METHOD AND SYSTEM FOR TREATING TARGET TISSUE WITHIN THE EUSTACHIAN TUBE

• US 20100198191A1
• Filed: 12/29/2009
• Published: 08/05/2010
• Est. Priority Date: 12/20/2007
• Status: Abandoned Application

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Morriss, John H., Clifford, Anton G., Makower, Joshua, Bright, Earl A. II, Goldfarb, Eric, Chang, John Y., Vrany, Julia D.
• Application Number:
  US12/649,078
• Publication Number:
  US 20100198191A1
• Time in Patent Office: Days
• US Class Current: 604/514
• CPC Class Codes: A61B 1/227 for ears, i.e. otoscopes
• 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 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 5/036 by means introduced into body tracts A61B5/032 and A61B5/035 take precedence
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61F 11/20 Ear surgery
• CPC Class Codes: A61F 11/202 Surgical middle-ear ventilation or drainage, e.g. permanent; Implants therefor
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/0039 characterized by lumina being arranged coaxially
• CPC Class Codes: A61M 2025/09008 having a balloon
• CPC Class Codes: A61M 2025/09183 having tools at the distal tip
• 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 2025/1054 having detachable or disposable balloons
• CPC Class Codes: A61M 2025/1086 having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
• 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 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/007 : Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/008 : Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0662 : Guide tubes
• CPC Class Codes: A61M 25/09 : Guide wires
• 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
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104
• CPC Class Codes: A61M 31/002 : Devices for releasing a drug at a continuous and controlled rate for a prolonged period of time artificial gland structures or devices A61F2/022; intra-uterine contraceptive devices A61F6/14; tampons for introducing into the vagina A61F13/20, A61L15/00; suppositories or bougies for intra-vaginal or intra-uterine application A61K9/02; physical forms of medicinal preparations for sustained or differential drug release A61K9/20, A61K9/50
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

Methods and systems for accessing a Eustachian tube of a patient are disclosed. The system includes a guide configured for passing into a nasal passage of the patient to position a distal tip of the catheter at or near a Eustachian tube, the guide having a distal tip with a bend having an angle between 30 and 90 degrees; and a guidewire configured to pass through the guide into the Eustachian tube. A device for providing therapy to the Eustachian tube is passed through the guide.

Claims

1. A method for dilating a Eustachian tube of a patient, the method comprising:

advancing a guide catheter through a nasal passage of the patient to position a distal end of the guide catheter at or near an opening of the Eustachian tube of the patient, wherein a distal portion of the guide catheter includes a bend having an angle between 30 and 90 degrees, and wherein the distal portion is more flexible than a proximal portion of the guide catheter;

advancing a guidewire through the guide catheter such that a distal end of the guidewire enters the Eustachian tube;

advancing a dilation catheter over the guidewire to position a dilator of the dilation catheter within the Eustachian tube;

expanding the dilator to dilate the Eustachian tube; and

removing the dilation catheter and guidewire from the patient.

2. The method of claim 1, wherein the distal portion of the guide catheter is malleable, the method further comprising forming, by a user of the guide catheter, the bend in the distal portion.

3. The method of claim 1, wherein the opening of the Eustachian tube comprises a pharyngeal ostium of the Eustachian tube, and wherein the dilation catheter is advanced to position the dilator in the pharyngeal ostium.

4. The method of claim 1, wherein the guidewire comprises an illuminating guidewire, the method further comprising:

emitting light from the illuminating guidewire; and

viewing the emitted light.

5. The method of claim 4, wherein the emitted light is viewed using an endoscope positioned in the patient'"'"'s head.

6. The method of claim 1, further comprising removing the guide catheter from the patient before advancing the dilation catheter over the guidewire.

7. The method of claim 1, wherein the dilation catheter is advanced over the guidewire and through the guide catheter, and wherein the removing step further comprises removing the guide catheter from the patient.

8. The method of claim 1, wherein the dilation catheter comprises a balloon dilation catheter, and wherein expanding the dilator comprises inflating a balloon of the balloon dilation catheter.

9. The method of claim 8, wherein inflating the balloon expands a stent within the Eustachian tube.

10. The method of claim 8, wherein the dilation catheter includes lateral wings adjacent to the balloon, and wherein expanding the dilator further comprises using the lateral wings to maintain the position of the balloon.

11. The method of claim 8, wherein the balloon is shaped when inflated to match a conical aperture of a pharyngeal ostium of the Eustachian tube ET, and wherein expanding the dilator further comprises expanding the balloon within the pharyngeal ostium of the Eustachian tube ET.

12. The method of claim 8, wherein the balloon is shaped to have a cross-section which does not occupy the entirety of the Eustachian tube, and wherein expanding the dilator further comprises maintaining the balloon in position to relieve pressure within the Eustachian tube.

13. The method of claim 8, wherein the balloon includes cutting members, and wherein expanding the dilator further comprises cutting the Eustachian tube wall with the cutting members.

14. The method of claim 1, further comprising:

advancing an endoscope through the nasal passage; and

viewing the dilation catheter with using the endoscope.

15. The method of claim 1, wherein viewing the dilation catheter comprises viewing a marker on a shaft of the catheter, and wherein the method further comprises approximating a location of the dilator relative to the opening of the Eustachian tube based on a distance of the marker from a proximal end of the dilator.

16. The method of claim 1, further comprising:

applying at least one substance to the Eustachian tube using the dilator.

17. The method of claim 16, wherein the dilator comprises a porous balloon for delivering the substance.

18. The method of claim 16, wherein the dilator comprises a balloon with a plurality of needles for delivering the substance.

19. The method of claim 1, wherein the dilation catheter applies a force against the Eustachian tube to maintain a position of the dilator during expanding.

20. A method for dilating a Eustachian tube of a patient, the method comprising:

advancing a guide catheter through a nasal passage of the patient to position a distal end of the guide catheter at or near an opening of the Eustachian tube of the patient, wherein a distal portion of the guide catheter includes a bend having an angle between 30 and 90 degrees, and wherein the distal portion is more flexible than a proximal portion of the guide catheter;

advancing a delivery catheter through the guide catheter to place the delivery catheter within the Eustachian tube;

delivering an elongate substance delivery device into the Eustachian tube using the delivery catheter; and

removing the dilation catheter and guidewire from the patient while leaving the elongate drug delivery device in the Eustachian tube.

21. The method of claim 20, wherein the elongate substance delivery device is an elongate string configured to elute at least one substance.

22. The method of claim 21, wherein delivering the elongate substance delivery device comprises internally detaching the elongate string from the delivery catheter.

23. The method of claim 21, wherein delivering the elongate substance delivery device comprises externally detaching the elongate polymer string from the delivery catheter.

24. The method of claim 20, wherein the elongate substance delivery device is a balloon configured to elute the substance over time.

25. The method of claim 24, wherein delivering the elongate drug deliver device comprises inflating the balloon within the Eustachian tube and decoupling the balloon from the delivery catheter.

26. The method of claim 25, wherein the balloon is configured to allow pressure equalization within the Eustachian tube.

27. The method of claim 20, wherein the elongate drug delivery device is an expandable stent.

28. The method of claim 27, wherein delivering the elongate drug delivery device comprises inserting the expandable stent into the Eustachian tube and unconstraining a proximal end of the expandable stent to allow the proximal end of the expandable stent to expand within the Eustachian tube.

29. The method of claim 20, wherein the elongate drug delivery device is an elongate insert including an elongate central member connected to a plurality of braces, each brace being connected to an elongate outer member.

30. The method of claim 29, wherein the braces provide and maintain open spaces in the Eustachian tube to maintain pressure equalization therein.