System and method for hyoidplasty

• US 20050126563A1
• Filed: 12/15/2003
• Published: 06/16/2005
• Est. Priority Date: 12/15/2003
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Dineen, Michael T., van der Burg, Erik J.
• Granted Patent: US 8,821,495 B2
• Time in Patent Office: Days
• US Class Current: 128/200.240
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/8071 for the jaw
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61F 2/00 Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents as cosmetic articles, see the relevant subclasses, e.g. wigs, hair pieces, A41G3/00, A41G5/00; artificial nails A45D31/00; dental prostheses A61C13/00; materials for prostheses A61L27/00; artificial hearts A61M60/00; artificial kidneys A61M1/14
• CPC Class Codes: A61F 5/56 Devices for preventing snoring by influencing the respiratory system by gas treatment A61M16/00
• CPC Class Codes: A61M 16/0472 Devices for performing a tracheostomy

Abstract

Methods and devices are disclosed for manipulating the hyoid bone, such as to treat obstructive sleep apnea. An implant is positioned adjacent a hyoid bone. The spatial orientation of the hyoid bone is manipulated, to affect the configuration of the airway. The implant restrains the hyoid bone in the manipulated configuration. The implant is positioned adjacent to pharyngeal structures to dilate the pharyngeal airway and/or to support the pharyngeal wall against collapse.

Claims

1. A method of treating a patient, comprising the steps of:

providing a hyoid bone support, having a first arm and a second arm which are transformable from a moveable relationship with respect to each other to a fixed relationship with respect to each other;

attaching the first arm to a first part of a hyoid bone;

attaching the second arm to a second part of the hyoid bone;

changing the configuration of the hyoid bone, and

securing the support in the fixed relationship.

2. A method of treating a patient as in claim 1, wherein the changing the configuration step comprises increasing a lateral distance between the first and second parts.

3. A method of treating a patient as in claim 1, wherein the changing the configuration step comprises increasing an anterior-posterior distance between the first and second parts of a hyoid bone.

4. A method of treating a patient as in claim 3, wherein the increasing the anterior-posterior distance of the changing the configuration step comprises inserting at least one spacer between the first and second parts of the hyoid bone.

5. A method of treating a patient as in claim 3, wherein the increasing the anterior-posterior distance of the changing the configuration step comprises attaching a brace to the first and second arms of the hyoid bone support to expand the distance between the first and second arms of the hyoid bone support.

6. A method of treating a patient as in claim 1, wherein the changing the configuration step is accomplished before at least one of the attaching steps.

7. A method of treating a patient as in claim 1, wherein the changing the configuration step is accomplished following both of the attaching steps.

8. A method of treating a patient as in claim 1, wherein at least one of the attaching steps comprises using a bone screw.

9. A method of treating a patient as in claim 1, wherein at least one of the attaching steps comprises using a bone clip.

10. A method of treating a patient as in claim 1, wherein at least one of the attaching steps comprises using a suture.

11. A method of treating a patient as in claim 1, wherein at least one of the attaching steps comprises using an adhesive.

12. A method of treating a patient as in claim 1, wherein at least one of the attaching steps comprises using a mechanical interfit between the hyoid bone and the hyoid bone support.

13. A method of treating a patient, comprising the steps of:

accessing a hyoid bone, having a first and a second greater horn spaced apart by a first distance;

increasing the space between the first and second greater horns to a second distance; and

restraining the first and second greater horns at the second distance.

14. A method of treating a patient as in claim 13, wherein the accessing step comprises accessing a human hyoid bone.

15. A method of treating a patient as in claim 13, wherein the accessing step is accomplished in a minimally invasive procedure.

16. A method of treating a patient as in claim 13, wherein the increasing the space step comprises flexing the hyoid bone.

17. A method of treating a patient as in claim 13, wherein the increasing the space step comprises separating the hyoid bone into at least two components.

18. A method of treating a patient as in claim 13, wherein the increasing the space step comprises separating the hyoid bone into at least three components.

19. A method of treating a patient as in claim 13, wherein the second distance is at least about 110% of the first distance.

20. A method of treating a patient as in claim 13, wherein the second distance is at least about 120% of the first distance.

21. A method of treating a patient as in claim 13, wherein the second distance is at least about 130% of the first distance.

