes a patient circuit coupling
port 310 that couples a patient circuit 20 to the shell in a
rotatable fashion, so that gas is communicated from the patient
circuit to a cavity defined by the shell and cushion, and
ultimately to the patient's airway.
[0119] Shell 306 includes an upper extension 312 and a lower
extension 314. In a preferred embodiment, the upper and lower
extensions are integral with the shell. Upper extension 312
provides a location for attaching upper headgear straps to the
patient interface assembly. In the illustrated embodiment, these
attachment locations are in the form of slots 316 defined in upper
extension 312. It is to be understood, however, that any
conventional technique for attaching a headgear strap to the upper
extension can be used.
[0120] A chin support arm 318 is coupled to lower extension 314
such that support arm 318 is slideable relative to lower extension
314 along an arc-shaped path, as indicated by arrow H. In this
embodiment, a portion of support arm 318 is received within lower
extension 314 and these two components are similarly shaped so that
the support arm can slide within the lower extension. A plurality
of teeth and teeth engaging members (not shown) are provided on
support arm 318 and lower extension 314 so that the relative
position between these two components can be controlled in a
ratchet-like fashion. A push-button 320 is provided on support arm
318 to disengage the teeth engaging members and teeth. Push-button
320 also slides in a slot 321 to help guide the movement of the
support relative to the lower extension. Guide slots 322 are also
provided on the sides of lower extension 314 and guide members 324
are provided on support arm 318 to facilitate movement of support
arm 318 relative to lower extension 314.
[0121] A chin support bracket 326 is adjustably coupled to support
arm 318 and a chin pad is coupled to the patient contacting side of
the chin support bracket. In this embodiment, chin support bracket
326 is a cup-shaped member that receives the user's chin. Chin
support bracket 326 includes headgear mounting elements 298', which
are similar to headgear mounting elements 290 and 298, so that
headgear straps 292 can be selectively attached to chin support
assembly 304. It is to be understood that the present invention
contemplates using any conventional connection assembly for
attaching the headgear straps 292 to the chin support assembly.
[0122] Chin support bracket 326 is adjustably connected to an end
portion of support arm 318 via a slide-and-rotate arrangement, as
done in the embodiment discussed above with respect to FIGS. 32 and
33. That is, chin support bracket 326 is configured to both slide
and rotate with respect to support arm 318. It can be appreciated
that this configuration for the chin support bracket provides three
independent positional adjustments for the chin support bracket
relative to patient interface 302. Lower extension 314 and the
components coupled thereto, such as support arm 318 and chin
support bracket 326, define chin support assembly 304.
[0123] A seventh embodiment of a patient interface assembly that is
yet another variation of patient interface assembly 330 is shown in
FIGS. 35-36. Patient interface 330 is generally similar to patient
interface 300, except that a chin support assembly 332 in patient
interface 330 is not integrally attached to shell 306'. In this
embodiment, chin support assembly 332 includes a mounting member
334 that attaches to a patient interface 302'. Mounting member 334
includes a lower extension 335 that attaches to a chin support arm
318' in generally the same manner that lower extension 318 attached
to chin support arm 318 discussed above.
[0124] Preferably mounting member 334 is capable of being retrofit
onto an existing mask so that the chin support assembly can be
added, if necessary, to a conventional mask. For example, mounting
member 334 illustrated in the figures includes an opening 336
defined in an upper end 337 of the mounting member. The chin
support assembly fits over a patient circuit coupling port defined
in the patient interface to enable the patient circuit, elbow
coupling, or other gas carrying conduit passes through opening
336.
[0125] Although not necessary, the present invention contemplates
attaching the headgear directly to mounting member 334. For this
purpose, slots 338 are provided on the mounting member to which the
headgear straps attach. Of course, the headgear can be attached to
the mounting member using any conventional technique. It should be
noted that mounting member 334 can have shapes, sizes, and features
other than those shown in the figures, for example, to accommodate
other types of headgear attachments elements, such as sockets,
snaps, claps, hooks, etc.
[0126] An eighth embodiment of a patient interface assembly 340,
which is generally similar to patient interface assembly 330, is
shown in FIG. 37. Patient interface assembly 340 includes a
mounting member 342 that is attached to shell 306' in patient
interface 302'. Preferably mounting member 342 is rotatably
attached to shell 306' and includes headgear mounting elements,
such as slots 338', to attach the headgear to the mounting member.
Unlike mounting member 334, mounting member 342 includes a hollow
lower extension 344 that attaches to a patient circuit 20 via a
patient circuit coupling port 346 and defines a portion of a chin
support assembly, generally indicated at 348.
