Patent Publication Number: US-2023147203-A1

Title: Connecting element for a patient interface

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims priority under 35 U.S.C. § 119 of German Patent Application No. 102021005565.9, filed Nov. 10, 2021, the entire disclosure of which is expressly incorporated by reference herein. 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The invention relates to a connecting element for a patient interface. 
     2. Discussion of Background Information 
     Patient interfaces, or respiratory masks, are used for ventilation, to support breathing or as a protective mask against aerosols of solid or liquid particles. Respiratory masks for ventilation or respiratory support form the interface between a user or patient and a ventilator and must be fixed to the head of the user by means of a connecting element. Both the respiratory masks and the connecting elements must satisfy high demands in terms of stability and safety and at the same time offer sufficient comfort and simple handling for the user. A distinction is made between respiratory masks with forehead supports and respiratory masks without forehead supports. 
     Respiratory masks without forehead supports conventionally have stiffening devices in the connecting elements in order to ensure adequate stability and a good fit of the respiratory mask. The stiffened region is generally cushioned toward the face of the user in order to increase wear comfort. The connecting elements are conventionally of complex construction and are sometimes not easy to use. 
     There is thus a need for connecting elements which are simple to handle and ensure a stable, secure and comfortable fit of the respiratory mask. 
     SUMMARY OF THE INVENTION 
     The invention provides a connecting element for a patient interface, wherein the connecting element comprises at least one strap which is configured for connection to the patient interface. According to the invention, the connecting element comprises two straps and at least one behind-the-ear element. 
     In some embodiments, the connecting element is characterized in that the at least one behind-the-ear element can be coupled reversibly and/or irreversibly to the straps. 
     In some embodiments, the connecting element is characterized in that the straps comprise a beginning and an end, wherein a coupling system for coupling the strap to the patient interface is disposed and configured adjacent to the beginning. 
     In some embodiments, the connecting element is characterized in that an end portion to which the behind-the-ear element can be coupled is arranged adjacent to the end. 
     In some embodiments, the connecting element is characterized in that the straps are produced at least from a stiffening and at the same time flexible material and/or composite material selected from plastics materials, metals, silicones and foams. 
     In some embodiments, the connecting element is characterized in that the straps are manufactured from polypropylene. 
     In some embodiments, the connecting element is characterized in that the straps have a length and a width, wherein the ratio of the length to the width is at least about 10:1, preferably at least about 20:1, particularly preferably at least about 25:1. 
     In some embodiments, the connecting element is characterized in that the straps additionally have a cushioning material with elastic and/or viscoelastic properties selected from foams, cotton wool, woven fabric, cotton, wool, rubber, neoprenes and gels. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element is manufactured from an elastic material selected from silicones, thermoplastic elastomers, neoprenes and textiles. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element is manufactured from silicone. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element comprises at least one retaining element which can be coupled to the end portion of the strap. 
     In some embodiments, the connecting element is characterized in that the retaining element is in the form of a hollow body with a lumen into which the end portion of the strap is placed for coupling at at least one position. 
     In some embodiments, the connecting element is characterized in that the retaining element is displaceably coupled at any desired positions of the end portion and a length adjustment of the connecting element is thus provided. 
     In some embodiments, the connecting element is characterized in that the end portions comprise at least one anchor element for anchoring the coupling of the retaining element to the straps. 
     In some embodiments, the connecting element is characterized in that the end portions alternatively or additionally comprise one or more fixing elements for fixing the coupling of the behind-the-ear element to the straps. 
     In some embodiments, the connecting element is characterized in that the fixing elements are formed by one or more thickened portions and/or indentations of the end portion of the straps. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element has counterpart elements corresponding to the fixing elements for assisting with fixing of the behind-the-ear element to the straps. 
     In some embodiments, the connecting element is characterized in that the fixing elements are in the form of buttons, mushroom buttons, hooks, bars, studs or Velcro tapes with hooks and/or loops, and the counterpart elements are in the form of buttonholes, holes, eyelets, loops or Velcro tapes with hooks and/or loops, and the fixing elements can be connected to the counterpart elements such that the behind-the-ear element is fixed to the straps. 
     In some embodiments, the connecting element is characterized in that the fixing of the behind-the-ear element to the straps permits a stepwise length adjustment of the connecting element. 
     In some embodiments, the connecting element is characterized in that the connecting element additionally comprises a head band which can be coupled to the straps. 
     In some embodiments, the connecting element is characterized in that the straps and the behind-the-ear element are in one-piece or two-piece form. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element has a length and a width, wherein the ratio of the length to the width of the behind-the-ear element is at least about 1:1, preferably at least about 5:1. 
     In some embodiments, the connecting element is characterized in that the connecting element comprises two straps and one behind-the-ear element with two retaining elements, wherein one retaining element is coupled to one strap and the second retaining element is coupled to the second strap. 
     In some embodiments, the connecting element is characterized in that the one behind-the-ear element runs across the back of the head of a user or patient in a use state. 
     In some embodiments, the connecting element is characterized in that the ratio of the length to the width of the behind-the-ear element is at least about 5:1, preferably at least about 20:1, particularly preferably at least about 30:1. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element is in itself adjustable in length. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear element comprises at least one eyelet which is configured and adapted to permit a length adjustment. 
     In some embodiments, the connecting element is characterized in that the connecting element comprises two straps and two behind-the-ear elements each with a retaining element, wherein a behind-the-ear element is coupled to each of the two straps. 
     In some embodiments, the connecting element is characterized in that the ratio of the length to the width of the behind-the-ear elements is in each case less than about 20:1, preferably less than about 10:1, particularly preferably less than about 5:1. 
     In some embodiments, the connecting element is characterized in that the behind-the-ear elements run behind the ear of a user or patient in a use state. 
     The object is further achieved by a system as claimed in claim  19 . The system for ventilation and/or respiratory support comprises at least a patient interface, the connecting element according to the invention for connection to the patient interface, a ventilator, at least one line, wherein the patient interface is coupled with the connecting element and is connected by way of the connecting element to the head of a patient, wherein the patient interface and the ventilator are connected together in a gas-conducting manner by way of the line. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Exemplary embodiments of the connecting element according to the invention are shown in the figures, in which: 
         FIG.  1    shows, by way of example, an overview of the system with an exemplary embodiment of the connecting element according to the invention which is connected to a patient interface. 
         FIG.  2    is a perspective top view of a part-region of the connecting element. 
         FIG.  3    is a schematic side view of an embodiment of the connecting element in a use state on the head of a user. 
         FIG.  4    and  FIG.  5    are side views of the strap. 
         FIG.  6 A  shows the connecting element according to the invention according to  FIG.  3    in a view from above and  FIG.  6 B  is a view from above of the connecting element in a use state on the head of a user. 
         FIGS.  7  to  9    are different views of the connecting element according to the invention from  FIG.  3   , wherein 
         FIG.  7    is a perspective view of the connecting element,  FIG.  8 A  and  FIG.  8 B  are views of the connecting element from the side, and  FIG.  9    is a view of the connecting element from the front. 
         FIGS.  10 A-C  show a part-region of the strap in different embodiments. 
         FIGS.  11 A,  11 B,  12 A,  12 B,  12 C,  13 A,  13 B,  13 C,  13 D,  14 A,  14 B,  14 C and  14 D  show different embodiments of a behind-the-ear element of the connecting element according to the invention from  FIG.  3   . 
         FIG.  15    is a schematic side view of an alternative embodiment of the connecting element according to the invention in a use state on the head of a user. 
         FIGS.  16 ,  17 ,  18 A and  18 B  are different views of the connecting element according to the invention from  FIG.  15   , wherein  FIG.  16    is a view of the connecting element from the side, 
         FIG.  17    is a perspective view of the connecting element,  FIG.  18 A  is a view of the connecting element from the front, and  FIG.  18 B  is a view of the connecting element from above. 
         FIGS.  19 A-C  show an exemplary embodiment of the behind-the-ear element of the connecting element according to the invention from  FIG.  15   , wherein  FIG.  19 A  is a view from the side,  FIG.  19    B is a view from the front, and  FIG.  19    C is a perspective view. 
         FIGS.  20 A-D  show alternative exemplary embodiments of the behind-the-ear element of the connecting element according to the invention from  FIG.  15    from the side. 
     
