U.S. patent application number 17/305269 was filed with the patent office on 2022-05-19 for nasal delivery devices.
The applicant listed for this patent is OptiNose AS. Invention is credited to Per Gisle DJUPESLAND, Joseph GORDON, Michael LECLERC, Ramy A. MAHMOUD, Shane SIWINSKI.
Application Number | 20220152324 17/305269 |
Document ID | / |
Family ID | |
Filed Date | 2022-05-19 |
United States Patent
Application |
20220152324 |
Kind Code |
A1 |
DJUPESLAND; Per Gisle ; et
al. |
May 19, 2022 |
NASAL DELIVERY DEVICES
Abstract
A nasal delivery device for delivering substance to a nasal
cavity of a subject comprises: a housing (15); a nosepiece (17) for
fitting to a nasal cavity of the subject: a mouthpiece (19) through
which the subject in use exhales; and a flexible coupling (20)
which couples the mouthpiece to the housing, wherein the flexible
coupling provides for asymmetric translation of the mouthpiece
relative to the nosepiece.
Inventors: |
DJUPESLAND; Per Gisle;
(Oslo, NO) ; GORDON; Joseph; (Mansfield, MA)
; LECLERC; Michael; (Cranston, RI) ; MAHMOUD; Ramy
A.; (Skillman, NJ) ; SIWINSKI; Shane;
(Barrington, RI) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
OptiNose AS |
Oslo |
|
NO |
|
|
Appl. No.: |
17/305269 |
Filed: |
July 2, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16102898 |
Aug 14, 2018 |
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17305269 |
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14380801 |
Aug 25, 2014 |
10076614 |
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PCT/EP2013/053747 |
Feb 25, 2013 |
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16102898 |
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61603093 |
Feb 24, 2012 |
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International
Class: |
A61M 15/08 20060101
A61M015/08; A61M 15/00 20060101 A61M015/00 |
Claims
1-38. (canceled)
39. A nasal delivery device for delivering substance to a nasal
cavity of a subject, the delivery device comprising: a housing; a
nosepiece for fitting to a nasal cavity of the subject, the
nosepiece having a longitudinal axis; a mouthpiece through which
the subject in use exhales, the mouthpiece including a tubular
section and having a longitudinal axis; a flexible coupling
connecting the mouthpiece to the housing, wherein the flexible
coupling comprises an annular coupling member which is attached at
a first end to the housing and at a second end to the tubular
section of the mouthpiece, wherein the annular coupling member
includes a hinge section disposed on a first side of the annular
coupling member, proximate the nosepiece and generally opposite a
second side of the annular coupling member, about which the
mouthpiece is hinged to permit the tubular section of the
mouthpiece to move towards or away from the longitudinal axis of
the nosepiece when biased towards or away from the nosepiece by
application of a biasing force, the first side of the annular
coupling member being relatively shorter in length than the second
side of the annular coupling member and forming an acute angle
between the longitudinal axis of the nosepiece and the longitudinal
axis of the mouthpiece; and a substance delivery system configured
to deliver the substance through the nosepiece during a period of
time when the subject exhales through the mouthpiece; wherein a
biasing force required to move the tubular section of the
mouthpiece towards the longitudinal axis of the nosepiece by
biasing the tubular section of the mouthpiece towards the nosepiece
is lower than a biasing force required to move the tubular section
of the mouthpiece away from the longitudinal axis of the nosepiece
by biasing the tubular section of the mouthpiece away from the
nosepiece.
40. The delivery device of claim 39, wherein the nosepiece includes
an outlet from which substance is in use delivered to the nasal
cavity of the subject, and a seat against which a nare of a nostril
of the subject is in use seated to achieve a sealing fit between
the nosepiece and the nasal cavity of the subject.
41. The delivery device of claim 39, wherein the annular coupling
member has an arcuate, bowed profile on the second side thereof and
is configured to stretch when the tubular section of the mouthpiece
is biased towards the nosepiece and compress when the tubular
section of the mouthpiece is biased away from the nosepiece.
42. The delivery device of claim 39, wherein the longitudinal axis
of the mouthpiece is disposed at an angle of between about 45 and
about 55 degrees relative to the longitudinal axis of the
nosepiece.
43. The delivery device of claim 42, wherein the longitudinal axis
of the mouthpiece is disposed at an angle of between about 48 and
about 52 degrees relative to the longitudinal axis of the
nosepiece.