[0127] As in the previous embodiment, chin support assembly 347
includes a chin support arm 318' that is slideably coupled to lower
extension 344. Preferably, patient circuit 20 is rotatably attached
to coupling port 346. This embodiment moves the attachment of the
patient circuit to a point lower on the face of the patient, so
that any torque present on the patient circuit is more equally
distributed on patient interface 302' and chin support assembly
348.
[0128] Referring now to FIGS. 38 and 39, a ninth embodiment of a
patient interface assembly 350 according to the principles of the
present invention will be discussed. Patient interface assembly 350
is somewhat similar to patient interface assembly 10 shown in FIGS.
1-5, except that a different configuration is used to support the
assembly on the user's mandible.
[0129] Patient interface assembly 350 includes a patient interface
352 coupled to conduits 354. In a preferred embodiment of the
present invention patient interface 352 is a nasal mask or nasal
prong type interface that is rotatably coupled to conduit 354. A
patient circuit coupling port 356 is provided at an end of the
conduit to couple the patient circuit 20 to the patient interface
assembly. The present invention contemplates providing an elbow
coupling 358 at port 356 for this purpose.
[0130] In an exemplary embodiment, conduits 354 are flexible enough
so that they can flex to some degree to conform to the facial
features of the patient, yet sufficiently rigid to retain enough
structural integrity to support the patient interface on the user's
airway. The structural integrity of the conduits can be provided by
the materials defining the conduit and/or by separate structure
enhancing elements, such as wire or rods coupled to or imbedded in
the conduit. The present invention also contemplates that the
conduits can be entirely rigid.
[0131] Conduits 354, including patient interface 352, are attached
to the patient via a chin support assembly, generally indicated at
360, and a headgear assembly 362, both of which are connected to
the conduit via an attachment member 364. Chin support assembly 360
includes chin straps 366 and a chin engaging member 368, which are
preferably formed from a soft-comfortable material, such as fabric,
foam, or an elastomeric material. Examples of such material include
a Lycra.RTM. foal lamination, neoprene, or TPE. Chin straps 366 and
chin engaging member 368 can be formed from the same material,
formed integrally with one another, or formed separate from
different materials.
[0132] Headgear assembly 362 includes headgear straps 370. The
headgear assembly includes a headpiece that overlies a portion of
the patient's crania, such as cap or bifurcated straps, as shown in
FIG. 39. It is to be understood that the present invention
contemplates that any conventional configuration or attachment
technique can used as the headgear assembly to maintain the patient
interface assembly on the patient's head. For example, the present
invention contemplates providing a mechanism that allows the length
of the headgear straps to be adjusted.
[0133] FIGS. 40 and 41 illustrate a tenth embodiment of a patient
interface assembly 380 according to the principles of the present
invention. Patient interface assembly 380 includes a patient
interface 382 coupled to a conduit 384, which effectively
corresponds to an end of patient circuit 20. In the illustrated
embodiment, patient interface 382 is a nasal mask type interface
that includes a cushion 386 and a relatively rigid cushion support
388.
[0134] Conduit 384 and patient interface 382 are attached to the
patient via a chin support assembly 390 that is held on the patient
by means of headgear assembly 362. Chin support assembly 390
includes a lower portion 392 that overlies the patient's chin, and
is preferably situated under the chin when the patient interface
assembly is donned by the patient. A conduit coupling structure is
provided on portion 392 to assist in maintaining a proper position
for conduit 384 so that a torque force acting on the conduit is not
imparted on the patient interface. In the illustrated embodiment
the conduit coupling structure includes a pair of engaging arms 394
that pinch or hold the conduit to the support member. Arms 394
allow the conduit to be detached and reattached to chin support
assembly 390. In addition, the frictional engagement between the
arms and the conduit allowed the conduit to be moved relative to
the chin support and maintained in the new position so that the
patient interface assembly can be configured to fit on differently
sized and shaped patient.
[0135] Chin support assembly 390 is configured to correspond to the
lower portion of a human face and is preferably configured from a
non-rigid material so that the chin support assembly can fit a
variety of different sized and shaped faces. An opening 396 is
provided in the support member so that the patient's mouth remains
exposed. Chin support assembly 390 can be formed integral with the
headgear assembly or as a separate element, that is either fixed to
or selectively attachable to the headgear assembly.
[0136] An optional conduit coupling assembly 397, shown in FIG. 41,
can be used in conjunction with patient interface assembly 380.