    
    
     The coordinate systems shown in some figures serve to illustrate the orientation of the views. The x-, y- and z-axes—unless described otherwise—in each figure describe the same direction. A direction denoted with an x-axis of one figure thus generally corresponds to the direction of the x-axis of the other figures. 
     DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS 
     The particulars shown herein are by way of example and for purposes of illustrative discussion of the embodiments of the present invention only and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the present invention. In this regard, no attempt is made to show details of the present invention in more detail than is necessary for the fundamental understanding of the present invention, the description in combination with the drawings making apparent to those of skill in the art how the several forms of the present invention may be embodied in practice. 
     In the following exemplary embodiments, a connecting element  10  according to the invention is shown. 
     The connecting element  10  according to the invention is suitable, for example, for use in a system  100  for ventilation and/or respiratory support. The system  100  comprises a patient interface  90  and a ventilator  70 , which are connected together in a gas-conducting manner by way of a line  80 . The patient interface  90  is connected by way of the connecting element  10  to the head  95  of a patient. 
     The connecting element  10  is in a use state when the connecting element  10  is applied at least partially at least in some regions to the head  95  of a patient and/or user. 
       FIG.  1    shows, by way of example, an overview of the system  100  with an exemplary embodiment of the connecting element  10  according to the invention, which is connected to a patient interface  90 . The patient interface  90  can be connected in a gas-conducting manner by way of a line  80  to a ventilator  70 . In  FIG.  1   , the patient interface  90 , line  80  and ventilator  70  are shown not connected. A gas-conducting connection can be established by connecting the line  80  by way of connectors, for example, at one end to the patient interface  90  and at a further end to the ventilator  70  (not shown). 
     The patient interface  90  is to be understood as being any peripheral device which is configured for interaction with a living being. In particular, the patient interface  90  is configured for therapeutic and/or diagnostic purposes in conjunction with the ventilator  70 . The patient interface  90  can be in the form of a respiratory mask. Patient interface  90  and respiratory mask are used herein as synonyms. 
     The patient interface  90  can be in the form of a nasal mask and can enclose the nose completely or partially. The patient interface  90  can also be in the form of a nasal pillow mask. Nasal pillow masks are used, for example, in CPAP or bilevel therapy. The patient interface  90  can also be in the form of a nasal cannula or oxygen nasal cannula. Nasal cannulas are used, for example, in high-flow therapy. Nasal cannulas can have nasal prongs  92 , which can be inserted at least partially into the nostrils. The patient interface  90  can also be in the form of a full face mask or total face mask, that is to say can enclose the nose and the mouth. Tracheal tubes or cannulas can also be used as the patient interface  90 . The connecting element  10  according to the invention is suitable in particular for nasal pillow masks and/or for high-flow interfaces. 
     The patient interface  90  can be applied or fastened to the head  95  of a user or patient by way of a connecting element  10  according to the invention. User and patient are used synonymously herein. When the term user or patient is mentioned, any individual who uses a respiratory mask  90  with a connecting element  10  is meant. 
     A ventilator  70  is to be understood as being all devices which support a user or patient with natural breathing and/or undertake ventilation of a user or patient and/or serve for respiratory therapy and/or otherwise act on the breathing of a user or patient. They include, for example but not exclusively, respiratory therapy devices, CPAP, APAP and bilevel devices, high-flow therapy devices, anesthesia machines, clinical, out-of-hospital or emergency ventilators, oxygen O 2 -delivering devices, diagnostic systems and cough-assist machines. 
     The patient interface  90  and the ventilator  70  are preferably connected together by way of at least one line  80 . The line  80  is in the form of a gas line which connects the individual components of the system  100  together in a gas-conducting manner. The line  80  is preferably flexible and/or rotatable. The line  80  can be in the form of, for example, an elastic tube and/or hose and/or hose system. 
       FIG.  2    is a perspective top view of a part-region of the connecting element  10 . The connecting element  10  and portions of the connecting element  20 ,  40 ,  60  have a width B, a thickness D and a length L. The width B is usually greater than the thickness D. The length L is usually greater than the width B. In a use state, that is to say when the connecting element  10  is applied at least partially to the head  95  (not shown here) of the user, the connecting element  10  faces the head  95  of the user at least in some regions on one side along the width B and along the length L. 
       FIG.  3    is a schematic side view of an embodiment of the connecting element  10  in a use state on the head  95  of a user. The connecting element  10  comprises at least one strap  20  and at least one behind-the-ear element  40 . In addition, the connecting element can comprise at least one head band  60 . 
     It is apparent from  FIG.  3    that the connecting element  10 , in a use state, is arranged on the head  95  of a patient such that the strap  20  is arranged at least in part between the nose and the ear. The strap  20  is thereby located at least in part in a cheekbone region J. 
     The connecting element  10  can be fundamentally mirror-symmetrical. The connecting element  10  can therefore have a notional plane of symmetry S (see  FIGS.  6 A,  9   ) which runs parallel to the plane spanned by the x- and y-axes (see for example  FIG.  3   ). Fundamentally mirror-symmetrical means that perfect symmetry is not generally present and the mirror images can differ from one another in one or more details. The connecting element  10  can additionally have one or more additional elements which, irrespective of the fundamental symmetry, can additionally be arranged on one side of the connecting element  10 . An example which may be mentioned here is a hose support  93 , which can be arranged on only one of the two straps  20  (see for example  FIG.  17   ). In the following text, only one of the mirror-symmetrical halves of the connecting element  10  will generally be described in each case. 
     The connecting element  10  comprises at least one strap  20 . The connecting element  10  generally comprises two straps  20 . In a use state, the straps  20  are located on the one hand over parts of the left side of the face and on the other hand over parts of the right side of the face (not shown). The connecting element  10  can also comprise more than two straps  20 . 
     The strap  20  comprises a coupling system  22 . By way of the coupling system  22 , the connecting element  10  can be coupled to the patient interface  90 . Coupling can take place reversibly or irreversibly. The coupling system  22  can comprise a mechanism for length adjustment. By way of the coupling system  22 , the length L of the connecting element  10  can thus be adapted. The coupling can be movable or unmovable. 
     The patient interface  90  can be in the form of a nasal pillow mask. Nasal pillow masks can be used, for example, for CPAP or bilevel therapies. For this purpose, the nasal pillow masks cover the nostrils and/or the region around the nostrils in a gas-tight manner with a nasal pillow  91 . The nasal pillow  91  can be inserted at least partially into the nostrils. 
       FIG.  4    and  FIG.  5    are side views of the strap  20 . The strap  20  comprises a beginning  30  and an end  38 . The beginning  30  and the end  38  lie at opposite ends of the strap  20  along the length L of the strap  20 . The strap  20  ends on one side at the beginning  30  and on the other side at the end  38 . In a use state, the beginning  30  can be arranged adjacent to the patient interface  90  and the end  38  can be arranged on the opposite side. The end  38  can be arranged on and/or behind the ear in a use state (see  FIG.  3   ). 
     The strap  20  extends along the length L from the beginning  30  to the end  38 . The length L of the strap  20  is substantially greater than the width B of the strap  20 . The ratio of the length L to the width B of the strap  20  can be in a range from about 10:1 to about 40:1. For example, the ratio of the length L to the width B of the strap  20  is at least about 10:1. In some embodiments, the ratio of the length L to the width B of the strap  20  is at least about 20:1. In a preferred embodiment, the ratio of the length L to the width B of the strap  20  is, for example, about 25:1 or more. The strap  20  has a particularly elongate, narrow shape. 
     The width B of the strap  20  can be constant or variable. In one exemplary embodiment, the width B of the strap  20  can be substantially constant and can increase or decrease in the width B toward the beginning  30  and/or toward the end  38 . 
     In a preferred embodiment, the width B increases toward the end  38  (see for example  FIG.  10 B ,  FIG.  16   ). The width B can increase or decrease toward the beginning  30 . In a preferred embodiment, the width B increases toward the beginning  30  ( FIG.  4   ). 
     The width B of the strap  20  can be in a range from about 1 mm to about 20 mm. Preferably, the width B of the strap  20  is from about 3 mm to about 10 mm. In a concrete exemplary embodiment, the width B of the strap  20  is about 7 mm. 
     The length L of the strap  20  can be in a range from about 50 mm to about 250 mm. Preferably, the length L of the strap  20  is from about 150 to about 220 mm. In a concrete exemplary embodiment, the length L of the strap  20  is, for example, about 200 mm. 