44. The delivery device of claim 42, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece towards the nosepiece through an angle of between
about 7 and about 17 degrees relative to the longitudinal axis of
the nosepiece.
45. The delivery device of claim 44, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece towards the nosepiece through an angle of between
about 9 and about 15 degrees relative to the longitudinal axis of
the nosepiece.
46. The delivery device of claim 44, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece towards the nosepiece through an angle of between
about 10 and about 14 degrees relative to the longitudinal axis of
the nosepiece.
47. The delivery device of claim 42, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece away from the nosepiece through an angle of between
about 4 and about 10 degrees relative to the longitudinal axis of
the nosepiece.
48. The delivery device of claim 47, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece away from the nosepiece through an angle of between
about 5 and about 9 degrees relative to the longitudinal axis of
the nosepiece.
49. The delivery device of claim 47, wherein the annular coupling
member is configured to permit movement of the tubular section of
the mouthpiece away from the nosepiece through an angle of between
about 6 and about 8 degrees relative to the longitudinal axis of
the nosepiece.
50. The delivery device of claim 39, wherein the annular coupling
member is formed of a thermoplastic elastomer (TPE).
51. The delivery device of claim 50, wherein the TPE has a
durometer of between about 40 and about 60.
52. The delivery device of claim 51, wherein the TPE has a
durometer of between about 45 and about 55.
53. The delivery device of claim 39, wherein the substance delivery
system is a substance supply unit which is configured to deliver
the substance following manual actuation of the substance supply
unit.
54. The delivery device of claim 39, wherein the second side of the
annular coupling member forms an obtuse angle relative to the
housing.
Description
[0001] The present invention relates to a nasal delivery device for
and a method of delivering substances, in particular one of a
liquid, as a suspension or solution, or a powder, containing a
medicament, especially systemic or topical pharmaceuticals, or a
vaccine, to the nasal airway of a subject.
[0002] Referring to FIG. 7, the nasal airway 1 comprises the two
nasal cavities separated by the nasal septum, which airway 1
includes numerous ostia, such as the paranasal sinus ostia 3 and
the tubal ostia 5, and olfactory cells, and is lined by the nasal
mucosa. The nasal airway 1 can communicate with the nasopharynx 7,
the oral cavity 9 and the lower airway 11, with the nasal airway 1
being in selective communication with the anterior region of the
nasopharynx 7 and the oral cavity 9 by opening and closing of the
oropharyngeal velum 13. The velum 13, which is often referred to as
the soft palate, is illustrated in solid line in the closed
position, as achieved by providing a certain positive pressure in
the oral cavity 9, such as achieved on exhalation through the oral
cavity 9, and in dashed line in the open position.
[0003] There are many nasal conditions which require treatment. One
such condition is nasal inflammation, specifically rhinitis, which
can be allergic or non-allergic and is often associated with
infection and prevents normal nasal function. By way of example,
allergic and non-allergic inflammation of the nasal airway can
typically effect between 10 and 20% of the population, with nasal
congestion of the erectile tissues of the nasal concha,
lacrimation, secretion of watery mucus, sneezing and itching being
the most common symptoms. As will be understood, nasal congestion
impedes nasal breathing and promotes oral breathing, leading to
snoring and sleep disturbance. Other nasal conditions include nasal
polyps which arise from the paranasal sinuses, hypertrophic
adenoids, secretory otitis media, sinus disease and reduced
olfaction.
[0004] In the treatment of certain nasal conditions, the topical
administration of medicaments is preferable, particularly where the
nasal mucosa is the prime pathological pathway, such as in treating
or relieving nasal congestion. Medicaments that are commonly
topically delivered include decongestants, anti-histamines,
cromoglycates, steroids and antibiotics. At present, among the
known anti-inflammatory pharmaceuticals, topical steroids have been
shown to have an effect on nasal congestion. Topical decongestants
have also been suggested for use in relieving nasal congestion. The
treatment of hypertrophic adenoids and chronic secretory otitis
media using topical decongestants, steroids and anti-microbial
agents, although somewhat controversial, has also been proposed.
Further, the topical administration of pharmaceuticals has been
used to treat or at least relieve symptoms of inflammation in the
anterior region of the nasopharynx, the paranasal sinuses and the
auditory tubes.
