Apparatus for treatment of air way obstructions

• US 5,879,349 A
• Filed: 08/12/1996
• Issued: 03/09/1999
• Est. Priority Date: 02/23/1996
• Status: Expired due to Fees

• Current Assignee: Somnus Medical Technologies, Inc. (Olympus Corporation)
• Original Assignee: Somnus Medical Technologies, Inc. (Olympus Corporation)
• Inventors: Edwards, Stuart D.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/695,802
• Time in Patent Office: 939 Days
• Field of Search: 604/22, 606/32, 606/41, 606/45-48, 607/42
• US Class Current: 606/45
• 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 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00814 Surgery of the tongue, e.g. glossoplasty
• CPC Class Codes: A61B 2017/248 Operations for treatment of snoring, e.g. uvulopalatoplasty
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00101 low, i.e. thermally insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00261 : arranged in a line
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00327 : Ear, nose or throat
• CPC Class Codes: A61B 2018/00636 : Sensing and controlling the application of energy
• CPC Class Codes: A61B 2018/00666 : using a threshold value
• CPC Class Codes: A61B 2018/00678 : upper
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00708 : switching the power on or off
• CPC Class Codes: A61B 2018/00744 : Fluid flow
• CPC Class Codes: A61B 2018/00773 : Sensed parameters
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00892 : Voltage
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/003 : using a spray or a foam
• CPC Class Codes: A61B 5/24 : Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/415 : the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61M 2025/0096 : being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/04 : Radiators for near-field treatment
• CPC Class Codes: A61N 5/045 : specially adapted for treatment inside the body

Abstract

An apparatus that reduces a volume of a selected site in an interior of the tongue includes a handpiece and an electrode at least partially positioned in the interior of the handpiece. The electrode includes an electrode electromagnetic energy delivery surface and is advance able from the interior of the handpiece into the interior of the tongue. An electrode advancement member is coupled to the electrode and configured to advance the electrode an advancement distance in the interior of the tongue. The advancement distance is sufficient for the electrode electromagnetic energy delivery surface to deliver electromagnetic energy to the selected tissue site and reduce a volume of the selected site without damaging a hypoglossal nerve. A cable is coupled to the electrode.

Claims

1. An apparatus to reduce a volume of a selected site in an interior of the tongue, comprising:

a handpiece including a handpiece tongue interface surface;

an energy delivery device at least partially positioned in the interior of the handpiece, the energy delivery device including an energy delivery surface and advance able from the interior of the handpiece into the interior of the tongue;

an advancement member coupled to the energy delivery device and configured to advance the energy delivery device an advancement distance in the interior of the tongue, wherein the advancement distance is sufficient for the energy delivery surface to deliver energy to the selected tissue site and reduce a volume of the selected site without permanently damaging a main branch of a hypoglossal nerve, wherein the advancement member advances at least a portion of the energy delivery device through the handpiece tongue interface surface in a lateral direction relative to a longitudinal axis of the handpiece; and

a cable coupled to the energy delivery device.

2. The apparatus of claim 1, wherein the energy delivery device is an RF electrode.

3. The apparatus of claim 2, further comprising:

an RF energy source coupled to the RF electrode.

4. The apparatus of claim 1, further comprising:

a cooling device at least partially positioned in the interior of the handpiece and configured to cool a surface of the tongue.

5. The apparatus of claim 4, further comprising:

a flow rate control device coupled to the cooling device and configured to control a cooling medium flow rate through the cooling device.

6. The apparatus of claim 1, further comprising:

an insulator at least partially positioned around an exterior of the energy delivery device.

7. The apparatus of claim 6, further comprising:

a sensor positioned at a distal end of the insulator.

8. The apparatus of claim 1, further comprising:

a sensor positioned at a distal end of the energy delivery device.

9. The apparatus of claim 1, further comprising:

a sensor positioned on an exterior of the handpiece.

10. The apparatus of claim 1, further comprising:

a first sensor positioned at a distal end of the energy delivery device and a second sensor positioned at a distal end of an insulator, wherein the insulator is at least partially positioned around an exterior of the energy delivery device.

11. The apparatus of claim 1, further comprising:

a feedback control means coupled to the energy delivery device, a sensor and an energy source.

12. The apparatus of claim 1, further comprising:

an infusion medium source coupled to the energy delivery device.