     It is apparent from  FIG.  4    that the strap  20  can be straight and/or bent at least in part.  FIG.  4    and  FIG.  5    show that the strap  20  can comprise a plurality of portions  31 ,  33 ,  35 ,  37  which can have different forms. The strap  20  can comprise a plurality of inflection points  30 ,  32 ,  34 ,  36 ,  38  between which portions  31 ,  33 ,  35 ,  37  are arranged. 
     The beginning  30  of the strap  20  can lie at the point of intersection of the x- and y-axes. The beginning  30  defines a first outer end of the strap  20 , namely the end that is adjacent to the patient interface  90  and to the coupling system  22  in a use state. The end  38  of the strap  20  defines a second outer end of the strap  20 , namely the end that is arranged on and/or behind the ear in a use state. The strap  20  can run between the beginning  30  and the end  38  straight and/or bent or curved in the x/y coordinate system. The strap  20  extends in the x/y coordinate system preferably such that the end  38  lies above the beginning  30  in the y-direction. 
     One or more inflection points  32 ,  34 ,  36  can lie between the beginning  30  and the end  38 . In the concrete exemplary embodiment shown in  FIGS.  4   / 5 , three inflection points  32 ,  34 ,  36 , for example, lie between the beginning  30  and the end  38 . In alternative embodiments, fewer than three or more than three inflection points can also be formed. 
     One or more portions  31 ,  33 ,  35 ,  37  can lie between the beginning  30  and the inflection points  32 ,  34 ,  36  and the end  38 . In the concrete exemplary embodiment shown in  FIGS.  4   / 5 , four portions  31 ,  33 ,  35 ,  37 , for example, lie between the beginning  30  and the end  38 . In alternative embodiments, fewer than four or more than four portions can also be formed. The portions  31 ,  33 ,  35 ,  37  can be straight and/or bent or curved. 
     A portion  31  of the strap  20  can be arranged between the beginning  30  and the inflection point  32 . Portion  31  denotes the strap portion that lies between the beginning  30  and the inflection point  32 . The portion  31  can be straight or bent or curved. In the concrete exemplary embodiment according to  FIG.  4   , the portion  31  is substantially straight in the direction of the x-axis. The coupling system  22  can be arranged in the portion  31 . A mechanism for length adjustment can be arranged in the portion  31 . 
     A further portion  33  of the strap  20  can be arranged between the inflection point  32  and the inflection point  34 . Portion  33  denotes the strap portion that lies between the inflection point  32  and the inflection point  34 . The portion  33  can be straight or bent or curved. In the concrete exemplary embodiment according to  FIGS.  4   / 5 , the portion  33  is bent in the x/y coordinate system. The inflection point  34  lies above the inflection point  32  in the y-direction. 
     A further portion  35  of the strap  20  can be arranged between the inflection point  34  and the inflection point  36 . Portion  35  denotes the strap portion that lies between the inflection point  34  and the inflection point  36 . The portion  35  can be straight or bent or curved. In the concrete exemplary embodiment according to  FIGS.  4   / 5 , the portion  35  is bent in the x/y coordinate system. The inflection point  36  lies above the inflection point  34  in the y-direction. 
       FIG.  5    clearly shows the bend of the portions  33  and  35  of the concrete exemplary embodiment according to  FIG.  4   . Portion  33  runs in a bent manner between the inflection points  32  and  34 . The bend corresponds to an arc of a notional circle or oval with a radius R 1 . The radius R 1  can be in a range between 60 mm and 75 mm, for example. If the inflection points  32  and  34  are joined to a center M 1  of the circle or oval, a sector with a central angle α1 is obtained. The central angle α1 can be in a range of from about 30° to about 80°. For example, the central angle α1 is in a range from about 60° to about 70°. 
     Portion  35  runs in a bent manner between the inflection points  34  and  36 . The bend corresponds to an arc of a notional circle or oval with a radius R 2 . The radius R 2  can be in a range from about 10 mm to about 20 mm, for example. If the inflection points  34  and  36  are joined to a center M 2  of the circle or oval, a sector with a central angle α2 is obtained. The central angle α2 can be in a range from about 30° to about 80°. For example, the central angle α2 is in a range from about 60° to about 75°. 
     The central angles α1 and α2 can be of the same size or can differ from one another in terms of their size. 
     The bend or curve of the portion  35  can, for example, be opposite to the bend or curve of the portion  33 . Thus, for example, a convexly bent strap portion  35  can adjoin a concavely bent strap portion  33  and vice versa. 
     In alternative embodiments, the strap  20 , instead of being formed of the arcuate curves shown in  FIGS.  4   / 5 , can also be formed of straight portions  31 ,  33 ,  35 ,  37  which are bent relative to one another such that the end  38  lies above the beginning  30  in the y-direction (not shown). 
     An end portion  37  of the strap  20  is arranged between the inflection point  36  and the end  38 . End portion  37  can denote the strap portion that lies between the inflection point  36  and the end  38 . The end portion  37  is adjacent to the end  38  and denotes the last portion of the strap  20 . 
     The end portion  37  can be straight and/or bent or curved. In the concrete exemplary embodiment according to  FIG.  4   , the end portion  37  is substantially straight in the direction of the x-axis. 
     In some embodiments, the end portion  37  can be substantially longer than is shown in  FIGS.  4   / 5 . The length L of the end portion  37  can account for up to about 80% of the total length L of the strap  20 . Preferably, the length L of the end portion  37  accounts for less than about 50% of the total length L of the strap  20 . In a concrete exemplary embodiment, the length L of the end portion  37  accounts for about 20% to about 25% of the total length L of the strap  20 . A short end portion  37  has a positive effect on the wear comfort for the user, for example when the user puts his head down when lying down, for example when sleeping. 
     In some embodiments, it is conceivable that an end portion  37  of elongate form can be straight and curved or bent. It is conceivable, for example, that the end portion  37  of the strap  20  is curved at least in part such that it passes at least partially around the ear in a use state (not shown). 
     In the concrete exemplary embodiment shown in  FIG.  4   / 5 , there are four portions  31 ,  33 ,  35 ,  37 , for example, between the beginning  30  and the end  38 . In alternative embodiments, fewer than four or more than four portions can also be formed. 
     The end portion  37  is adapted and configured, at least in part, to enter into a coupling with the behind-the-ear element  40 . By way of the end portion  37 , the behind-the-ear element  40  can be connected to the strap  20 . 
     In some embodiments, the strap  20  can additionally comprise at least one coupling element  26 . The coupling element  26  can, for example and preferably, be in the form of an aperture in the strap  20 . The coupling element  26  can also be in the form of an additional element, for example in the form of a loop or eyelet, which is molded onto the strap  20  (not shown). 
     The at least one coupling element  26  is adapted and configured to couple the head band  60  as an additional connecting element to the strap  20 . The coupling element  26  can be arranged at all the portions  31 ,  33 ,  35 ,  37  of the strap  20 . Preferably, the coupling element  26  is arranged in portion  35  and/or in the end portion  37 . 
     In a concrete exemplary embodiment, the coupling element  26  can be formed by a cutout in the material of the strap  20  (see  FIG.  4   ). The head band  60  can be guided through the coupling element  26 . For this purpose, the coupling element  26  preferably has a complementary shape to the head band  60 . For example, the coupling element  26  is minimally wider than the head band  60  is wide and minimally higher than the head band  60  is thick. 
     The strap  20  is preferably formed at least of a solid, stiffening material which nevertheless has a certain flexibility. The straps  20  should have a certain stiffness while at the same time having flexibility so as to impart sufficient stability to the connecting element  10  as a whole and nevertheless permit flexible contact with the head  95 . 
     In a simple embodiment, the strap  20  can be manufactured from only one material, which forms a layer. In some embodiments, it is also possible that the strap  20  is composed of a plurality of layers (e.g., two or three layers). 
     The strap  20  can be formed of plastics material, metal, silicone, foam and/or a composite material. The base material of the strap  20  can be rigid plastics material, for example. For example, the strap  20  is manufactured from polypropylene. 
     The strap  20  can have additional reinforcing and/or flexible and/or deformable elements in a base material, at least in some regions. For example, there can additionally be arranged in a base material of plastics material, for example, wire, inorganic and/or organic reinforcing fibers, short and/or long fibers, rods, strips, woven fabrics, knitted fabrics, meshes and/or structural mats. 
     In some embodiments, the strap  20  can be in the form of a deformable element which can be adapted individually to the shape of the head. For example, the strap  20  can be formed of at least one wire of a wrought alloy, for example of a wrought aluminum alloy. Other materials with deformable properties are also conceivable, for example plastics materials such as thermoplastics or the like. In an alternative embodiment, the strap  20  can be formed of a composite material, preferably of a rigid plastics material and silicone and/or of a rigid plastics material and a thermoplastic elastomer (TPE). 
     The strap  20  is not limited to these embodiments. Any materials which have reinforcing and/or stiffening and/or flexible properties are conceivable. In a simple embodiment, the strap  20  can be manufactured from only one of the above-mentioned materials or composite materials. 