[0005] Medicaments can also be systemically delivered through the
nasal pathway, the nasal pathway offering a good administration
route for the systemic delivery of pharmaceuticals, such as
hormones, for example, oxytocin and calcitonin, and analgetics,
such as anti-migraine compositions, as the high blood flow and
large surface area of the nasal mucosa advantageously provides for
rapid systemic uptake.
[0006] Nasal delivery is also expected to be advantageous for the
administration of medicaments requiring a rapid onset of action,
for example, analgetics, anti-emetics, insulin, anti-epileptics,
sedatives and hypnotica, and also other pharmaceuticals, for
example, cardio-vascular drugs. It is envisaged that nasal
administration will provide for a fast onset of action, at a rate
similar to that of injection and at a rate much faster than that of
oral administration. Indeed, for the treatment of many acute
conditions, nasal administration is advantageous over oral
administration, since gastric stasis can further slow the onset of
action following oral administration.
[0007] It is also expected that nasal delivery could provide an
effective delivery route for the administration of proteins and
peptides as produced by modern biotechnological techniques. For
such substances, the metabolism in the intestines and the
first-pass-effect in the liver represent significant obstacles for
reliable and cost-efficient delivery.
[0008] Furthermore, it is expected that nasal delivery using the
nasal delivery technique of the present invention will prove
effective in the treatment of many common neurological diseases,
such as Alzheimer's, Parkinson's, psychiatric diseases and
intracerebral infections, where not possible using existing
techniques. The nasal delivery technique of the present invention
allows for delivery to the olfactory region, which region is
located in the superior region of the nasal cavities and represents
the only region where it is possible to circumvent the
blood-to-brain barrier (BBB) and enable communication with the
cerebrospinal fluid (CSF) and the brain.
[0009] Also, it is expected that the nasal delivery technique of
the present invention will allow for the effective delivery of
vaccines.
[0010] Aside from the delivery of medicaments, the irrigation of
the nasal mucosa with liquids, in particular saline solutions, is
commonly practised to remove particles and secretions, as well as
to improve the mucociliary activity of the nasal mucosa. These
solutions can be used in combination with active
pharmaceuticals.
[0011] For any kind of drug delivery, accurate and reliable dosing
is essential, but it is of particular importance in relation to the
administration of potent drugs which have a narrow therapeutic
window, drugs with potentially serious adverse effects and drugs
for the treatment of serious and life-threatening conditions. For
some conditions, it is essential to individualize the dosage to the
particular situation, for example, in the case of diabetes
mellitus. For diabetes, and, indeed, for many other conditions, the
dosage of the pharmaceutical is preferably based on actual
real-time measurements. Currently, blood samples are most
frequently used, but the analysis of molecules in the exhalation
breath of subjects has been proposed as an alternative to blood
analysis for several conditions. Breath analysis is currently used
for the diagnosis of conditions such as Helicobacter pylori
infections which cause gastric ulcers.
[0012] WO-A-2000/051672 discloses a delivery device for delivering
a substance, in particular a medicament, in a bi-directional flow
through the nasal cavities, that is, an air flow which passes into
one nostril, around the posterior margin of the nasal septum and in
the opposite direction out of the other nostril. This
bi-directional air flow advantageously acts to stimulate the
sensory nerves in the nasal mucosa, thereby conditioning the
subject for the delivery and providing a more comfortable delivery
situation.
[0013] It is an aim of the present invention to provide nasal
delivery devices and nasal delivery methods for providing for
delivery of a substance to a nasal cavity of subject, and in
particular relatively-simple mechanically-actuatable delivery
devices.
[0014] In one aspect the present invention provides a nasal
delivery device for delivering substance to a nasal cavity of a
subject, the delivery device comprising: a housing; a nosepiece for
fitting to a nasal cavity of the subject; a mouthpiece through
which the subject in use exhales; and a flexible coupling which
couples the mouthpiece to the housing, wherein the flexible
coupling provides for asymmetric translation of the mouthpiece
relative to the nosepiece.
[0015] In one embodiment the nosepiece includes an outlet from
which substance is delivered, and a seat against which the nare of
a nostril of the subject is in use seated, in achieving a sealing
fit between the nosepiece and the nasal cavity of the subject.
[0016] In one embodiment the nosepiece includes a tapered section
which in use is located within a nasal cavity of the subject and
tapers outwardly from the outlet.
[0017] In one embodiment the mouthpiece comprises a tubular
section.
[0018] In one embodiment the tubular section is formed of a rigid
material.
