Devices, systems and methods for treating disorders of the ear, nose and throat

• US 7,727,226 B2
• Filed: 10/29/2007
• Issued: 06/01/2010
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Makower, Joshua, Lamson, Theodore C., Walke, Amrish Jayprakash, Chang, John Y., Vrany, Julia D.
• Primary Examiner(s): Sirmons; Kevin C
• Assistant Examiner(s): Hall; Deanna K
• Application Number:
  US11/926,524
• Publication Number:
  US 20080097516A1
• Time in Patent Office: 946 Days
• Field of Search: 600/461, 606/185, 606/196, 604/73, 604/543
• US Class Current: 604/543
• 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 method for treating a flowable-substance-containing structure located within a paranasal sinus, said method comprising the steps of:

advancing a distal end of a guide device to a position in or near an opening into a paranasal sinus;

advancing a penetrator over or through the guide into the paranasal sinus;

advancing the penetrator into the flowable-substance-containing structure to form an opening in the structure; and

expanding a compressor in the paranasal sinus to compress the flowable-substance-containing structure and thus force flowable substance out of the opening formed by the penetrator.

2. A method as in claim 1, wherein advancing the guide comprises advancing a tubular guide through a nostril, and wherein the penetrator is advanced through the tubular guide.

3. A method as in claim 2, further comprising, before advancing the penetrator, advancing a guidewire through the tubular guide into the paranasal sinus, wherein the penetrator is advanced over the guidewire and through the guide.

4. A method as in claim 3, wherein the penetrator and the compressor are coupled together in a penetrator/compressor device, wherein advancing the penetrator into the structure comprises advancing a penetrating member out of the penetrator/compressor device, and wherein expanding the compressor comprises inflating a balloon of the penetrator/compressor device.

5. A method as in claim 3, further comprising, before the expanding step:

removing the penetrator through the guide; and

advancing the compressor into the paranasal sinus through the guide and over the guidewire, wherein expanding the compressor comprises inflating a balloon catheter.

6. A method as in claim 4, further comprising:

removing the penetrator and compressor from the paranasal sinus;

advancing an irrigation catheter over or through the guide into the sinus; and

passing irrigation fluid through the irrigation catheter into the sinus.

7. A method as in claim 1, wherein the flowable-substance-containing structure is selected from the group consisting of mucocysts, cysts, hematomas and pustules.

8. A method for treating a flowable-substance-containing structure located within a paranasal sinus, said method comprising the steps of:

advancing a tubular guide device through a nostril to a position a distal end of the guide in or near an opening into a paranasal sinus;

advancing a penetrator/compressor device through the guide device into the paranasal sinus;

advancing a penetrating member of the penetrator/compressor into the flowable-substance-containing structure to form an opening in the structure; and

expanding a compressing member of the penetrator/compressor in the paranasal sinus to compress the flowable-substance-containing structure such that its contents will be forced out of the opening formed by the penetrating member.

9. A method as in claim 8, further comprising, before advancing the penetrator/compressor, advancing a guidewire through the tubular guide into the paranasal sinus, wherein the penetrator/compressor is advanced over the guidewire and through the guide.

10. A method as in claim 8, wherein expanding the compressor comprises inflating a balloon of the penetrator/compressor device.

11. A method as in claim 8, further comprising:

removing the penetrator/compressor from the paranasal sinus;

advancing an irrigation catheter over or through the guide into the sinus; and

passing irrigation fluid through the irrigation catheter into the sinus.