     In some embodiments, the strap  20  can additionally be surrounded at least in some regions by a textile. The textile can increase the wear comfort of the strap  20 . Conceivable textiles can be cotton, silk and/or of synthetic fibers such as, for example, polyester, polyurethane, neoprene, spandex and/or nylon. Mixed fabrics are also conceivable. Other substances which appear suitable in relation to biocompatibility, comfort, stability, elasticity and costs are also conceivable. 
     Alternatively or additionally, the strap  20  can have at least in some regions a cushioning material. The cushioning material can be manufactured, for example, from foam, cotton wool, woven fabric, cotton, wool, rubber, neoprene, gel and/or other elastic and/or viscoelastic materials. The cushioning material can increase the wear comfort and/or make the wearing of a cannula more agreeable. 
       FIGS.  6  to  9    are views of the connecting element  10  according to the invention from  FIG.  3   , wherein  FIG.  6 A  is a view of the connecting element  10  from above,  FIG.  6 B  is a view from above of the connecting element  10  in a use state on the head  95  of a user,  FIG.  7    is a perspective view of the connecting element  10 ,  FIG.  8    is a view of the connecting element  10  from the side, and  FIG.  9    is a view of the connecting element  10  from the front. 
     The straps  20  can be straight and/or bent or curved in the x/z coordinate system. Preferably, there is at least one curve and/or bend of the strap  20  within the x/z coordinate system. As a result of the bend or curve of the straps  20  in the x/z coordinate system, the straps  20  can run from the patient interface  90  to the ears and can be adapted to the shape of the head of the user and/or patient. As a result of the bend or curve of the straps  20  in the x/z coordinate system, the connecting element  10  can be made narrower at the patient interface  90  than in the regions which lie against the head  95  of the user in the use state (see  FIG.  6 B ). As a result of the bend or curve in the z-direction, the end  38  of the strap lies above and/or below the beginning of the strap  20 . 
     The portions  31 ,  33 ,  35 ,  37  can be straight and/or bent or curved in the x/z coordinate system. All the portions  31 ,  33 ,  35 ,  37  can be bent or curved in the x/z coordinate system. In some embodiments, it is also possible for only some or only one of the portions  31 ,  33 ,  35 ,  37  to be bent or curved in the x/z coordinate system. 
     In the concrete exemplary embodiment according to  FIG.  6 A-B , at least one portion of the strap  20  is bent or curved in the x/z coordinate system. By way of example, portion  31  is curved in the x/z coordinate system by an angle β. The inflection point  32  then lies above the inflection point  34  in the z-direction. The angle β is in a range from 120° to 180°. For example, the angle β is in a range between 130° and 170°. 
     The strap  20  is preferably bent or curved at least in part between the beginning  30  and the end  38  in two planes, namely both in the x/y coordinate system and in the x/z coordinate system. 
     The behind-the-ear element has a length L and a width B. In a simple exemplary embodiment, the length L can be equal to the width B. The ratio of the length L to the width B of the behind-the-ear element  40  can be about 1:1 (not shown). In preferred embodiments, the ratio of the length L to the width B of the behind-the-ear element  40  can preferably be about 5:1 or more. 
     It is apparent from  FIG.  6    and  FIG.  7    that the behind-the-ear element  40  in this exemplary embodiment is adapted and configured to be so long that it can run from the end  38  of one strap  20  to the end  38  of the second strap  20 . In a use state, the behind-the-ear element  40  is arranged at the back of the head of the user. In the exemplary embodiment according to  FIG.  3     ff , only a single behind-the-ear element  40  is arranged on the straps  20 . 
     The behind-the-ear element  40  has, for example, an elongate form with two ends  44 . The ends  44  can be shaped such that they form one or more retaining elements  42 . The behind-the-ear element  40  can be coupled to the ends  38  of the two straps  20  by way of the, for example, two retaining elements  42 . This coupling can be reversible or irreversible. This coupling can be adapted to be movable or unmovable. A length adjustment can take place by way of the coupling of the behind-the-ear element  40  and the strap  20 . Depending on the position at which the retaining elements  42  are placed on the strap  20 , the connecting element  10  can be adjusted to be wider or narrower (see also hereinbelow). 
     In the exemplary embodiment shown in  FIGS.  3  and  5  to  8   , the connecting element  10  can comprise, in addition to the strap  20  and the behind-the-ear element  40 , a further element in the form of at least one head band  60 . 
     The head band  60  can be fastened to the strap  20 . The fastening can be adapted to be releasable and/or non-releasable. Preferably, the head band  60  can be releasably fastened to the strap  20 . The head band  60  can pass through the apertures  26  of the straps  20  in order to couple the head band  60  to the straps  20 . 
     The head band  60  can have an elongate narrow shape. The length L of the head band  60  is substantially greater than the width B of the head band  60 . The ratio of the length L to the width B of the head band  60  can be in a range from about 10:1 to about 50:1. For example, the ratio of the length L to the width B of the head band  60  is at least about 10:1. In some embodiments, the ratio of the length L to the width B of the head band  60  is at least about 20:1. In a preferred embodiment, the ratio of the length L to the width B of the head band  60  is about 28:1 or more. The head band  60  preferably has an elongate, narrow shape. 
     The width B of the head band  60  can be constant or varying. In one exemplary embodiment, the width B of the head band  60  can be constant. The width B of the head band  60  can be in a range from about 1 mm to about 50 mm, preferably in a range from about 3 to about 30 mm. Particularly preferably, the width B of the head band  60  is from about 5 to about 20 mm. In a concrete embodiment, the width B of the head band  60  is about 12 mm. 
     The length L of the head band  60  can be in a range from about 150 mm to about 500 mm. Preferably, the length L of the head band  60  is from about 300 mm to about 500 mm. In a concrete exemplary embodiment, the length L of the head band  60  is by way of example about 340 mm. 
     The head band  60  can be manufactured from a textile. The material of the head band  60  is preferably soft and flexible. The head band  60  is particularly preferably configured to be stretchable. Conceivable textiles can be cotton, silk and/or synthetic fibers such as, for example, of polyester, polyurethane, neoprene, spandex and/or nylon. Mixed fabrics are also conceivable. Other substances which appear suitable in relation to biocompatibility, comfort, stability, elasticity and costs are also conceivable. 
     In a simple embodiment, the head band  60  is manufactured from only one textile and is adapted and configured to impart to the connecting element  10  additional hold and stability. Alternatively or additionally, the head band  60  can also have reinforcing and/or cushioning materials. This can be advantageous in order to increase the wear comfort and/or to facilitate fitting to the head  95 . For example, it is conceivable that the head band  60  contains reinforcing structures, which provides the head band  60  in a shape that is optimal for the head shape. 
     The head band  60  can have a narrow, elongate shape with two ends  64  and two end regions  63 . The two end regions  63  can account for up to about 50% of the total length L of the head band  60  as a whole. In preferred embodiments, the end regions  63  together account for about 25% of the total length L of the head band  60  as a whole. Fastening elements  62  can be arranged at one and/or at both end regions  63  of the head band  60 . 
     In some embodiments, both end regions  63  of the head band  60  can comprise one or more fastening elements  62 . For example, the end regions  63  of the head band  60  can comprise one or more Velcro fasteners and/or hooks and eyelets and/or buttons and buttonholes and/or snap fasteners and/or buckles or similar elements. With these fastening elements  62 , the head band  60  can be reversibly fastened to the one or more straps  20 . The fastening elements  62  are adapted and configured such that a length adjustment of the head band is possible. 
     The end regions  63  of the head band  60  preferably have one or more Velcro fasteners. For this purpose, there can be arranged at one or at both end regions  63  a Velcro region with flexible hooks, which can enter into a loadable, strong and reversible connection with the base material of the head band  60  (not shown). 
     For fastening the head band  60  to the straps, the two ends  64  and the end regions  63  of the head band  60  can pass through the apertures  26  of the straps  20 . The head band  60  can then be bent in a loop shape so that the end regions  63  can be connected with other regions of the head band  60  (see for example  FIG.  7   ). The connection can preferably be maintained by way of a Velcro fastener. 
     It is also conceivable that at least one of the two ends  64  and/or end regions  63  of the head band  60  is irreversibly connected to one of the straps  20  for protection against loss. Preferably at least one of the two end regions  63  of the head band  60  is fastened to the strap  20  in a length-adjustable manner as described above. 
       FIG.  10 A-C  shows a part-region of the strap  20  in different embodiments. It is apparent from  FIG.  10    that the end portion  37  of the strap  20  can have different forms toward the end  38 . In some embodiments, the end portion  37  can have a constant width B ( FIG.  10 A ). In alternative embodiments, at least a part-region of the end portion  37  can have a particular form. For example, the end portion  37  can be widened at least in part relative to the fundamentally constant width B. An end portion  37  of widened form can be advantageous for the fastening of the behind-the-ear element  40  to the strap  20 . 