22. A method of treating a patient as in claim 13, wherein the restraining step comprises securing the hyoid bone to a hyoid bone support.

23. A method of performing hyoidplasty as in claim 13, wherein the restraining step is accomplished without attaching an implant to the hyoid bone.

24. A method of treating a patient, comprising the steps of:

identifying a hyoid bone, having a first and a second greater horns and a midpoint on the hyoid bone half way between the ends of the first and a second greater horns such that a first line extending from the midpoint through an end of the first greater horn and a second line extending from the midpoint through an end of the second greater horn define an angle therebetween;

increasing the angle; and

securing the hyoid bone to retain the increased angle.

25. The method of treating a patient as in claim 24, further comprising minimally invasively accessing the hyoid bone.

26. A method of treating a patient as in claim 24, wherein the hyoid bone also comprises an arc length along the hyoid bone between the ends of the first and second greater horns;

and the method additionally comprises the step of increasing the arc length.

27. An implant for attachment to a hyoid bone, comprising:

an implant body;

a first attachment zone configured for attachment to a first portion of a hyoid bone;

a second attachment zone configured for attachment to a second portion of a hyoid bone;

a connection between the first and second attachment zones which allows movement of the first and second attachment zones with respect to each other; and

a lock carried by the body, for fixing the relationship between the first and second attachment zones.

28. An implant for attachment to a hyoid bone as in claim 27, wherein the connection comprises a flexible portion of the body.

29. An implant for attachment to a hyoid bone as in claim 27, wherein the connection comprises a hinge.

30. An implant for attachment to a hyoid bone as in claim 27, wherein the connection comprises a flexible element carried by the body.

31. An implant for attachment to a hyoid bone as in claim 27, wherein the lock comprises a threaded shaft.

32. An implant for attachment to a hyoid bone as in claim 27, wherein the lock comprises an interference fit.

33. A method of treating a patient, comprising the steps of:

providing a pharyngeal support, having a first arm and a second arm which are transformable from a moveable relationship with respect to each other to a fixed relationship with respect to each other;

positioning the first arm with respect to a first part of a pharynx;

positioning the second arm with respect to a second part of the pharynx;

changing the configuration of the pharynx, and

securing the support in the fixed relationship.

34. A method of treating a patient as in claim 33, wherein at least one positioning step comprises an interference fit formed in a fascial plane in proximity to a pharyngeal wall.

35. A method of treating a patient as in claim 34, wherein at least one positioning step comprises an interference fit formed in a fascial plane between two pharyngeal muscles.

36. A method of treating a patient as in claim 35, wherein at least one pharyngeal muscle is a suprahyoid muscle.

37. A method of treating a patient as in claim 35, wherein at least one pharyngeal muscle is an infrahyoid muscle.

38. A method of treating a patient as in claim 33, further comprising attaching at least one arm to a part of the pharynx.

39. A method of treating a patient as in claim 38, wherein the attaching step occurs before the changing the configuration step.

40. A method of treating a patient as in claim 38, wherein the attaching step occurs after the changing the configuration step.

41. A method of treating a patient as in claim 38, wherein the attaching step is performed using a tissue anchor.

42. A method of treating a patient as in claim 38, wherein the attaching step is performed using a hook.

43. A method of treating a patient as in claim 38, wherein the attaching step is performed using a suture.

44. A method of treating a patient as in claim 38, wherein the attaching step is performed using a clip.

45. A method of treating a patient as in claim 38, wherein the attaching step is performed using an adhesive.

46. An implant for positioning in a pharyngeal structure, comprising:

an implant body;

a first tissue contact zone configured for contacting a first portion of a pharyngeal structure;

a second tissue contact zone configured for contacting a second portion of a pharyngeal structure;

a connection between the first and second contact zones which allows movement of the first and second contact zones with respect to each other; and

a lock carried by the body, for fixing the relationship between the first and second contact zones.

47. An implant for positioning in a pharyngeal structure as in claim 46, wherein at least one portion of the pharyngeal structure comprises a suprahyoid muscle.

48. An implant for positioning in a pharyngeal structure as in claim 46, wherein at least one portion of the pharyngeal structure comprises a hyoid bone.

49. An implant for positioning in a pharyngeal structure as in claim 46, wherein at least one portion of the pharyngeal structure comprises an infrahyoid muscle.