[0019] In one embodiment the tubular section is formed of a
semi-rigid material.
[0020] In one embodiment the flexible coupling is a resilient
element.
[0021] In one embodiment the asymmetric translation of the
mouthpiece relative to the nosepiece provides for greater movement
in a direction along the axis of the nosepiece than in a direction
laterally to the nosepiece.
[0022] In one embodiment the distal end of the mouthpiece is
configured to move a distance at least 1.5 times greater in a
direction parallel to the axis of the nosepiece than in a direction
orthogonally to the axis of the nosepiece.
[0023] In one embodiment the distal end of the mouthpiece is
configured to move a distance at least 1.75 times greater in a
direction parallel to the axis of the nosepiece than in a direction
orthogonally to the axis of the nosepiece.
[0024] In one embodiment the distal end of the mouthpiece is
configured to move a distance at least 2 times greater in a
direction parallel to the axis of the nosepiece than in a direction
orthogonally to the axis of the nosepiece.
[0025] In one embodiment the flexible coupling comprises an annular
coupling member which is attached in one part to the housing and
another part to the mouthpiece, such that exhalation through the
mouthpiece delivers an air flow into the housing.
[0026] In one embodiment the coupling member is configured to
provide a hinge section about which the mouthpiece is
preferentially hinged when biased upwardly or downwardly by
application of a biasing force.
[0027] In one embodiment the hinge section is provided to one side
thereof, proximate the nosepiece.
[0028] In one embodiment the coupling member has a shorter
dimension to the one side thereof, thereby ensuring that the
mouthpiece is hinged about the one side of the coupling member.
[0029] In one embodiment the coupling member has a
progressively-increasing dimension to the other side thereof,
distal the nosepiece.
[0030] In one embodiment the coupling member has an arcuate, bowed
profile which becomes larger towards the other side thereof, and
provides for stretching when the mouthpiece is biased upwardly and
compression when the mouthpiece is biased downwardly.
[0031] In one embodiment the profile section is bowed outwardly,
whereby the biasing force required to bias the mouthpiece upwardly
is less than the biasing force required to bias the mouthpiece
downwardly.
[0032] In one embodiment the profile section of the coupling member
is formed of graded material, such that the material of the
coupling member is less resilient at the one side thereof than the
other side thereof.
[0033] In one embodiment the coupling member is formed of graded
material, such that the material of the coupling member is less
resilient at the one side thereof than the other side thereof.
[0034] In one embodiment the coupling member is configured to
provide the axis of the mouthpiece at an angle of between about 45
and about 55 degrees relative to the axis of the nosepiece.
[0035] In one embodiment the coupling member is configured to
provide the axis of the mouthpiece at an angle of between about 48
and about 52 degrees relative to the axis of the nosepiece.
[0036] In one embodiment the coupling member is configured to
provide the axis of the mouthpiece at an angle of about 50 degrees
relative to the axis of the nosepiece.
[0037] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved upwardly through an angle of between
about 7 and about 17 degrees relative to the axis of the
nosepiece.
[0038] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved upwardly through an angle of between
about 9 and about 15 degrees relative to the axis of the
nosepiece.
[0039] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved upwardly through an angle of between
about 10 and about 14 degrees relative to the axis of the
nosepiece.
[0040] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved upwardly through an angle of about
12 degrees relative to the axis of the nosepiece.
[0041] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved downwardly through an angle of
between about 4 and about 10 degrees relative to the axis of the
nosepiece.
[0042] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved downwardly through an angle of
between about 5 and about 9 degrees relative to the axis of the
nosepiece.
[0043] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved downwardly through an angle of
between about 6 and about 8 degrees relative to the axis of the
nosepiece.
[0044] In one embodiment the coupling member is configured to allow
for the mouthpiece to be moved downwardly through an angle of about
7 degrees relative to the axis of the nosepiece.
[0045] In one embodiment the coupling member is formed of a
thermoplastic elastomer (TPE).
[0046] In one embodiment the TPE has a durometer of between about
40 and about 60.
[0047] In one embodiment the TPE has a durometer of between about
45 and about 55.
[0048] In one embodiment the TPE has a durometer of about 50.
[0049] In one embodiment the delivery device further comprises: a
substance supply unit which is manually actuated to deliver
substance to the nasal cavity of the subject.