     The end portion  37  can, for example, be widened at least in part to form an anchor element  25 . The anchor element  25  can be configured such that the end  38  is widened in the shape of an arrow ( FIG.  10 B ). The arrow-like widening can effectively prevent the behind-the-ear element  40  from unintentionally slipping off the strap  20 . The anchor element  25  is not limited to the arrow-like shape. For example, the anchor element  25  can also be circular and/or oval and/or polygonal. The anchor element  25  can also have any other suitable geometry which allows the behind-the-ear element  40  to be coupled to the strap  20  and at the same time prevents unintentional slipping. 
     Alternatively or additionally, the end portion  37  of the strap  20  can comprise one or more fixing elements  24  which can positively influence the fastening of the behind-the-ear element  40  to the strap  20  ( FIG.  10 C ). The fixing elements  24  on the strap  20  can be in the form of buttons, mushroom buttons, hooks, bars, studs, Velcro tape with hooks and/or loops or the like. One or more counterpart elements, that is to say buttonholes, holes, eyelets, loops, Velcro tape with hooks and/or loops or the like, can correspondingly be located on and/or at the ends  44  or end regions  43  of the behind-the-ear element  40  (not shown). 
     The fixing elements  24  can also be formed on the straps  20  by one or more thickened portions and/or indentations or similar structures, which permit latching on the strap  20  (not shown). 
     The fastening of one or more fixing elements  24  to a corresponding counterpart element can enhance and/or secure the fastening of the behind-the-ear element  40  to the straps  20 . By arranging a plurality of fixing elements  24  on the strap, which are located at different positions of the strap  20 , a further length adjustment of the connecting element  10  can be made possible. 
     The arrangement of additional fixing elements  24  on the end portion  37  of the strap  20  can be advantageous in particular in the case of positive pressure ventilation, because in this case a high force acts on the connecting element  10 . Additional fixing elements  24  can secure and stabilize the fastening of the behind-the-ear element  40  to the straps  20 . 
       FIGS.  11  to  14    show different embodiments of the behind-the-ear element  40  of the connecting element  10  according to the invention from  FIG.  3   . 
     In the embodiment according to  FIG.  3     ff , a single behind-the-ear element  40  is provided. The single behind-the-ear element  40  can be manufactured from one or more manufactured parts. In this concrete embodiment, the behind-the-ear element  40  comprises at least two end regions  43 . At least one center piece  45  can be formed between the two end regions  43 . 
     The two end regions  43  can account for up to about 100% of the total length L of the behind-the-ear element  40  as a whole, so that the behind-the-ear element  40  is formed without the center piece  45  (not shown). In alternative embodiments, a center piece  45 , which can be of different lengths, is formed between the two end regions  43 . For example, the two end regions  43  together can account for up to about 50% of the total length L of the behind-the-ear element  40  as a whole, and the center piece  45  can account for the remaining 50%. The center piece  45  can also be shorter or longer. 
     In preferred embodiments, the end regions  43  account for at most about 25% or less of the total length L of the behind-the-ear element  40  as a whole. The behind-the-ear element  40  can be coupled by way of its two end regions  43  to the end portions  37  of the two straps  20 . 
     The center piece  45  can preferably account for at least about 50% of the total length L of the behind-the-ear element  40  as a whole. In preferred embodiments, the center piece  45  accounts for at least about 75% or more of the total length L of the behind-the-ear element  40  as a whole. 
     In the exemplary embodiments according to  FIGS.  11  to  14   , the length L of the behind-the-ear element  40  is substantially greater than the width B of the behind-the-ear element  40 . For example, the ratio of the length L to the width B of the behind-the-ear element  40  is at least about 5:1. In some embodiments, the ratio of the length L to the width B of the behind-the-ear element  40  is at least about 20:1. In a preferred embodiment, the ratio of the length L to the width B of the behind-the-ear element  40  is about 30:1 or more. In the exemplary embodiments according to  FIGS.  11  to  14   , the behind-the-ear element  40  preferably has an elongate, narrow shape. 
     The width B of the behind-the-ear element  40  can be constant or varying. In one exemplary embodiment, the width B of the behind-the-ear element  40  can be substantially constant ( FIGS.  11 ,  13 ,  14   ). In some embodiments, the width B of the behind-the-ear element  40  can also be varying ( FIG.  12   ). The width B of the behind-the-ear element  40  can be in a range from about 0.2 mm to about 30 mm. Preferably, the width B of the behind-the-ear element  40  is from about 0.5 mm to about 25 mm, particularly preferably from about 7 mm and about 25 mm. 
     The length L of the behind-the-ear element  40  can be in a range from about 50 mm to about 400 mm. Preferably, the length L of the behind-the-ear element  40  is from about 100 to about 300 mm. In a concrete exemplary embodiment, the length L of the behind-the-ear element  40  is by way of example about 210 mm. 
     Preferably, the behind-the-ear element  40  is manufactured from an elastic material. The behind-the-ear element  40  can be manufactured from at least one material selected from silicones, thermoplastic elastomers (TPE), neoprenes or textiles. Conceivable textiles for the behind-the-ear element can be cotton, silk and/or synthetic fibers such as, for example, polyester, polyurethane, neoprene, spandex, nylon. The behind-the-ear element  40  is preferably manufactured from silicone. 
     The behind-the-ear element  40  can be coupled to the straps  20 . The behind-the-ear element  40  can comprise at least one, preferably two retaining elements  42 . The retaining elements  42  can be formed within the end regions  43  and/or can be formed by the end regions  43  (see  FIGS.  11 ,  12 ,  14   ). In alternative embodiments, the retaining elements  42  can also be molded on the end regions  43  (see  FIG.  13   ). By way of the retaining elements  42 , the behind-the-ear element  40  can be coupled to the straps  20 . The retaining elements  42  can preferably be coupled to the end portions  37  of the straps  20 . 
     The coupling of the behind-the-ear element  40  to the straps  20  can be irreversible or reversible. In some embodiments, it is conceivable that one retaining element  42  is coupled irreversibly to one strap  20  and the other retaining element  42  is coupled reversibly to the second strap  20  (not shown). It is also conceivable that the behind-the-ear elements  40  are integral components of the straps  20  and/or that straps  20  and behind-the-ear elements  40  are manufactured in one piece. 
     The coupling of the behind-the-ear element  40  to the straps  20  is preferably reversible. The coupling of the behind-the-ear element  40  to the straps  20  can be movable or unmovable. Preferably, the coupling of the behind-the-ear element  40  to the straps  20  is movable. By means of a movable coupling of the behind-the-ear element  40  to the straps  20 , the positioning of the behind-the-ear element  40  within the connecting element  10  can be changed (see  FIG.  8 A  and  FIG.  8 B ). 
       FIG.  11    shows a simple exemplary embodiment of the behind-the-ear element  40  of the connecting element  10  according to the invention from  FIG.  3   , wherein  FIG.  11 A  is a view from the side and  FIG.  11    B is a perspective view. 
     In the concrete exemplary embodiment according to  FIG.  11   , the length L of the center piece  45  can account for up to about 90% and the length L of the two end regions  43  together can account for about 10% of the total length L of the behind-the-ear element  40 . In the exemplary embodiment according to  FIG.  11   , the width B of the behind-the-ear element  40  can be substantially constant. The width B of the center piece  45  can be constant. 
     The end regions  43  can each be configured at least in part as retaining elements  42  in the form of elongate hollow bodies. The elongate hollow bodies can have, for example, a round and/or oval or angular cross-section. The elongate hollow bodies can be formed by joining each of the end regions  43  at least in part along the length L to form a closed profile. Joining of the end regions  43  to form a hollow body can be carried out by stitching, welding, adhesive bonding or the like, so that the end region  43  can have a joining groove  48 . Joining of the end region  43  to form a hollow body is generally and preferably irreversible. 
     The retaining elements  42  so formed can be fitted onto the end portions  37  of the straps  20  (not shown). The end portions  37  of the straps  20  are then located at least in part in the lumen  50  of the retaining elements  42 . The retaining elements  42  there hold the behind-the-ear element  40  on the end portions  37  of the straps  20  under pretension by friction. 
     In order that the connecting element  10  is held firmly on the head  95  of a user, the connecting element  10  must be adjusted to be slightly smaller than the circumference of the head  95  is large. Thus, in a use state, a tensile force F can act on the behind-the-ear element  40 . The tensile force F generally runs in the direction of the length L of the behind-the-ear element  40 . In the exemplary embodiment according to  FIG.  11   , the retaining elements  42  are in a plane with the center piece  45  along the tensile force F. 
     Holding can alternatively or additionally be implemented and/or assisted by fixing elements  24  and/or anchor elements  25  at the end portions  37  of the straps (see  FIG.  10   ). For this purpose, at least one end region  43  of the behind-the-ear element  40  can have at least one buttonhole or hole or an eyelet or a loop or a Velcro tape with hooks and/or loops or the like. In some embodiments, it is also conceivable that the end region  43  has a plurality of buttonholes or holes or eyelets or loops or the like, so that a length adjustment is possible (not shown). 
     An additional fixing offers the advantage that the behind-the-ear element  40  can be firmly connected to the strap  20  and unintentional slipping on the strap  20  can be prevented. This is advantageous in particular in the case of the use of respiratory masks  90  for positive pressure ventilation, because the tensile force F for sealing the respiratory mask  90  can thus be enhanced by way of the behind-the-ear element  40 . 