Optional conduit coupling assembly 397 includes a neck strap 398
that attaches to the patient's neck and an attachment 399. Optional
conduit coupling assembly 397 provides an additional mechanism for
controlling the position of patient circuit 20/conduit 384 to
prevent twisting of the patient interface.
[0137] FIG. 42 illustrates an eleventh embodiment of a patient
interface assembly 400 according to the principles of the present
invention that is similar to patient interface assembly 380. The
primary difference between interface assembly 400 and interface
assembly 380 is that patient interface assembly 400 includes a
swivel connection 402 provided on portion 392' of chin support
assembly 390' as the conduit coupling structure. Swivel connection
402 is a relatively rigid member having a patient circuit
connection port 404 to which the patient circuit is attached. In
the illustrated embodiment, an elbow coupling 406 is provided to
couple the patient circuit to portion 404. Of course, this elbow
coupling can be eliminated. Conduit 384 communicates gas from
swivel connection 402 to patient interface 382.
[0138] A twelfth embodiment of a patient interface assembly 410
according to the principles of the present invention is shown in
FIGS. 43 and 44. Patient interface assembly 410 includes a chin
support assembly 412 that is held on the patient by means of
headgear assembly 362. Chin support assembly 412 is a relative
rigid U-shaped structure contoured to correspond to the lower
portion of the user's face. In particular, chin support assembly
412 includes a portion 414 that is disposed under the user's
mandible to provide a relatively stable platform for mounting the
patient interface portion on the patient. The central opening of
the U-shape leaves the patient's mouth and nose exposed.
[0139] A rigid support 416 is coupled to portion 414 of chin
support assembly 412 such that the rigid support is aligned with a
centerline of the patient. A flexible conduit 418 is provided in
support 416 to communicate a flow of gas from patient circuit 20 to
a cushion 420 disposed at an end portion of support 416. Thus,
support 416 and cushion 420 effectively act as the patient
interface. A patient interface coupling port 422 is provided in
support 416 to couple the patient circuit to conduit 418 such that
patient circuit can rotate relative to support 416. In the
illustrated embodiment, an elbow coupling 424 is provided to couple
the patient circuit to the coupling port. Of course, the elbow
coupling is not required.
[0140] The present invention contemplates that the connection of
support 416 to chin support assembly 412 should be sufficient to
maintain the cushion on the airway of the patient. That is, the
cantilever type attachment is sufficient to hold cushion 420 over
the patient's airway. However, if additional force is needed to
keep the cushion on the patient, optional cross straps 426 can be
provided that connect each leg of the U-shaped support member to
the free end of support 416.
[0141] FIGS. 45 and 46 illustrate a thirteenth embodiment of a
patient interface assembly 430 according to the principles of the
present invention. Patient interface assembly 430 includes a
patient interface 432 coupled to conduits 434 that are disposed on
either side of the patient's face and extend to a location above
the patient's head where they attach to patient circuit 20. In the
illustrated embodiment, patient interface 382 is a nasal mask type
interface having ends that are rotatably coupled to conduits 434.
However, the present invention contemplates that a nasal prong type
interface can be used as the patient interface.
[0142] Conduits 434 are coupled to a chin support assembly 436 that
loops around the patient's mouth and includes a portion 438 that is
disposed under the mandible. The chin support assembly defines an
opening 439 so that the mouth is exposed. Headgear straps 370 hold
chin support assembly 436 on the patient's face. In an alternative
configuration shown by the dashed lines in FIGS. 45 and 46,
conduits 434' are disposed on either side of the patient's face and
extend to a location below the patient's head where they attach to
the patient circuit.
[0143] FIGS. 47 and 48 illustrate a fourteenth embodiment of a
patient interface assembly 440 according to the principles of the
present invention. Patient interface assembly 440 includes a
patient interface 442 coupled to a chin support assembly 444.
Patient interface 442 corresponds to any of the interfaces
discussed herein and is either fixed or rotatably attached to chin
support 444.
[0144] Chin support assembly 444 is a relatively rigid structure so
as to support the patient interface, contoured to correspond to the
facial features of a human, and includes a sufficient degree of
flexibility so that it can conform or flex to fit a variety of
patients. Chin support assembly 444 is also hollow, or includes a
gas carrying conduit, to communicate a flow of gas from patient
circuit 20 to patient interface 442. A patient circuit coupling
port 446 is provided at a frontal, lower portion 448 of chin
support assembly 444 to rotatably couple the patient circuit to the
chin support. In the illustrated embodiment, an elbow coupling 450
is provided to couple the patient circuit to portion 448. Of
course, this elbow coupling can be eliminated.