51. The apparatus of claim 1, wherein the energy delivery device is a waveguide configured to be coupled to a light source.

52. The apparatus of claim 1, wherein the energy delivery device is an ultrasound emitter configured to be coupled to an ultrasound source.

53. The apparatus of claim 1, wherein the energy delivery device is a microwave antenna configured to be coupled to a microwave source.

13. An apparatus to reduce a volume of a selected site in an interior of the tongue, comprising:

a handpiece including a handpiece tongue interface surface;

an energy delivery device at least partially positioned in the interior of the handpiece, the energy delivery device including an energy delivery surface and advance able from the interior of the handpiece into the interior of the tongue;

an advancement and retraction member coupled to the energy delivery device and configured to advance at least a portion of the energy delivery device to a placement position in the interior of the tongue, wherein at the placement position the energy delivery surface delivers sufficient energy to reduce a volume of the selected site without permanently damaging a main branch of a hypoglossal nerve, wherein the advancement and retraction member advances at least a portion of the energy delivery device through the handpiece tongue interface surface in a lateral direction relative to a longitudinal axis of the handpiece, and

a cable coupled to the energy delivery device.

14. The apparatus of claim 13, wherein the advancement and retraction member further comprises:

a guide channel configured to receive the energy delivery device in at least a portion of the interior of the handpiece and configured to guide an advancement direction of the energy delivery device from the handpiece into the interior of the tongue.

15. The apparatus of claim 13, wherein the energy delivery device is an RF electrode.

16. The apparatus of claim 15, further comprising:

an RF energy source coupled to the RF electrode.

17. The apparatus of claim 13, further comprising:

a cooling device at least partially positioned in the interior of the handpiece and configured to cool a surface of the tongue.

18. The apparatus of claim 17, further comprising:

a flow rate control device coupled to the cooling device and configured to control a cooling medium flow rate through the cooling device.

19. The apparatus of claim 13, further comprising:

an insulator at least partially positioned around an exterior of the energy delivery device.

20. The apparatus of claim 19, further comprising:

a sensor positioned at a distal end of the insulator.

21. The apparatus of claim 13, further comprising:

a sensor positioned at a distal end of the energy delivery device.

22. The apparatus of claim 13, further comprising:

a sensor positioned on an exterior of the handpiece.

23. The apparatus of claim 13, further comprising:

a first sensor positioned at a distal end of the energy delivery device and a second sensor positioned at a distal end of an insulator, wherein the insulator is at least partially positioned around an exterior of the energy delivery device.

24. The apparatus of claim 13, further comprising:

a feedback control means coupled to the energy delivery device, a sensor and an energy source.

25. The apparatus of claim 13, further comprising:

an infusion medium source coupled to the energy delivery device.

54. The apparatus of claim 13, wherein the energy delivery device is a waveguide configured to be coupled to a light source.

55. The apparatus of claim 13, wherein the energy delivery device is an ultrasound emitter configured to be coupled to an ultrasound source.

56. The apparatus of claim 13, wherein the energy delivery device is a microwave antenna configured to be coupled to a microwave source.

26. An apparatus to reduce a volume of a selected site in an interior of the tongue, comprising:

a handpiece including a handpiece tongue interface surface;

an energy delivery device at least partially positioned in the interior of the handpiece, the energy delivery device including an energy delivery surface and an energy delivery device advancement length extending from an exterior of the handpiece to the interior of the tongue, delivery surface at the selected site and deliver sufficient energy to reduce a volume of the selected tissue site without permanently damaging a main branch of a hypoglossal nerve;

an advancement and retraction member coupled to the energy delivery device and configured to advance and retract at least a portion of the energy delivery device, wherein the advancement and retraction member advances at least a portion of the energy delivery device through the handpiece tongue interface surface in a lateral direction relative to a longitudinal axis of the handpiece; and

a cable coupled to the energy delivery device.

27. The apparatus of claim 26, wherein the energy delivery device is an RF electrode.

28. The apparatus of claim 27, further comprising:

an RF energy source coupled to the RF electrode.

29. The apparatus of claim 26, further comprising:

a cooling device at least partially positioned in the interior of the handpiece and configured to cool a surface of the tongue.

30. The apparatus of claim 29, further comprising:

a flow rate control device coupled to the cooling device and configured to control a cooling medium flow rate through the cooling device.