       FIG.  12    shows a further exemplary embodiment of the behind-the-ear element  40  of the connecting element  10  according to the invention from  FIG.  3   . The behind-the-ear element  40  shown in  FIG.  12    corresponds substantially to the behind-the-ear element  40  shown in  FIG.  11   , but shows that the behind-the-ear element  40  can in some embodiments be substantially lengthened. The behind-the-ear element  40  can be up to about 200% longer than described above. 
     In this embodiment, the behind-the-ear element  40  can additionally comprise at least one eyelet  46 . The eyelet  46  can have one or more openings  49  (see detail view of  FIG.  12 C ). The behind-the-ear element  40  can pass through the one or more openings  49  such that the center piece  45  is formed at least in part into a loop. By displacing the eyelet  46 , the length L of the behind-the-ear element  40  can be adjusted. The behind-the-ear element  40  is thus in itself adjustable in length. The eyelet  46  holds the behind-the-ear element  40  by friction and/or under pretension. 
     Alternatively or additionally, the eyelet  46  can contain a spring mechanism and/or a latching mechanism (not shown). The spring mechanism of the eyelet  46  can comprise a spring and an actuating element. By means of the spring mechanism, the behind-the-ear element  40  can be fixed in its position by clamping. The fixed position can be released by pressure on the actuating element, so as to permit adjustment of the position of the eyelet  46  and thus a length adjustment. The exemplary embodiment shown in  FIG.  12    offers the advantage of a very flexible, simple, quick and reliable length adjustment of the behind-the-ear element  40 . 
       FIG.  13 A-D  shows a further exemplary embodiment of the behind-the-ear element  40  of the connecting element  10  according to the invention from  FIG.  3   .  FIG.  13    shows exemplary embodiments of the behind-the-ear element  40  in which the width B of the center piece  45  can be wider and/or narrower compared to the width B of the end regions  43 . In these exemplary embodiments, the center piece  45  can account for about 50% of the total length L of the behind-the-ear element  40 . In these exemplary embodiments, the end regions  43  together can account for about 50% of the total length L of the behind-the-ear element  40 . The center piece  45  can also be shorter than shown. 
       FIG.  13 A  shows a simple embodiment of a behind-the-ear element  40  having a substantially constant width B. Only the retaining elements  42  are wider than the basic width B of the behind-the-ear element  40 .  FIGS.  13 B-D  show that the center piece  45  can be wider compared to the width B of the end regions  43 . A wide center piece  45  can have a positive effect on the comfort and stability of the behind-the-ear element  40 . 
     It is further apparent from  FIG.  13    that the retaining elements  42  can be molded onto the end regions  43 . The retaining elements  42  can be molded on above and/or below the end regions  43 . The retaining elements  42  can also be configured such that they are arranged in a plane with the end regions  43  (see  FIGS.  11 ,  12 ,  14   ). 
     In the embodiments according to  FIG.  13   , the retaining elements  42  are molded onto the end regions  43  such that the retaining elements  42  do not lie in a plane with the center piece  45  along the tensile force F. The tilting moment in the retaining element  42  effects stronger clamping and thus a better hold of the behind-the-ear element  40  on the strap  20 . 
     A further advantage of these embodiments is that the position of the behind-the-ear element  40  in the use state can be varied. The behind-the-ear element  40  can be rotated so that, in a use state, it runs in the nape of the neck (not shown) (see  FIG.  8 A ) or across the back of the head (not shown) (see  FIG.  8 B ). 
       FIG.  14    shows an alternative exemplary embodiment of the behind-the-ear element  40  of the connecting element  10  according to the invention from  FIG.  3   . 
     The behind-the-ear element  40  according to  FIG.  14 A-D  can be manufactured from a plurality of manufactured parts, for example two manufactured parts, which to produce a finished component can be joined together to form a behind-the-ear element  40 . As a result of the two-part manufacture, a mechanism for length adjustment can be formed. The illustration in  FIG.  14 A  shows the behind-the-ear element  40  in a partially disassembled state.  FIGS.  14 B-D  show the behind-the-ear element  40  in an assembled, ready-for-use state. 
       FIG.  14 A  shows that the behind-the-ear element  40  can be manufactured from two manufactured parts of identical construction. Each of the two manufactured parts comprises an end region  43  with a retaining element  42 , a center piece  45  and an eyelet  46 . The eyelet  46  can in each case be fixedly connected to one end of the center piece  45 . The end region  43  can be fixedly connected to the other end of the center piece  45 . The eyelet  46  can have at least one opening  49 . The opening  49  can be arranged in the eyelet  46  on one side. The opening  49  can be arranged in the eyelet  46  on both sides and form a through-passage through the eyelet  46 . 
     The assembled behind-the-ear element  40  shown in  FIGS.  14 B-D  shows that the behind-the-ear element  40  can in some embodiments comprise a length adjustment mechanism. For establishing the length adjustment mechanism, the behind-the-ear element  40  can comprise at least two or more eyelets  46 ,  46   i  and/or two or more center pieces  45 ,  45   i.    
     For the concrete exemplary embodiment according to  FIG.  14   , the behind-the-ear element  40  preferably has two eyelets  46 ,  46   i  and two center pieces  45 ,  45   i . The first eyelet  46  can be fixedly connected to the first center piece  45 . The second center piece  45   i  can pass through the first eyelet  46  in a movable manner through the opening  49 . The second eyelet  46   i  can be fixedly connected to the second center piece  45   i . The first center piece  45  can pass through the second eyelet  46   i  in a movable manner through the opening  49 . By means of such a two-part embodiment, simple and reliable length adjustment of the behind-the-ear element  40  can be made possible. The behind-the-ear element  40  is thus in itself adjustable in length. 
     The eyelets  46 ,  46   i  hold the center piece  45 ,  45   i  passing through the opening  49  of the eyelet  46 ,  46   i  by friction and/or under pretension and/or by way of a spring mechanism. It is also conceivable that the center pieces  45 ,  45   i  have thickened portions which permit length adjustment by latching (not shown). 
       FIG.  15    is a schematic side view of an alternative embodiment of the connecting element  10  according to the invention in a use state on the head  95  of a user.  FIGS.  16  to  18    are different views of the connecting element  10  according to the invention from  FIG.  15   , wherein  FIG.  16    is a view of the connecting element  10  from the side,  FIG.  17    is a perspective view of the connecting element  10 ,  FIG.  18 A  is a view of the connecting element  10  from the front, and  FIG.  18 B  is a view of the connecting element  10  from above. 
     In the alternative embodiment, the connecting element  10  comprises at least one strap  20  and at least one behind-the-ear element  40 . Preferably, the connecting element  10  comprises two straps  20  and two behind-the-ear elements  40 . 
     The connecting element  10  of the alternative embodiment according to  FIG.  15     ff  and the connecting element  10  according to  FIG.  3     ff  both comprise the straps  20  according to the invention which have been described in detail above. The straps  20  comprise the coupling system  22  for coupling to the patient interface  90  and the end portion  37  for coupling of the at least one behind-the-ear element  40 . Coupling of the behind-the-ear element  40  to the straps  20  preferably takes place by way of the retaining elements  42 . The retaining elements  42  can be configured and adapted to permit a length adjustment and/or to permit fixing and/or anchoring to the strap  20 . A head band  60  is conceivable but not necessary in the alternative embodiment. 
     It is apparent from  FIG.  15    that the connecting element  10  of the alternative embodiment, in a use state, is arranged, similarly to the connecting element  10  according to  FIG.  3     ff , on the head  95  of a patient such that the strap  20  is arranged at least in part between the nose and the ear. The strap  20  is thereby located at least in part in the cheekbone region J. The strap  20  is configured according to the embodiment described in detail above. 
     The alternative embodiment according to  FIG.  15     ff  differs from the embodiments according to  FIG.  3     ff  in the form of the behind-the-ear element  40 . In the embodiment according to  FIG.  15     ff , at least two behind-the-ear elements  40  are provided, each of which can be coupled to one of the at least two straps  20 . 
     The patient interface  90  can be in the form of a high-flow interface, HF interface for short. By way of the HF interface  90 , the patient can receive high-flow oxygen therapy, HFOT for short. HFOT is a non-invasive form of respiratory support and/or respiratory therapy. In HFOT, oxygen and/or an oxygen-containing gas mixture can be supplied to the patient. The oxygen and/or the gas mixture can be administered at a very high gas flow rate of up to 60 l/min. The HF interface is usually in the form of a nasal cannula and can comprise nasal prongs  92 . For example, the HF interface is in the form of a nasal cannula with at least one, preferably two nasal prongs  92 . The nasal prongs  92  (see  FIG.  16   ) can be inserted at least partially into the nose (not shown). 
       FIGS.  19  and  20    show exemplary embodiments of the behind-the-ear element  40  of the connecting element  10  according to the invention according to  FIG.  15     ff . Unlike in the exemplary embodiments according to  FIGS.  11  to  14   , the behind-the-ear element  40  can be made shorter. In these exemplary embodiments, the ratio of the length L to the width B of the behind-the-ear element  40  can in each case be less than about 20:1, preferably less than about 10:1, particularly preferably less than about 5:1. 