[0050] In another aspect the present invention provides a nasal
delivery device for delivering substance to a nasal cavity of a
subject, the delivery device comprising: a housing; a nosepiece for
fitting to a nasal cavity of the subject; a mouthpiece through
which the subject in use exhales; and a flexible coupling which
couples the mouthpiece to the housing, providing for movement of
the mouthpiece relative to the nosepiece.
[0051] In a further aspect the present invention provides a method
of delivering substance to a nasal cavity of a subject, the method
comprising the steps of: providing a nasal delivery device
comprising: a housing; a nosepiece for fitting to a nasal cavity of
the subject; a mouthpiece through which the subject in use exhales;
and a flexible coupling which couples the mouthpiece to the
housing, wherein the flexible coupling provides for asymmetric
translation of the mouthpiece relative to the nosepiece; fitting
the nosepiece to a nasal cavity of the subject; and locating the
mouthpiece in the mouth of the subject by flexing the asymmetric
coupling and thereby asymmetrically translating the mouthpiece
relative to the nosepiece.
[0052] Preferred embodiments of the present invention will now be
described hereinbelow by way of example only with reference to the
accompanying drawings, in which:
[0053] FIG. 1 illustrates a perspective view of a nasal delivery
device in accordance with a first embodiment of the present
invention;
[0054] FIG. 2 illustrates a vertical sectional view of the delivery
device of FIG. 1, with the mouthpiece in the at rest position;
[0055] FIG. 3 illustrates a vertical sectional view of the delivery
device of FIG. 1, with the mouthpiece in a position biased upwardly
relative to the nosepiece;
[0056] FIG. 4 illustrates a vertical sectional view of the delivery
device of FIG. 1, with the mouthpiece in a position biased
downwardly relative to the nosepiece;
[0057] FIG. 5 illustrates the results of a study to determine
adequacy of fit of the delivery device of FIG. 1, as compared to
three comparator devices;
[0058] FIG. 6 illustrates success of subjects in achieving a
plurality of steps in fitting the delivery device of FIG. 1;
and
[0059] FIG. 7 schematically illustrates the anatomy of the upper
respiratory tract of a human subject.
[0060] The delivery device comprises a housing 15, a nosepiece 17
for fitting in a nasal cavity of a subject, a mouthpiece 19 through
which the subject in use exhales, a flexible coupling 20 which
couples the mouthpiece 19 to the housing 15, and a substance supply
unit 21 which is manually actuated to deliver substance to the
nasal cavity of the subject.
[0061] The nosepiece 17 includes an outlet 25 from which substance
is delivered, a tapered section 27 which in use is located within a
nasal cavity of the user and tapers outwardly from the outlet 25,
and a seat 29 against which the nare of the nostril is in use
seated, in achieving a sealing fit between the nosepiece 17 and the
nasal cavity of the user.
[0062] The mouthpiece 19 comprises a tubular section 31, in this
embodiment of a rigid or semi-rigid material.
[0063] The flexible coupling 20 is a resilient element which allows
for movement of the mouthpiece 19 relative to the nosepiece 17, in
this embodiment an asymmetric translation of the mouthpiece 19
relative to the nosepiece 17.
[0064] The present inventors have recognized that a fixed
relationship between the mouthpiece 19 and the nosepiece 17 would
not allow the delivery device to accommodate sufficient of the
possible patient population using a single delivery device, given
the variance that exists between patients, particularly in terms of
age, gender and ethnicity, and have further recognized that an
entirely free and flexible coupling between the mouthpiece 19 and
the nosepiece 17, without any constraint, would not be sufficient,
in not maintaining a desired relationship between the mouthpiece 19
and the nosepiece 17, which the present inventors have determined
to be necessary to achieve a required orientation of the delivery
device for optimizing delivery of substance.
[0065] The present inventors have determined that the provision of
asymmetric translation of the mouthpiece 19 relative to the
nosepiece 17 when the mouthpiece 19 is moved, and specifically in a
manner which provides for greater movement in a direction along the
axis of the nosepiece 17 than in a direction laterally to the
nosepiece 17, provides an arrangement which allows for fitting of a
single-sized delivery device in a much greater range of the
possible patient population.
[0066] FIG. 5 illustrates the results of a study of 29 subjects to
determine adequacy of fit of the delivery device, as compared to
three comparator delivery devices (Products A, B and C). Adequate
fit is defined as the delivery device fitting the subject and
sealing sufficiently in the nose and mouth as to allow use of the
delivery device, though may not find the delivery device preferable
or comfortable.
