Use of mechanical dilator devices to enlarge ostia of paranasal sinuses and other passages in the ear, nose, throat and paranasal sinuses

• US 20070135789A1
• Filed: 01/18/2007
• Published: 06/14/2007
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Chang, John, Makower, Joshua, Ha, Hung, Morriss, John, Vrany, Julia, Muni, Ketan, Facteau, William, Walke, Amrish, Kim, Isaac
• Granted Patent: US 8,858,586 B2
• Time in Patent Office: Days
• US Class Current: 604/500
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/1657 Bone breaking devices
• CPC Class Codes: A61B 17/1688 for the sinus or nose
• CPC Class Codes: A61B 17/24 for use in the oral cavity, larynx, bronchial passages or nose for medical inspection of cavities or tubes in the body A61B1/00; Tongue scrapers
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3764 with a rotating C-arm having a cone beam emitting source
• CPC Class Codes: A61B 2503/40 Animals
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61M 2025/0008 having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
• CPC Class Codes: A61M 2025/1079 having radio-opaque markers in the region of the balloon
• CPC Class Codes: A61M 2029/025 characterised by the guiding element
• CPC Class Codes: A61M 2210/0618 Nose
• CPC Class Codes: A61M 2210/1028 Larynx
• CPC Class Codes: A61M 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0054 : with regions for increasing flexibility
• CPC Class Codes: A61M 25/0662 : Guide tubes
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat. Specific devices (e.g., tubular guides, guidewires, balloon catheters, tubular sheaths) are provided as are methods for manufacturing and using such devices to treat disorders of the ear, nose or throat.

Claims

1-197. -197. (canceled)

198. A method for using a mechanical dilator that has a non-expanded configuration and an expanded configuration to dilate an opening or passage in the nose or paranasal sinus of a subject, said method comprising the steps of:

(A) positioning the mechanical dilator, while in its non-expanded configuration, within the opening or passage to be dilated; and

(B) expanding the dilator to its expanded configuration causing dilation of the opening or passage.

199. A method according to claim 198 wherein the opening or passage comprises the ostium of a paranasal sinus.

200. A method according to claim 199 wherein Step B results in breaking or remodeling of bone adjacent to the ostium.

201. A method according to claim 198 wherein Step B comprises causing the dilator to shorten as it expands.

202. A method according to claim 198 wherein the mechanical dilator comprises at least one moveable member, the moveable member being moveable from a first position to a second position thereby causing the mechanical dilator to transition from its non-expanded configuration to its expanded configuration, and wherein:

Step A comprises positioning the mechanical dilator within the opening or passage while the moveable member is in the first position and the dilator is in its non-expanded configuration; and

Step B comprises moving the moveable member to the second position, thereby causing the dilator to transition to its expanded configuration to cause dilation of the opening or passage.

203. A method according to claim 202 wherein the moveable member comprises an elongate member that moves longitudinally from the first position to the second position during performance of Step B.

204. A method according to claim 203 wherein the moveable member comprises a screw member that rotatably moves from the first position to the second position during performance of Step B.

205. A method according to claim 203 wherein the moveable member comprises a pullable member that is pulled from the first position to the second position during performance of Step B.

206. A method according to claim 202 wherein the mechanical dilator comprises at least one bendable member that bends as the dilator transitions to its expanded configuration in Step B.

207. A method according to claim 206 wherein said at least one bendable member bows outwardly in Step B.

208. A method according to claim 202 wherein the mechanical dilator comprises a bendable region.

209. A method according to claim 208 wherein said bendable region expands radially in Step B.

210. A method according to claim 209 wherein the bendable region foreshortens as it expands radially in Step B.

211. A method according to claim 198 wherein the mechanical dilator comprises a plurality of members that spread apart in Step B.

212. A method according to claim 211 wherein the members that spread apart in Step B are hemi-tubular in configuration.

213. A method according to claim 211 wherein the members spread apart in diametrically opposite directions in Step B.

214. A method according to claim 198 wherein the mechanical dilator comprises a plurality of displaceable members that are displaced so as to expand radially in Step B.