       FIG.  19 A-C  shows a simple exemplary embodiment of the behind-the-ear element  40  of the connecting element  10  according to the invention according to  FIG.  15   , wherein  FIG.  19 A  is a view from the side,  FIG.  19 B  is a view from the front, and  FIG.  19 C  is a perspective view. 
     In the embodiment according to  FIG.  15     ff , a behind-the-ear element  40  is provided for each strap  20 . Preferably, the connecting element  10  has two straps  20  each having a behind-the-ear element  40 .  FIG.  19    shows a behind-the-ear element  40  which is arranged behind the ear in a use state (see  FIG.  15   ). It is apparent from  FIG.  19    that the length L of the behind-the-ear element  40  can be slightly greater than the width B. For example, the ratio of the length L to the width B of the behind-the-ear element  40  is less than about 20:1, preferably less than about 10:1, particularly preferably less than about 5:1. The ratio of the length L to the width B of the behind-the-ear element  40  in this concrete embodiment is by way of example about 3:1. 
     The behind-the-ear element  40  in this concrete embodiment comprises a retaining element  42 . The retaining element  42  is in the form of a hollow body and comprises at least one lumen  50 . The hollow bodies and the lumen  50  can have, for example, a round and/or oval and/or angular cross-section. In some embodiments, the behind-the-ear element  40  can consist only of the retaining element  42  (not shown). In alternative embodiments, the behind-the-ear element  40  can additionally comprise an end piece  41  ( FIGS.  19   / 20 ). 
     In order to establish a use state, the behind-the-ear element  40  can be coupled to the strap  20 . Coupling takes place by way of the retaining element  42 , which can be coupled to the end portion  37  of a strap  20 . Preferably, a behind-the-ear element  40  is coupled to both straps  20 . The end portion  37  of a strap  20  is then located at least in part in the lumen  50  of a retaining element  42 . The retaining elements  42  there hold the behind-the-ear element  40  at the end portions  37  of the straps  20  under pretension by friction. Alternatively or additionally—as described hereinabove in relation to  FIG.  10   —holding can be implemented and/or assisted by fixing elements  24  and/or anchor elements  25  at the end portions  37  of the straps and with corresponding counterpart elements on the behind-the-ear elements  40 . 
     Coupling of the behind-the-ear elements  40  to the straps  20  can allow the connecting element  10  to be adapted to the respective head shape. The positioning of the behind-the-ear elements  40  on the end portions  37  of the straps  20  can preferably be variably adjustable. For smaller head shapes, the behind-the-ear element  40  can be pushed on the strap  20  in the direction toward the beginning  30 . For larger head shapes, the behind-the-ear element  40  can be pushed on the strap  20  in the direction toward the end  38 . This offers the advantage of very simple and quick size adjustment of the connecting element  10 . 
     In contrast to the behind-the-ear element  40  according to  FIG.  3     ff , the behind-the-ear element  40  according to  FIG.  15     ff  does not run across the back of the head of a user in a use state. Instead, the behind-the-ear element  40  according to  FIG.  15     ff  is arranged on and/or behind the ear in a use state. The behind-the-ear element  40  can be substantially shorter than in the embodiments according to  FIGS.  11  to  14   . The length L of the behind-the-ear element  40  can be varied by center pieces  45  and/or end pieces  41  of different lengths. 
     The end piece  41  according to  FIGS.  19   / 20  can be substantially shorter than the corresponding center piece  45  of the embodiments according to  FIGS.  11 - 14   .  FIG.  19 A-C  shows a behind-the-ear element  40  which is arranged behind the ear in a use state (see  FIG.  15   ). The length L of the end piece  41  can be in a range from about 10 mm to about 150 mm. Preferably, the length L of the end piece  41  is from about 15 mm to about 100 mm. In the concrete exemplary embodiment according to  FIG.  19   , the length L of the end piece  41  is by way of example about 32 mm. 
       FIG.  20 A-D  shows alternative exemplary embodiments of the behind-the-ear element  40  of the connecting element  10  according to the invention according to  FIG.  15    from the side. It is apparent from  FIG.  20    that the end piece  41  of the behind-the-ear element  40  can have different lengths L.  FIG.  20 A  shows a particularly short exemplary embodiment of a behind-the-ear element  40  with a total length L of about 20 mm. 
     The behind-the-ear element  40  can have different lengths L ( FIG.  20 A-D ). For example, the behind-the-ear element  40  can be long and bent such that it encloses the ear in a use state (not shown) such that the connecting element  10  is held particularly advantageously ( FIG.  20 D ).  FIG.  20 D  shows a particularly long exemplary embodiment of a behind-the-ear element  40  with a total length L of about 150 mm. 
     To sum up, the present invention provides the following items:
     1. A connecting element for a patient interface, which connecting element comprises at least one strap which is configured for connection to the patient interface and comprises two straps and at least one behind-the-ear element.   2. The connecting element of item 1, wherein the at least one behind-the-ear element can be coupled reversibly to the two straps.   3. The connecting element of item 1, wherein the at least one behind-the-ear element can be coupled irreversibly to the two straps.   4. The connecting element of at least one of the preceding items, wherein the two straps comprise a beginning and an end, a coupling system for coupling a strap to the patient interface being disposed and configured adjacent to the beginning, and wherein an end portion to which the behind-the-ear element can be coupled is arranged adjacent to the end.   5. The connecting element of at least one of the preceding items, wherein the two straps are produced at least from a stiffening and at the same time flexible material and/or composite material selected from plastics materials, metals, silicones and foams, preferably from polypropylene.   6. The connecting element of at least one of the preceding items, wherein the two straps have a length L and a width B, a ratio of the length L to the width B being at least about 10:1, preferably at least about 20:1, particularly preferably at least about 25:1.   7. The connecting element of at least one of the preceding items, wherein the behind-the-ear element is manufactured from an elastic material selected from silicones, thermoplastic elastomers, neoprenes and textiles, preferably from silicone.   8. The connecting element of at least one of the preceding items, wherein the behind-the-ear element comprises at least one retaining element which can be coupled to an end portion of a strap.   9. The connecting element of item 8, wherein the retaining element is in the form of a hollow body with a lumen into which the end portion of the strap is placed for coupling at at least one position.   10. The connecting element of at least one of items 8 and 9, wherein the retaining element is displaceably coupled at any desired positions of the end portion and a length adjustment of the connecting element is thus provided.   11. The connecting element of at least one of items 8 to 10, wherein the end portion comprises at least one anchor element for anchoring the coupling of the retaining element to the straps.   12. The connecting element of at least one of items 8 to 11, wherein the end portions alternatively or additionally comprise one or more fixing elements for fixing the coupling of the behind-the-ear element to the straps.   13. The connecting element of item 12, wherein the fixing of the behind-the-ear element to the straps permits a stepwise length adjustment of the connecting element.   14. The connecting element of at least one of the preceding items, wherein the behind-the-ear element has a length L and a width B, a ratio of the length L to the width B of the behind-the-ear element being at least about 1:1, preferably at least about 5:1.   15. The connecting element of at least one of the preceding items, wherein the connecting element comprises two straps and one behind-the-ear element with two retaining elements, wherein one retaining element is coupled to one strap of the two straps and the second retaining element is coupled to the other strap of the two straps, and wherein the one behind-the-ear element runs across a back of a head of a user or patient in a use state.   16. The connecting element of at least one of the preceding items, wherein a ratio of a length L to a width B of the behind-the-ear element is at least about 5:1, preferably at least about 20:1, particularly preferably at least about 30:1.   17. The connecting element of at least one of the preceding items, wherein the behind-the-ear element is in itself adjustable in length and comprises at least one eyelet which is adapted and configured to permit a length adjustment.   18. The connecting element of at least one of the preceding items, wherein the connecting element comprises two straps and two behind-the-ear elements each with a retaining element, wherein a behind-the-ear element is coupled to each of the two straps, and wherein the behind-the-ear elements run behind a ear of a user or patient in a use state.   19. The connecting element of item 18, wherein a ratio of the length L to the width B of the behind-the-ear elements in each case is less than about 20:1, preferably less than about 10:1, particularly preferably less than about 5:1.   20. A system for ventilation and/or respiratory support, wherein the system comprises at least a patient interface, a connecting element for connection to the patient interface, a ventilator, and at least one line, the patient interface being coupled with the connecting element and being connected by the connecting element to a head of a patient, and the patient interface and the ventilator being connected together in a gas-conducting manner by the at least one line, and wherein the connecting element is adapted and configured as set forth in any of the preceding items.   

