Method for treating obstructive sleep disorder includes removing tissue from the base of tongue

• US 20040006339A1
• Filed: 07/02/2003
• Published: 01/08/2004
• Est. Priority Date: 06/07/1995
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Ellsberry, Maria B., Underwood, Ronald A.
• Granted Patent: US 7,090,672 B2
• Time in Patent Office: Days
• US Class Current: 606/45
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 2018/165 : Multiple indifferent electrodes
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

A method for treating obstructive sleep disorders includes accessing the interior of the tongue through an incision made in the skin in the vicinity of the jaw of a patient; advancing an instrument through the incision into the interior of the tongue; and removing an amount of tissue from the interior of the base of the tongue with the instrument. The present invention includes forming a cavity or plurality of channels in the tongue. The cavity may be collapsed using a suture, fastener or bioadhesive. An emplaced suture may be provided to hold the cavity in a collapsed position thereby reducing the degree of obstruction. Additionally, thermal energy may be applied to the tissue surface immediately surrounding the channels to cause thermal damage to the tissue surface, thereby creating hemostasis and stiffening the surrounding tissue structure.

Claims

1. A method for treating obstructive sleep disorders, the method comprising:

accessing the interior of the tongue through an incision made in the skin in the vicinity of the jaw of a patient;

advancing an instrument through the incision into the interior of the tongue; and

removing an amount of tissue from the interior of the base of the tongue with the instrument.

2. The method of claim 1, wherein the incision is made under the jaw between the mandible and the hyoid bone.

3. The method of claim 1, wherein the accessing the interior of the tongue comprises creating a channel in the tissue between the incision and the interior of the tongue.

4. The method of claim 3, wherein the channel passes through the mylohyoid and the geniohyoid muscles into the genioglossus muscle.

5. The method of claim 1, wherein the instrument is an electrosurgical instrument.

6. The method of claim 5, wherein the electrosurgical instrument has a curved distal end.

7. The method of claim 1, wherein the removing of tissue comprises:

applying a high frequency voltage difference between one or more active electrodes and one or more return electrodes; and

providing an electrically conductive medium over at least a portion of the one or more active electrodes and the tissue to be removed.

8. The method of claim 7, further comprising coagulating tissue in a region adjacent to the location where tissue is removed.

9. The method of claim 1, wherein the removing of tissue is performed without breaching the mucosal surface of the tongue.

10. The method of claim 8, wherein the applying thermal energy is performed subsequently to the applying a high frequency voltage.

11. The method of claim 1, wherein the removing of tissue comprises forming a cavity within the interior of the base of the tongue.

12. The method of claim 7, further comprising collapsing the cavity.

13. The method of claim 12, further comprising suturing the cavity.

14. The method of claim 12, further comprising stapling the cavity.

15. The method of claim 12, further comprising gluing the cavity.

16. The method of claim 1, wherein the removing of tissue decreases the volume of the tongue by about 5% to about 15%.

17. The method of claim 1, wherein the instrument removes tissue through a mechanical process.

24. A kit for treating obstructive sleep disorders comprising:

at least one instrument for removing tissue; and

instructions for using the at least one instrument according to the method of claim 1.

25. The kit of claim 24, further comprising a closure instrument.

26. The kit of claim 25, further comprising at least one closure means.

27. The kit of claim 25, wherein the closure instrument comprises one of the group consisting of a suturing instrument, a stapling instrument and a biological glue dispenser.

28. The kit of claim 26, wherein the closure means comprises one of the group consisting of a suture, a staple and a biological glue.

19. A method for treating obstructive sleep disorders, the method comprising:

forming a cavity within the interior of the tongue without breaching the mucosal surface of the tongue.

18. The method of claim 19, wherein the instrument is a rotary shaver.

21. The method of claim 19, further comprising permanently collapsing the cavity.

20. The method of 19, further comprising accessing the interior of the tongue without accessing an opening of the mouth in order to form the cavity.

22. A method for accessing the interior of the tongue, the method comprising:

making an incision under the jaw of a patient; and

channeling through tissue to within the interior of the tongue.

23. The method of claim 22, wherein the tissue channeled comprises the mylohyoid muscle, the geniohyoid muscle and the genioglossus muscle.

29. An emplaced suture for treating obstructive sleep disorders, the emplaced suture comprising:

a length from about 3 to about 6 inches extending between two ends wherein the ends are secured together at a securement location under the chin, the length being selected to extend between the base of the tongue and the securement location.

30. The emplaced suture of claim 29 further comprising a knot securing the ends together.

31. The emplaced suture of claim 29 wherein a pledget is provided at the securement location.

32. The emplaced suture of claim 29 wherein the suture is bio-resorbable.

33. The emplaced suture of claim 29 wherein the suture is non-resorbable.

34. The emplaced suture of claim 29 wherein said length of the suture is sufficient to provide a distance between the securement location and the base of tongue is from about 1 to 2 inches.