[0145] A lower portion 452 of the chin support assembly is disposed
under the patient's mandible when the patient interface assembly is
being worn. Portions 448 and 452 effectively encircle the patient's
chin such that the chin is disposed in an opening 454. Another
opening 456 is defined in the chin support assembly so that
patient's mouth is exposed. A connection piece 458 is coupled to
chin support 444 to attach the headgear straps to the chin support
assembly.
[0146] A fifteenth embodiment of a patient interface assembly 460
according to the principles of the present invention is shown in
FIG. 49. Patient interface assembly 460 includes a patient
interface 462 coupled to a conduit 464 which functions as the chin
support. Patient interface 462 corresponds to any of the interfaces
discussed herein and is either fixed or rotatably attached to
conduit 464. Conduit 464 includes sub-mandible portion 466 that is
disposed under and engages the patient's mandible. Conduit 464 is a
rigid or semi-rigid structure, at least when gas is provided by the
pressure generating system, so that it effectively functions as the
chin support.
[0147] Please note that FIG. 49 illustrates only one side of the
patient. A mirror image of the patient interface assembly shown in
FIG. 49 is also provided on the other side of the patient. Please
also note that FIG. 49 does not show the connection of conduit 464
to a patient circuit. It is to be understood that this connection
can be provided in an manner discussed herein or in any
conventional manner.
[0148] A headgear assembly 362 is coupled to conduit 464 to hold
the patient interface assembly on the patient. In the illustrated
embodiment, a headgear fastener 468 is provided for connecting the
conduit to headgear strap 370. It is to be understood that the
headgear fastener can have any configuration suitable for
connecting to the conduit, such as a loop that encircles the
conduit.
[0149] The present invention contemplates providing an optional
chin strap 470 that connects to conduit 464 by means of a chin
strap fastener 472 for providing additional stability for the
patient interface assembly. Chin strap 470 can also be attached to
or integral with the headgear assembly.
[0150] FIG. 50 illustrates a sixteenth embodiment of a patient
interface assembly 480 according to the principles of the present
invention. Patient interface assembly 480 includes a patient
interface 482 coupled to a chin support assembly 484. Patient
interface 482 corresponds to any of the interfaces discussed herein
and is either fixed or rotatably attached to a conduit 486.
[0151] Chin support assembly 484 includes a first portion 488 that
is disposed under and engaged with the patient's mandible and a
second portion 490 that contacts the user's face below the lips,
generally at the chin. Conduit 486 is coupled to chin support
assembly 484. In the illustrated embodiment, a conduit receiving
loop 492 is provided in the chin support through which the conduit
passes. The present invention also contemplates passing the conduit
under the chin support assembly, i.e., between the patient and the
chin support assembly.
[0152] FIGS. 51 and 52 illustrate a seventeenth embodiment of a
patient interface assembly 500 according to the principles of the
present invention. Patient interface assembly 500 includes a
patient interface 502 coupled to a chin support assembly 504.
Patient interface 502 corresponds to any of the interfaces
discussed herein and is either fixed or rotatably attached to
conduits 506, which are, in turn, attached to chin support assembly
504.
[0153] Chin support assembly 504 is a cup-like structure having a
first portion 508 disposed under the mandible and a second portion
510 disposed at the front of the patient below the lips and at or
above the chin. Preferably, an opening 512 is provided in the chin
support assembly to minimize contact with the patient. Coupling
members 514 attach chin support assembly 504 to conduits 506. In
the illustrated exemplary embodiment, coupling members 514 are
permanently attached to chin support assembly 504 and are
selectively attached to conduits 506. For example, the present
invention contemplates forming the coupling members from a strip of
material, such as a fabric, having one end fixed to the chin
support. The strip of material is sized and configured to loop over
(and around, if desired) the conduits. The free end of the strip of
material is attached back onto itself or the chin support using any
conventional technique, such as a hook and loop type fastener.
[0154] In one embodiment, conduits 506 extend up from the patient
interface device to a location proximate to the top of the
patient's head where it attaches to patient circuit 20. An
alternative embodiment of the present invention, which is shown by
dashed lines in FIG. 51, contemplates extending conduit 506' to a
location below the patient, where it attaches to the patient
circuit. If this alternative embodiment is used, a headgear
assembly, similar to that discussed herein, should be used to
couple the chin support to the patient. For example, the present
invention contemplates attaching conduit 506' to the chin support
assembly and attaching the chin support assembly to a headgear via
coupling members 514.