     Although the present invention has been described in detail with reference to the exemplary embodiments, it will be clear to the person skilled in the art that the invention is not limited to these exemplary embodiments. Rather, modifications are possible such that individual features are omitted or different combinations of the described individual features can be implemented, providing that there is no departure from the scope of protection of the accompanying claims. The present disclosure includes all combinations of the described individual features. 
     
       
         
           
               
             
               
                   
               
               
                 List of reference signs 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                   
                  10 
                 Connecting element 
               
               
                   
                  20 
                 Strap 
               
               
                   
                  22 
                 Coupling system 
               
               
                   
                  24 
                 Fixing element 
               
               
                   
                  25 
                 Anchor element 
               
               
                   
                  26 
                 Coupling element 
               
               
                   
                  30 
                 Beginning 
               
               
                   
                  31 
                 Portion 
               
               
                   
                  32 
                 Inflection point 
               
               
                   
                  33 
                 Portion 
               
               
                   
                  34 
                 Inflection point 
               
               
                   
                  35 
                 Portion 
               
               
                   
                  36 
                 Inflection point 
               
               
                   
                  37 
                 End portion 
               
               
                   
                  38 
                 End 
               
               
                   
                  40 
                 Behind-the-ear element 
               
               
                   
                  41 
                 End piece 
               
               
                   
                  42 
                 Retaining element 
               
               
                   
                  43 
                 End region 
               
               
                   
                  44 
                 End 
               
               
                   
                  45 
                 Center piece 
               
               
                   
                  45i 
                 Second center piece 
               
               
                   
                  46 
                 Eyelet 
               
               
                   
                  46i 
                 Second eyelet 
               
               
                   
                  48 
                 Connecting groove 
               
               
                   
                  49 
                 Opening 
               
               
                   
                  50 
                 Lumen 
               
               
                   
                  60 
                 Head band 
               
               
                   
                  62 
                 Fastening element 
               
               
                   
                  63 
                 End region 
               
               
                   
                  64 
                 End 
               
               
                   
                  70 
                 Ventilator 
               
               
                   
                  80 
                 Line 
               
               
                   
                  90 
                 Patient interface 
               
               
                   
                  91 
                 Nasal pillow 
               
               
                   
                  92 
                 Nasal prong 
               
               
                   
                  93 
                 Hose support 
               
               
                   
                  95 
                 Head 
               
               
                   
                 100 
                 System 
               
               
                   
                 B 
                 Width 
               
               
                   
                 D 
                 Thickness 
               
               
                   
                 F 
                 Tensile force 
               
               
                   
                 J 
                 Cheekbone region 
               
               
                   
                 L 
                 Length 
               
               
                   
                 M1, M2 
                 Center 
               
               
                   
                 R1, R2 
                 Radius 
               
               
                   
                 S 
                 Plane of symmetry 
               
               
                   
                 x 
                 x-axis 
               
               
                   
                 y 
                 y-axis 
               
               
                   
                 z 
                 z-axis 
               
               
                   
                 α1, α2 
                 Central angle 
               
               
                   
                 β 
                 Angle