[0067] In this study, the asymmetric translation of the mouthpiece
19 relative to the nosepiece 17 provides an arrangement which
allowed for fitting of a single-sized delivery device in 28 of 29
subjects.
[0068] FIG. 6 illustrates success of subjects in achieving a
plurality of steps in fitting the delivery device.
[0069] In this study, the subjects were required repeatedly to
perform the steps of (1) fitting the nosepiece 17 in a nasal
cavity, (2) locating the mouthpiece 19 in the mouth, and (3)
blowing into the mouthpiece 19.
[0070] In these steps, the following parameters were measured for
the first and last sequence of steps: (A) achieving a proper seal
at the nosepiece 17, (B) aiming the nosepiece 17 correctly, (C)
achieving a proper seal at the mouthpiece 19, (D) blowing into the
mouthpiece 19, (E) blowing into the mouthpiece 19 with adequate
exhalation force, and (F) performing the sequence of steps in the
appropriate order.
[0071] As will be observed, a very high degree of patient
compliance is achieved by the delivery device, which improves with
use of the delivery device.
[0072] In this embodiment the distal end D of the mouthpiece 19 is
configured to move a distance Y at least 1.5 times greater in a
direction parallel to the axis of the nosepiece 17 than in a
direction X orthogonally to the axis of the nosepiece 17. More
preferably, the distal end D of the mouthpiece 19 is configured to
move a distance at least 1.75 times or at least 2 times greater in
a direction Y parallel to the axis of the nosepiece 17 than in a
direction X orthogonally to the axis of the nosepiece 17.
[0073] In this embodiment the flexible coupling 20 comprises an
annular coupling member 41 which is attached in one part to the
housing 15 and another part to the tubular section 31 of the
mouthpiece 19, such that exhalation through the mouthpiece 19
delivers an air flow into the housing 15.
[0074] In this embodiment the coupling member 41 is configured to
provide a hinge section 43, here, to one, upper side thereof,
proximate the nosepiece 17, about which the mouthpiece 19 is
preferentially hinged when biased upwardly or downwardly by the
application of a biasing force F.
[0075] In this embodiment the coupling member 41 has a shorter
dimension to the one, upper side, thereby ensuring that the
mouthpiece 19 is hinged about the one, upper side, and a
progressively-increasing dimension to the other, lower side, distal
the nosepiece 17.
[0076] In this embodiment the coupling member 41 has an arcuate,
bowed profile 45 which becomes larger towards the other lower side,
and allows for stretching in the event of the mouthpiece 19 being
biased upwardly, as illustrated in FIG. 3, and compression in the
event of the mouthpiece 19 being biased downwardly, as illustrated
in FIG. 4.
[0077] In this embodiment the profile section 45 is bowed
outwardly, whereby the biasing force required to bias the
mouthpiece 19 upwardly is less than the biasing force required to
bias the mouthpiece 19 downwardly. Again, for reasons of optimizing
fitting and orientation of the delivery device, the present
inventors have recognized that this is achieved by requiring the
mouthpiece 19 to be biased upwardly from a lower position. Thus,
the delivery device is configured to facilitate operation by
providing that raising the mouthpiece 19 is easier than lowering
the mouthpiece 19, and this is further promoted by configuring the
mouthpiece 19 such that the position of the mouthpiece 19 is lower
than required for a majority of the patient population.
[0078] In this embodiment the coupling member 41 is configured to
provide the axis of the mouthpiece 19 at an angle of about 50
degrees relative to the axis of the nosepiece 17, and allow for the
mouthpiece 19 to be moved upwardly through an angle of about 12
degrees to enclose an angle of about 38 degrees relative to the
axis of the nosepiece 17 and downwardly through an angle of about 7
degrees to enclose an angle of about 57 degrees relative to the
axis of the nosepiece 17.
[0079] In an alternative embodiment the coupling member 41, instead
or in addition to having a bowed profile section 45, can be formed
of graded material, such that the material of the coupling member
41 is less resilient at the one, upper side than the other, lower
side.
[0080] In this embodiment the coupling member 41 is formed of a
thermoplastic elastomer (TPE), preferably having a durometer of
50.
[0081] Finally, it will be understood that the present invention
has been described in its preferred embodiments and can be modified
in many different ways without departing from the scope of the
invention as defined by the appended claims.
* * * * *