[0155] An eighteenth embodiment of a patient interface assembly 520
according to the principles of the present invention is shown in
FIG. 53. Patient interface assembly 520 includes a patient
interface 522 coupled to a chin support assembly 524. Patient
interface 502 corresponds to any of the interfaces discussed herein
and is either fixed or rotatably attached to conduits 506 or 506',
which are, in turn, attached to chin support assembly 524. Conduits
506 and 506' show two alternative arrangements for locating the gas
delivery conduit on the patient. In both embodiments, the conduits
are secured to the chin support in any conventional fashion. The
patient interface is connected to the one end of the conduit in
either a fixed or rotatable fashion, and the other end of the
conduit is coupled to the patient circuit.
[0156] It should be understood that FIG. 53 illustrates only one
side of the patient. A mirror image of the patient interface
assembly shown in this figure is also provided on the other side of
the patient. The connection of the conduit to a patient circuit is
also not show. It is to be understood, however, that this
connection can be provided in an manner discussed herein or in any
conventional manner.
[0157] Chin support assembly 524 is attached to a headgear assembly
362 and includes a first portion 526 that is disposed under the
mandible and a second portion 528 that extends from the first
portion to the patient interface. The chin support assembly also
includes a neck strap 530 that extends around the patient,
generally at the neck. This embodiment leaves a substantial portion
of the chin exposed and uses the rear of the jaw and neck to
provide stability for the patient interface assembly.
[0158] A nineteenth embodiment of a patient interface assembly 540
according to the principles of the present invention is shown in
FIG. 54. In this embodiment, a patient interface 542 provides the
function of the chin support, in that a portion of the patient
interface is disposed at the chin, under the mandible, or at both
locations. For example, portion 544 of the seal or cushion portion
of the patient interface contacts the user's chin. This portion is
shown in section in FIG. 54. An interior chamber 546 is defined in
the patient interface, and a conduit 548 communicates with chamber
546. A headgear assembly 362 is coupled to patient interface 542 to
hold the patient interface assembly on the patient. The patient
interface shown in this embodiment is a nasal/oral mask in that it
encompasses the nose and mouth. It is to be understood that the
patient interface can be a oral-only mask that encompasses only the
mouth.
[0159] It should again be understood that FIG. 54 illustrates only
one side of the patient interface assembly. A mirror image of the
patient interface assembly shown in this figure is also provided on
the other side of the patient. Also, the connection of the conduit
to a patient circuit is also not shown. It is to be understood,
however, that this connection can be provided in an manner
discussed herein or in any conventional manner.
[0160] In the illustrated embodiment, conduits 548 extend up from
the patient interface device to a location proximate to the top of
the patient's head where it attaches to patient circuit 20. Conduit
548 can be attached to headgear assembly 362, if desired. An
alternative embodiment of the present invention, which is shown by
dashed lines in FIG. 54, contemplates extending conduit 548' to a
location below the patient, where it attaches to the patient
circuit. Yet another alternative embodiment of the present
invention, contemplates attaching conduit 548'' to the front of the
patient interface 542, preferably in a rotatable fashion.
[0161] FIGS. 55 and 56 illustrate a twentieth embodiment of a
patient interface assembly 550 according to the principles of the
present invention. Patient interface assembly 550 includes a
patient interface 552 coupled to conduits 554. Patient interface
552 corresponds to any of the interfaces discussed herein and is
either fixed or rotatably attached to conduits 554. A chin support
assembly 556 is coupled to conduits 554 such that a portion of the
chin support is disposed under the patient's mandible. Chin support
assembly 556 is preferably a flexible structure, for example, a
cloth material that is attached to conduits 554 in any conventional
manner. The patient interface assembly is held on the patient by
means of headgear assembly 362. More specifically, headgear straps
370 are coupled to conduits 554 in any conventional fashion.
[0162] FIGS. 57 and 58 illustrate a twenty-first embodiment of a
patient interface assembly 560 according to the principles of the
present invention. Patient interface assembly 560 includes a
patient interface 562 coupled to conduits 564, which are connected
to patient circuit 20. A chin support assembly 566 is coupled to
conduits 546 such that the mouth remains exposed and a portion of
the chin support passes under the mandible. Chin support assembly
566 is preferably formed from a flexible material, such as cloth or
fabric. A head strap 568 that connects to conduits 546 across the
back of the patient's head is provided for facilitating the
attachment of the conduits on the user's head.
[0163] FIGS. 59 and 60 illustrate a twenty-second embodiment of a
patient interface assembly 570 according to the principles of the
present invention. Patient interface assembly 570 is similar in
many respect to patient interface assembly 270 shown in FIGS. 32
and 33. The two main differences between patient interface assembly
570 and patient interface assembly 270 are the configuration for an
arm 582 and the configuration for a chin pad 596.
