System and method for percutaneous glossoplasty

• US 7,992,567 B2
• Filed: 02/07/2006
• Issued: 08/09/2011
• Est. Priority Date: 02/08/2005
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Frazier, Andrew, Jackson, Jasper, Dineen, Michael, van der Burg, Erik, Hirotsuka, Mark, Roue, Chad C.
• Primary Examiner(s): Bianco; Patricia M
• Assistant Examiner(s): NELSON, KERI JESSICA
• Application Number:
  US11/349,067
• Publication Number:
  US 20060207608A1
• Time in Patent Office: 2,009 Days
• Field of Search: 128/848, 606/286, 606/310, 606/319, 623/13.14, 623/22.36, 623/22.37, 623/23.27, 623/23.26, 607/126, 607/130, 433/225, 411/519, 411/446, 600/375
• US Class Current: 128/848
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• 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 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/00814 Surgery of the tongue, e.g. glossoplasty
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0422 by insertion of a separate member into the body of the anchor
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0433 the anchor or the separate member comprising threads, e.g. a set screw or a worm gear for moving spreading members
• CPC Class Codes: A61B 2017/0435 the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/044 : with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61F 5/56 : Devices for preventing snoring by influencing the respiratory system by gas treatment A61M16/00

Abstract

Methods and devices are disclosed for manipulating the tongue. An implant is positioned within at least a portion of the tongue and may be secured to other surrounding structures such as the mandible and/or hyoid bone. In general, the implant is manipulated to displace at least a portion of the posterior tongue in an anterior or lateral direction, or to alter the tissue tension or compliance of the tongue. Methods and devices are also disclosed for manipulating other soft tissue structures, including the soft palate and pharyngeal airway.

Claims

1. A method for treating a patient, comprising:

providing a tongue remodeling system, the system comprising at least one tether support and at least one tongue element, the at least one tongue element having at least one expandable tissue anchor joined to at least one tether, the at least one expandable tissue anchor being structured to pierce tissue;

accessing a region about a mandible;

inserting the at least one expandable tissue anchor through a first pathway along the region about the mandible to a tongue;

piercing tissue in the tongue with the at least one expandable tissue anchor by expanding the at least one expandable tissue anchor, thus securing the at least one expandable tissue anchor to the tongue;

attaching the at least one tether of the at least one tongue element to the at least one tether support;

positioning the at least one tether support against the mandible; and

fixing the at least one tether support to the mandible.

2. The method for treating a patient as in claim 1, wherein the expandable tissue anchor of the providing step is self-expandable.

3. The method for treating a patient as in claim 1, wherein the expandable tissue anchor comprises a plurality of expandable elongate members.

4. The method for treating a patient as in claim 3, wherein the expandable tissue anchor comprises a plurality of expandable elongate piercing members.

5. The method for treating a patient as in claim 1, wherein the expandable tissue anchor comprises a plurality of expandable tissue-grasping members.

6. The method for treating a patient as in claim 1, wherein the fixing step is performed before the attaching step.

7. The method for treating a patient as in claim 1, wherein at least a portion of the first pathway passes through the mandible.

8. A method for treating a patient, comprising:

providing a tongue element having an attachment end and an expandable tissue-anchoring end, the expandable tissue-anchoring end being structured to pierce tissue when expanded;

inserting the expandable tissue-anchoring end into a tongue;

piercing tissue in the tongue with the expandable tissue-anchoring end by expanding the expandable tissue-anchoring end thus securing the expandable tissue-anchoring end to the tongue; and

securing the attachment end of the tongue element to a body structure.

9. The method for treating a patient as in claim 8, wherein the securing of the attachment end of the tongue element to the body structure is performed with an adjustment assembly.

10. The method for treating a patient as in claim 9, wherein the adjustment assembly comprises a moving part, a non-moving part and a movement interface between the moving part and the non-moving part.

11. The method for treating a patient as in claim 8, wherein the expandable tissue-anchoring end comprises one or more tissue-grasping members.

12. The method for treating a patient as in claim 11, wherein the expandable tissue-anchoring end comprises at least two tissue-piercing members.

13. The method for treating a patient as in claim 11, wherein the one or more tissue-grasping members are metallic.

14. The method for treating a patient as in claim 11, wherein the one or more tissue-grasping members are radially expandable elongate members.

15. The method for treating a patient as in claim 8, wherein the expandable tissue-anchoring end comprises a wire coil.

16. The method for treating a patient as in claim 8, wherein the expandable tissue-anchoring end comprises a T-tag.

17. The method for treating a patient as in claim 8, wherein the expandable tissue-anchoring end comprises an expandable polymer plug.

18. The method for treating a patient as in claim 17, wherein the expandable tissue-anchoring end comprises a fibrous or porous expandable polymer plug.

19. The method for treating a patient as in claim 8, wherein the expandable tissue-anchoring end of the providing step comprises a slotted tube having a distal end, a proximal end, and a plurality of expandable middle bands between the distal end and proximal end.

20. The method for treating a patient as in claim 19, wherein the at least one tether is secured to the distal end of the slotted tube.

21. The method for treating a patient as in claim 19, wherein the at least one tether is secured to the proximal end of the slotted tube.

22. The method for treating a patient as in claim 19, wherein the slotted tube is self-expandable.

23. The method for treating a patient as in claim 19, wherein the slotted tube of the providing step is expandable by shortening the slotted tube along its longitudinal length.

24. The method for treating a patient as in claim 23, further comprising the step of pulling the at least one tether to expand the slotted tube.

25. A method for treating a patient, comprising:

accessing a tissue anchor implanted in a tongue, the tissue anchor having a deployment configuration in which the tissue anchor has pierced tissue in the tongue thus securing the tissue anchor to the tongue, and a removal configuration;

deforming the tissue anchor to the removal configuration; and

withdrawing the tissue anchor from the tongue.

26. The method for treating a patient as in claim 25, wherein the tissue anchor further comprises a proximal tether.

27. The method for treating a patient as in claim 26, further comprising exposing the proximal tether.

28. The method for treating a patient as in claim 27, wherein accessing the tissue anchor implanted in the tongue comprises passing a tubular member along the proximal tether, the tubular member comprising a distal opening, a proximal opening and a lumen therebetween.

29. The method for treating a patient as in claim 28, wherein deforming the tissue anchor to the removal configuration comprises collapsing the tissue anchor into the lumen of the tubular member.

30. The method for treating a patient as in claim 29, wherein withdrawing the tissue anchor from the tongue comprises withdrawing the tubular member from the tongue.

31. The method for treating a patient as in claim 28, wherein the tubular member further comprises a longitudinal slot contiguous with the lumen of the tubular member.

32. The method for treating a patient as in claim 31, wherein the longitudinal slot of the tubular member is contiguous with the distal opening of the tubular member.

33. The method for treating a patient as in claim 32, wherein the tubular member further comprises a movable slot blocking member capable of blocking the distal portion of the longitudinal slot of the tubular member.

34. The method for treating a patient as in claim 33, wherein the movable slot blocking member is a slidable slot blocking member.

35. The method for treating a patient as in claim 33, wherein the movable slot blocking member is a rotatable slot blocking member.

36. The method for treating a patient as in claim 33, wherein the movable slot blocking member is located within the lumen of the tubular member.