Endoscopic methods and devices for transnasal procedures

• US 20070293727A1
• Filed: 07/31/2007
• Published: 12/20/2007
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Goldfarb, Eric, Morriss, John, Chang, John
• Granted Patent: US 9,265,407 B2
• Time in Patent Office: Days
• US Class Current: 600/178
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/0014 Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/044 for absorption imaging
• CPC Class Codes: A61B 1/0607 for annular illumination
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 17/24 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 17/3421 Cannulas
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Medical devices, systems and methods that are useable to facilitate transnasal insertion and positioning of guidewires and various other devices and instruments at desired locations within the ear, nose, throat, paranasal sinuses or cranium.

Claims

1. A method for positioning a working device at a desired location within the ear, nose, throat or cranium of a human or animal subject, said method comprising the steps of:

(A) inserting an endoscope into or through the first channel of a guide device that includes an elongate shaft, a distal end a second channel into which a working device may be inserted and a first channel into which the endoscope is inserted;

(B) inserting the guide device into or through a nostril of the subject;

(C) inserting the working device into or through the second channel; and

(D) using the endoscope to view, guide or verify the positioning of the guide device and/or the working device.

2. The method of claim 1, further comprising inserting a second endoscope into or through the nostril.

3. The method of claim 2, wherein the second endoscope is used to view, guide or verify the positioning of the guide device and/or the working device.

4. The method of claim 1, wherein the working device includes a guidewire, said method further comprising advancing another device over the guidewire.

5. The method of claim 1, wherein the working device includes an illuminating guidewire.

6. The method of claim 5, further comprising advancing another device over the illuminating guidewire.

7. The method of claim 1, wherein the desired location is within or adjacent to a natural or man made opening in a paranasal sinus or air cell, or within a paranasal sinus or air cell.

8. The method of claim 1, wherein the desired location is within a Eustachian tube or within the nasopharyngeal opening of a Eustachian tube.

9. The method of claim 1, wherein the desired location is within the middle ear and wherein advancement of the working device is performed through a Eustachian tube.

10. The method of claim 1, wherein the desired location is within a nasolacrimal duct.

11. The method of claim 1, wherein the desired location is within the cranial vault and wherein advancement of the working device is performed to pass through skull bone into the cranial vault.

12. The method of claim 1, wherein the desired location is in contact with or adjacent to the pituitary gland.

13. The method of claim 1, wherein the desired location is in contact with or adjacent to a pathological lesion, tumor, abscess, mucocoele, polyp, cyst, fracture, or other disease-affected tissue.

14. The method of claim 1, wherein the order of performance of steps A-D is different from the order recited.

15. The method of claim 1, wherein the first channel of the guide device comprises an endoscope lumen, wherein the endoscope is longitudinally advanced into or through the endoscope lumen.

16. The method of claim 1, wherein the first channel is substantially continuous over an entire length of the elongate shaft and has a distal end, wherein the endoscope is advanced to or out of the distal end of the first channel.

17. The method of claim 1, wherein the first channel comprises a proximal first channel having a distal end and a distal first channel having a proximal end, wherein the endoscope is advanced through the proximal first channel and out of its distal end, then inserted into the proximal end of the distal first channel.

18. The method of claim 17, wherein the distal first channel has a distal end, and wherein the endoscope is advanced to a position where it is adjacent to or out of the distal end of the distal first channel.

19. The method of claim 17, wherein the guide device includes a sheath member, wherein the sheath member is positioned over a portion of the endoscope between the distal end of the proximal first channel and the proximal end of the distal first channel.

20. The method of claim 1, wherein the working device is advanced to or out of the distal end of the second channel of the guide device.

21. The method of claim 1, wherein the endoscope is used to view, guide or visually verify the position of the working device.

22. The method of claim 1, wherein the working device comprises a guidewire, and wherein a second working device is advanced over the guidewire.

23. The method of claim 22, wherein the guidewire is an illuminating guidewire.

24. The method of claim 22, wherein the second working device comprises a catheter having a dilator thereon and the dilator is used to dilate an opening or anatomical structure.

25. The method of claim 24, wherein the dilator comprises a balloon.

26. The method of claim 24, wherein the opening or anatomical structure is an opening of a paranasal sinus.

27-95. -95. (canceled)