31. The apparatus of claim 26, further comprising:

an insulator at least partially positioned around an exterior of the energy delivery device.

32. The apparatus of claim 31, further comprising:

a sensor positioned at a distal end of the insulator.

33. The apparatus of claim 26, further comprising:

a sensor positioned at a distal end of the energy delivery device.

34. The apparatus of claim 26, further comprising:

a sensor positioned on an exterior of the handpiece.

35. The apparatus of claim 26, further comprising:

a first sensor positioned at a distal end of the energy delivery device and a second sensor positioned at a distal end of an insulator, wherein the insulator is at least partially positioned around an exterior of the energy delivery device.

36. The apparatus of claim 26, further comprising:

a feedback control means coupled to the energy delivery device, a sensor and an energy source.

37. The apparatus of claim 26, further comprising:

an infusion medium source coupled to the energy delivery device.

57. The apparatus of claim 26, wherein the energy delivery device is a waveguide configured to be coupled to a light source.

58. The apparatus of claim 26, wherein the energy delivery device is an ultrasound emitter configured to be coupled to an ultrasound source.

59. The apparatus of claim 26, wherein the energy delivery device is a microwave antenna configured to be coupled to a microwave source.

38. An apparatus to reduce a volume of a selected site in an interior of the tongue, comprising:

a handpiece including a handpiece tongue interface surface;

an energy delivery device at least partially positioned in the interior of the handpiece and advance able from the interior of the handpiece into the interior of the tongue, wherein the energy delivery device has a geometric shape configured to reduce a volume of the selected site without permanently damaging a main branch of a hypoglossal nerve;

an advancement and retraction member coupled to the energy delivery device and configured to advance and retract at least a portion of the energy delivery device, wherein the advancement and retraction member advances at least a portion of the energy delivery device through the handpiece tongue interface surface in a lateral direction relative to a longitudinal axis of the handpiece; and

a cable coupled to the energy delivery device.

39. The apparatus of claim 38, wherein the energy delivery device is an RF electrode.

40. The apparatus of claim 39, further comprising:

an RF energy source coupled to the RF electrode.

41. The apparatus of claim 38, further comprising:

a cooling device at least partially positioned in the interior of the handpiece and configured to cool a surface of the tongue.

42. The apparatus of claim 41, further comprising:

a flow rate control device coupled to the cooling device and configured to control a cooling medium flow rate through the cooling device.

43. The apparatus of claim 38, further comprising:

an insulator at least partially positioned around an exterior of the energy delivery device.

44. The apparatus of claim 43, further comprising:

a sensor positioned at a distal end of the insulator.

45. The apparatus of claim 38, further comprising:

a sensor positioned at a distal end of the energy delivery device.

46. The apparatus of claim 38, further comprising:

a sensor positioned on an exterior of the handpiece.

47. The apparatus of claim 38, further comprising:

a first sensor positioned at a distal end of the energy delivery device and a second sensor positioned at a distal end of an insulator, wherein the insulator is at least partially positioned around an exterior of the energy delivery device.

48. The apparatus of claim 38, further comprising:

a feedback control means coupled to the energy delivery device, a sensor and an energy source.

49. The apparatus of claim 38, further comprising:

an infusion medium source coupled to the energy delivery device.

60. The apparatus of claim 38, wherein the energy delivery device is a waveguide configured to be coupled to a light source.

61. The apparatus of claim 38, wherein the energy delivery device is an ultrasound emitter configured to be coupled to an ultrasound source.

62. The apparatus of claim 38, wherein the energy delivery device is a microwave antenna configured to be coupled to a microwave source.

50. An apparatus to reduce a volume of a selected site in an interior of the tongue, comprising:

a handpiece including a handpiece tongue interface surface; and

an energy delivery device at least partially positioned in the interior of the handpiece, the energy delivery device including an energy delivery surface and an energy delivery device advancement length extending from an exterior of the handpiece to the interior of the tongue, the energy delivery device having an advancement length sufficient to position the energy delivery surface at the selected site and deliver sufficient energy to reduce a volume of the selected tissue site without permanently damaging a main branch of a hypoglossal nerve, wherein at least a portion of the energy delivery device extends from the handpiece tongue interface surface in a lateral direction relative to a longitudinal axis of the handpiece.