[0164] Patient interface assembly 570 includes a patient interface
572 and a chin support assembly 574. Patient interface 572 also
includes a cushion 576 and a cushion support 578. As in the
previous embodiments, the cushion support and cushion can have a
variety of different configurations, only one of which is shown in
the figures. Arm 582 couples to patient circuit 20 to the patient
interface via a coupling member 584. In the illustrated embodiment,
arm 582 is a curved member form as a single, arcuate tube, thereby
minimizing changes in direction for the flow of gas to the patient.
It is to be understood that the present invention contemplates
connecting the patent circuit to arm 582 using any suitable
coupling technique, i.e., any suitable structure for coupling
member 584. Gas from the pressure generating system is provided to
a cavity defined by cushion 576 via patient circuit 20 and through
the hollow interior of arm 582.
[0165] An exhaust element 588 is also provided on arm 582. Exhaust
element 588 and headgear mounting elements 590 are provided on
cushion support 578. In this embodiment, the exhaust elements
include a plurality of holes provided in arm 582. FIGS. 59 and 60
show headgear connectors 592 connected to the headgear mounting
elements 590. Headgear connectors 592 can have any suitable
configuration. In addition, any conventional configuration for
attaching the headgear strap to the cushion support 278 are
contemplated by the present invention, not just that shown in the
figures.
[0166] In the illustrated embodiment, cushion 576 is a nasal mask
type interface and rests against the underside of the patient's
nose. As with cushion 276, cushion 576 is formed from any suitable
material, such as foam, silicone, rubber, gel, or any combination
thereof, and is can be detachable from cushion support 578 so that
it can be cleaned, or so that different sizes of cushions can be
used on one size of cushion support. Of course, the present
invention contemplates that cushion 576 (or 276) can have any other
configuration.
[0167] Chin support assembly 574 includes a chin support arm 593
and a chin support bracket 595. Chin support bracket 595 is a
substantially rigid member that supports chin pad 596. Chin support
assembly 574 includes headgear mounting elements 598 provided on
chin support bracket 595 that are similar to headgear mounting
elements 590. It is to be understood that the present invention
contemplates using any conventional connection assembly for
attaching the headgear straps to the chin support assembly.
[0168] Chin support arm 593 is adjustably coupled to arm 582 so
that chin support assembly 574 is adjustable relative to cushion
support 578. In this illustrated exemplary embodiment, a ratchet
mechanism 594 couples arms 582 and 593 so that the relative
position of these two member can be set to discrete locations. In
particular, arm 582 includes a plurality of teeth 596 disposed on
arm 582. A ratchet arm (or plurality of ratchet arm) 598 are
coupled to arm 593 so as to selectively engage the teeth. Arm 593
is capable of moving along an axis or curve, as indicated by arrow
E, relative to arm 582.
[0169] Chin support bracket 595 is adjustably connected to an end
portion of chin support arm 293 via a slide-and-rotate arrangement.
This is accomplished by providing a slot 600 on chin support
bracket 595 and a pin 602 on arm 593 that is provided in slot 600.
Slot 600 includes detents 604 to allow the pin to be provided and
held at discrete locations along the length of the slow. This
configurations allow chin support bracket 595 to both slide and
rotate with respect to chin support arm 593. It can be appreciated
that this configuration for the chin support bracket provides three
independent positional adjustments for the chin support bracket
relative to cushion support 578. First, the chin support bracket is
capable of moving in a lengthwise direction, as indicated by arrow
E. Second, the chin support bracket moves in a sliding direction,
as indicated by arrow F. Finally, chin support bracket 595 pivots
about pin 602, as indicated by arrow G.
[0170] Chin pad 596, like chin pad 296, can have any one of a
variety of configurations. On such configuration is shown in U.S.
patent application Ser. No. 10/953,642, the contents of which are
incorporated herein by reference. Any suitable configuration is
shown in FIGS. 59 and 60. In this embodiment, the chin pad is
formed form a pliable, resilient material, such as silicone, and
includes a patient contacting surface 610 that is shaped to
correspond, in general, to the shape of a human chin. Chin pad 596
also includes a hollow interior, i.e., a chamber 612 is defined in
the interior of the chin pad. In the illustrated exemplary
embodiment, chamber 612 is exposed by means of an opening 614
provided in the patient contacting side of the chin pad.
