Methods and apparatus for treating disorders of the ear nose and throat

• US 8,090,433 B2
• Filed: 10/30/2007
• Issued: 01/03/2012
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Makower, Joshua, Chang, John Y., Muni, Ketan P., Morriss, John H., Ha, Hung V., Kim, Isaac J., Vrany, Julia D.
• Primary Examiner(s): KASZTEJNA, MATTHEW JOHN
• Application Number:
  US11/929,237
• Publication Number:
  US 20080103361A1
• Time in Patent Office: 1,526 Days
• Field of Search: 600114-116
• US Class Current: 600/510
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• 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 17/2804 with two or more pivotal connections A61B17/29 takes precedence
• CPC Class Codes: A61B 17/282 Jaws
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/063 for measuring volume
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3941 Photoluminescent markers
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• 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 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 2029/025 : characterised by the guiding element
• CPC Class Codes: A61M 2210/0681 : Sinus (maxillaris)
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Methods and apparatus for treating disorders of the ear, nose, throat or paranasal sinuses, including methods and apparatus for dilating ostia, passageways and other anatomical structures, endoscopic methods and apparatus for endoscopic visualization of structures within the ear, nose, throat or paranasal sinuses, navigation devices for use in conjunction with image guidance or navigation system and hand held devices having pistol type grips and other handpieces.

Claims

1. A method for accessing a paranasal sinus, the method comprising:

advancing a seeker device through a nostril to position an enlarged, atraumatic tip of the seeker at an opening to a paranasal sinus;

pushing the atraumatic tip at least partway into the paranasal sinus opening to contact tissue forming the opening;

positioning the atraumatic tip at least partway into the paranasal sinus opening;

advancing a guidewire through a lumen in the seeker device to position a distal end of the guidewire within the paranasal sinus; and

withdrawing the seeker device out through the nostril, leaving the guidewire in place with its distal end in the paranasal sinus.

2. A method as in claim 1, further comprising:

advancing a balloon dilation catheter over the guidewire to position a balloon of the catheter in the paranasal sinus opening;

dilating the balloon to expand the opening; and

withdrawing the balloon catheter and guidewire out through the nostril.

3. A method as in claim 1 or 2, further comprising:

advancing an irrigation catheter over the guidewire to position a distal end of the catheter in the paranasal sinus; and

passing irrigation fluid into the paranasal sinus via the catheter.

4. A method as in claim 1, further comprising inflating a balloon coupled with the seeker device to expand the paranasal sinus opening, wherein the guidewire is advanced through a first lumen and the balloon is inflated through a second lumen of the seeker device.

5. A method as in claim 1, wherein the accessed paranasal sinus opening comprises a natural paranasal sinus ostium.

6. A method as in claim 1, further comprising directing the guidewire laterally out of a slit along a proximal portion of the seeker device before withdrawing the seeker device to facilitate the withdrawing.

7. A method for accessing a Eustachian tube, the method comprising:

advancing a seeker device through a nostril to position an enlarged, atraumatic tip of the seeker at an opening to a Eustachian tube;

pushing the atraumatic tip at least partway into the Eustachian tube opening to contact tissue forming the opening;

positioning the atraumatic tip at least partway into the Eustachian tube opening;

advancing a guidewire through a lumen in the seeker device to position a distal end of the guidewire within the Eustachian tube; and

withdrawing the seeker device out through the nostril, leaving the guidewire in place with its distal end in the Eustachian tube.

8. A method as in claim 7, further comprising:

advancing a balloon dilation catheter over the guidewire to position a balloon of the catheter in the Eustachian tube;

dilating the balloon to expand the Eustachian tube; and

withdrawing the balloon catheter and guidewire out through the nostril.

9. A method as in claim 7, further comprising inflating a balloon coupled with the seeker device to expand the Eustachian tube, wherein the guidewire is advanced through a first lumen and the balloon is inflated through a second lumen of the seeker device.

10. A method as in claim 7, further comprising directing the guidewire laterally out of a slit along a proximal portion of the seeker device before withdrawing the seeker device to facilitate the withdrawing.