Devices, systems and methods useable for treating sinusitis

• US 7,771,409 B2
• Filed: 10/30/2007
• Issued: 08/10/2010
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Ha, Hung, Morriss, John H., Makower, Joshua, Muni, Ketan P., Kim, Isaac J., Facteau, William M., Chang, John Y., Vrany, Julia D.
• Primary Examiner(s): Mendez; Manuel A
• Application Number:
  US11/928,160
• Publication Number:
  US 20090093823A1
• Time in Patent Office: 1,015 Days
• Field of Search: 604/96.01, 604/101.01, 604/500, 604/514, 600104-107, 600/153, 606191-194
• US Class Current: 604/514
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/1657 Bone breaking devices
• 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3764 with a rotating C-arm having a cone beam emitting source
• CPC Class Codes: A61B 2503/40 Animals
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61M 2025/0008 having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
• CPC Class Codes: A61M 2025/1079 having radio-opaque markers in the region of the balloon
• CPC Class Codes: A61M 2029/025 characterised by the guiding element
• CPC Class Codes: A61M 2210/0618 Nose
• CPC Class Codes: A61M 2210/1028 Larynx
• 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 25/0662 : Guide tubes
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat. Specific devices (e.g., tubular guides, guidewires, balloon catheters, tubular sheaths) are provided as are methods for manufacturing and using such devices to treat disorders of the ear, nose or throat.

Claims

1. A method of performing a surgery on a paranasal sinus of a human or animal subject, said method comprising:

inserting an endoscope into a head of the subject;

inserting an at least partially rigid guide tool into the head to position a distal end of the guide tool at or near an opening of the paranasal sinus and at least part of the guide tool within a field of view of the endoscope;

advancing at least one tubular device that has at least one flexible region along the guide tool to advance a distal end of the tubular device through the opening of the paranasal sinus and outside the field of view of the endoscope; and

performing a surgery on the paranasal sinus using the tubular device, wherein at least a portion of the tubular device remains outside the field of view of the endoscope during the surgery.

2. A method according to claim 1, wherein the tubular device comprises a dilator apparatus, and wherein performing the surgery comprises using the dilator apparatus to dilate an opening in the paranasal sinus.

3. A method according to claim 2, wherein the dilator apparatus is advanced distally beyond a terminal end of the endoscope.

4. A method according to claim 2, wherein the dilator apparatus comprises a balloon dilation catheter, wherein using the tubular device comprises inflating a balloon of the catheter to dilate the opening, and wherein a portion of the balloon located on an opposite side of the paranasal sinus opening from the endoscope is outside the field of view when the balloon is inflated.

5. A method according to claim 1, wherein the guide tool comprises a guide catheter, the method further comprising advancing a guidewire through the guide catheter prior to advancing the tubular device, wherein the tubular device is advanced over the guidewire through the guide catheter.

6. A method according to claim 1, further comprising suctioning bodily fluid through the guide tool.

7. A method according to claim 1, further comprising passing irrigation fluid through the tubular device into the paranasal sinus.

8. A method according to claim 1, further comprising suctioning bodily fluid through the tubular device while a distal end of the tubular device is located in the paranasal sinus.

9. A method according to claim 1, wherein the endoscope, guide tool and tubular device are inserted through a nostril of the subject'"'"'s head.