[0171] In the illustrated embodiment, opening 614 has a shape that
generally matches an outer edge or perimeter of the chin pad. It is
to be understood, however, that opening 614 can have a variety of
other configurations. In addition, multiple opening can be provided
to chamber 612. Moreover, multiple chambers can be provided in the
chin pad by providing walls within the interior of chin pad to
define the separate chambers. Such separate chambers or areas can
be completely isolated from other portions of the interior of the
chin pad or can be connected. The walls of the chin pad provide the
cushion-type support for the user's chin.
[0172] FIG. 61 illustrates a twenty-third embodiment of a patient
interface assembly 650 according to the principles of the present
invention. Patient interface assembly 650 includes a patient
interface 652 coupled to a conduit 654 that is provided at the end
of patient circuit 20. Patient interface 652 includes a cushion and
may include a faceplate, i.e., a rigid or semi-rigid member that
supports the cushion. Conduit 654 is a relatively rigid conduit
that is coupled to the patient circuit via an elbow, ball and
socket, or any suitable connecting member. Conduit 654 is attached
to the patient via a chin support assembly 656 that overlies the
user's chin and is connected about the head via a headgear 658.
[0173] Patient interface 652 is also coupled to headgear 658 using
connecting members 660. In the illustrated embodiment, connecting
members 660 are straps that tread through slots (not shown)
provided on the patient interface. The length of the straps is made
adjustable by providing a hook and loop fastener, or any suitable
fastener, to attached the free end at a selected location along the
length of the strap. Of course, the present invention contemplates
that any suitable mechanism can be used to couple the patient
interface to the headgear. In an exemplary embodiment, the coupling
member should allow patient interface 652 to be detached from
headgear 658, for example by unthreading the straps from the slots
provided on the patient interface.
[0174] The present invention also contemplates that patient
interface 652 and conduit 654 are detachable so that the conduit
can be detached from the patient interface while leaving the
patient interface in place on the user. To accomplish this
function, a quick release mechanism 662 is provided on the distal
end of conduit 654. Quick release mechanism 662 can be any device,
assembly, or arrangement that allows the end of conduit 654 to be
releasably connected to patient interface 652. For example, the
quick release mechanism shown in FIG. 23 can be used for this
purpose. In the embodiment shown in FIG. 61, a pair of tabs 664 are
provided to unlock or lock the conduit to the patient interface
manually. Obviously, when connected, the lumen defined in conduit
654 should be in fluid communication with the interior or patient
interface 652.
[0175] Another feature of the patient interface assembly 650 is the
ability to adjust the position of conduit 654 relative to chin
support 656, as indicated by arrow 666. This feature of the present
invention allows the distance, i.e., the length of conduit 652,
between a chin portion 668 of chin support 656 and patient
interface 652 to be controlled and adjusted to accommodate patients
of different sizes. The patient interface assembly illustrated in
FIG. 61 includes an adjustment mechanism 668 that enables this
length adjustment. In the illustrated exemplary embodiment,
adjustment assembly 668 includes threads 670 provided on conduit
654 and a movable member 672. Moveable member 672 includes threads
(not shown) that engage threads 670 such that rotating the moveable
member around the conduit moves the moveable member up or down the
conduit. This provides an infinite degree of adjustment between the
moveable member and the locking mechanism. In the illustrated
embodiment, locking mechanism 674 includes a pair of arms that
frictionally engage the moving member so as to selectively attache
the moveable member to the locking mechanism.
[0176] The engagement between the locking mechanism and the
moveable member can be fixed, so that there is no relative movement
between these two component when locked together, or moveable, so
that the locking member (and the conduit) rotate relative to the
chin support even when the moveable member is locked into a locking
mechanism. Providing the moveable member and locking mechanism with
a ball-and-socket configuration is one exemplary way to accomplish
this latter function.
[0177] It can thus be appreciated that the patient interface
assembly shown in FIG. 61, by including quick release mechanisms
662 and 668, allows the conduit to be removed from the patient,
leaving the chin support and the patient interface on the patient.
This gives be patient the ability to quickly and easily detach
himself or herself from the pressure support system, for example,
to use the restroom during the night, and reattach himself or
herself to the pressure support system without changing any of the
adjustable components of the patient interface assembly.
[0178] FIG. 62 illustrates a twenty-forth embodiment of a patient
interface assembly 700 according to the principles of the present
invention. Patient interface assembly 700 includes a patient
interface 702 coupled to a conduit 704. Conduit 704 is coupled to
the end of a patient circuit (not shown) using any conventional
coupling technique, including any technique discussed above.
