Devices, Systems and Methods for Treating Disorders of the Ear, Nose and Throat

• US 20080097514A1
• Filed: 10/26/2007
• Published: 04/24/2008
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Vrany, Julia, Chang, John, Makower, Joshua, Lamson, Theodore, Walke, Amrish
• Granted Patent: US 8,088,101 B2
• Time in Patent Office: Days
• US Class Current: 606/196
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1608 the two jaw elements being linked to two elongated shaft elements moving longitudinally relative to each other
• CPC Class Codes: A61B 17/1679 for the ear
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/065 : Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 50/13 : Trolleys, e.g. carts
• CPC Class Codes: A61B 50/15 : Mayo stands; Tables
• CPC Class Codes: A61B 50/20 : Holders specially adapted for surgical or diagnostic appliances or instruments drapes with means to hold surgical instruments A61B46/23; for catheters A61M25/02
• CPC Class Codes: A61B 90/16 : Bite blocks
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 11/202 : Surgical middle-ear ventilation or drainage, e.g. permanent; Implants therefor
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2250/0067 : Means for introducing or releasing pharmaceutical products into the body
• CPC Class Codes: A61M 2025/105 : having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/007 : Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00

Abstract

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

Claims

1. A device for occluding a nostril of a human or animal subject while permitting a catheter, guidewire or other working device to be inserted through that nostril, said device comprising:

an occluder member that conforms to the shape of the nostril in which it is inserted; and

a passageway that extends through said occluder member to permit the catheter, guidewire or other working device to be inserted through the occluder member when the occluder member is positioned within the nostril.

2. A device according to claim 1 wherein the occluder member comprises a resilient material that may be compressed, inserted into the nostril while in a compressed state and subsequently allows to re-expand to a non-compressed state wherein it conforms to the shape of the nostril in which it is positioned.

3. A device according to claim 1 wherein the occluder member comprises a balloon that is sufficiently compliant to conform to the shape of the nostril in which it is positioned.

5. A device according to claim 1 wherein the occluder balloon has one or more ribs formed on its outer surface to frictionally engage the adjacent anatomical wall of the nostril in which it is positioned to resist pulling of the device out of the nostril.

4. A device for occluding a nostril of a human or animal subject while permitting a catheter, guidewire or other working device to be inserted through that nostril, said device comprising:

an occluder balloon that occludes the nostril, said balloon being configured to resist pulling of the device out of the nostril; and

a passageway that extends through said occluder balloon to permit the catheter, guidewire or other working device to be inserted through the occluder balloon when the occluder balloon is positioned within the nostril.

6. An adhesive device useable to resist pulling of a device out of a nostril of a human or animal subject, said device comprising:

a flexible article having an inner adhesive surface and an outer non-adhesive surface, said flexible article being shaped such that a portion of the device may be positioned over the nares to deter pulling of the device from the nostril and at least a portion of the inner adhesive surface is adhered to skin to hold the device in place.

7. A device according to claim 6 wherein the article has upper wings that adhere to the skin in the sides of the nose and/or cheeks adjacent to the nose.

8. A device according to claim 6 wherein the article has lower wings that adhere to the skin of the upper lip and/or face adjacent to the upper lip.

9. A device according to claim 6 wherein an opening is formed in the portion of the device that is positioned over the nares to permit insertion of a catheter, guidewire or other working device through said opening and through the nostril.

10. A device for occluding the nasal cavity or nasopharynx of a human or animal subject, posterior to the intranasal septum, said device comprising:

a tube having a proximal portion of a first diameter and a distal portion of a second diameter that is larger than said first diameter;

a balloon mounted on the distal portion of the tube;

said tube being insertable through a nostril to a position where the distal portion of the tube is posterior to the intranasal septum, said balloon being thereafter inflatable to substantially block the nasal cavity or nasopharynx posterior to the nasal septum.

11. A device according to claim 10 further comprising at least one aperture formed in the tube proximal to the balloon to facilitate suctioning of matter from the nasal cavity proximal to the balloon.

12. A device according to claim 10 further comprising an anterior occluder on the proximal portion of the tube for occluding the nostril through which the tube is inserted.

a dilator located proximal to the intrasinus balloon, said dilator being useable to dilate the ostium.