Patient interface 702 includes a cushion and may include a
faceplate, i.e., a rigid or semi-rigid member that supports the
cushion. Conduit 704 is a relatively rigid conduit that is attached
to the patient via a chin support assembly 706 that overlies the
user's chin and is connected about the head via a headgear 708.
[0179] In the illustrated embodiment, patient interface assembly
700 includes an connecting member 710 that connects patient
interface 702 to chin support assembly 706/headgear 708. It is to
be understood, however, that this connecting member is optional. If
eliminated, the patient interface is held against the airway of the
patient by conduit 704. In the illustrated embodiment, connecting
member 710 is an adjustable length strap that passes through a slot
in the patient interface and connects to the chin support
assembly/headgear on each side of the patient. It is to be
understood that any device for securing the patient interface to
the chin support assembly/headgear, which includes a detachable
and/or adjustably connection.
[0180] Patient interface assembly 700 further includes an
adjustment mechanism 712 that connects conduit 704 to chin support
706 and provides the ability of the conduit to be moved relative to
the chin support, as indicated by arrow 714 over a plurality of
discrete positions. In the illustrated exemplary embodiment,
adjustment assembly 712 includes slots 716 provided on conduit 704
and an engaging member 718 that engage the slots. The slots and
engaging member can have any one of a number of different
configurations, only one example of which is shown in FIG. 62. In
this embodiment, the slots are provided on each side of the conduit
and an engaging member is disposed on the chin support also on each
side of the conduit to grapple to the conduit via the slots. Any
suitable release mechanism can be used to maintain the engaging
member in an engaged relationship with the conduit. It should be
noted that the one portion of the adjustment assembly is shown in
FIG. 62, the other portion being on the other side of conduit
704.
[0181] By disengaging conduit 708 from chin support 706 via
adjustment mechanism 712, the patient interface and conduit can be
easily and quickly decoupled from the patient interface assembly,
leaving the chin support and headgear on the patient. Likewise, the
patient interface and conduit can also be easily reattached to the
chin support, without changing any of the adjustable components of
the patient interface assembly so that the patient interface
assembly does not need to be readjusted when it is donned by the
user.
[0182] The embodiments of the invention discussed above described
only a few techniques for selectively attaching the conduit to the
chin support. It should be understood that other techniques for
accomplishing this function are contemplated by the present
invention. The conduit can be attached to the chin support such
that it is fixed, i.e., does not move, or is adjustable. The
position of the conduit relative to the chin support can be
adjusted in discrete steps, for example, using a ratchet or that
shown in FIG. 62, or it can have an infinite number of positions,
using a sliding friction lock (FIGS. 40, 41) or a treaded screw
(FIG. 61). The present invention also contemplates using a hook and
loop adhesive type of attaching mechanism so that the conduit can
be detached from the chin support, moved to a desired position,
reattached to the chin support, and maintained in the new position
by the hoop and loop fastener.
[0183] In the above-described embodiments for the patient interface
assembly of the present invention, the pads that attach to the chin
support assemblies and that contact the surface of the patient were
discussed briefly. It is to be understood that the present
invention contemplates attaching any conventional pad to the
present forehead support assemblies and the chin support
assemblies. For example, various types of patient contacting pads
that are suitable for use with the present invention are described
in U.S. provisional patent application Ser. No. 10/884,060,
(Publication no. US 2005-0011522 A1), the contents of which are
incorporated herein by reference. Those skilled in the art will
understand, however, that other pads, and materials for the pad
(such as gels, foams, silicon, and fabric) can be used in
conjunction with the patient interface device of the present
invention.
[0184] It can also be appreciated that the description of the
present invention, while discussing some different embodiments for
the cushion and mask, is not intended to be an exhaustive listing
of the seals and masks suitable for use with the patient interface
device of the present invention. On the contrary, those skilled in
the art can appreciate that the mask shell can have almost any
configuration or size and still be used in conjunction with the
patient interface device of the present invention. Likewise, the
cushion can comprise multiple cushions or flaps and can have almost
any configuration and size so long as it provides a sealed contact
between the patient interface and the patient.
[0185] Although the invention has been described in detail for the
purpose of illustration based on what is currently considered to be
the most practical and preferred embodiments, it is to be
understood that such detail is solely for that purpose and that the
invention is not limited to the disclosed embodiments, but, on the
contrary, is intended to cover modifications and equivalent
arrangements that are within the spirit and scope of the appended
claims. For example, it is to be understood that the present
invention contemplates that, to the extent possible, one or more
features of any embodiment can be combined with one or more
features of any other embodiment.
* * * * *