Method for accessing a sinus cavity and related anatomical features

• US 8,585,728 B2
• Filed: 07/24/2007
• Issued: 11/19/2013
• Est. Priority Date: 04/21/2006
• Status: Active Grant

• Current Assignee: Entellus Medical Incorporated (Stryker Corporation)
• Original Assignee: Entellus Medical Incorporated (Stryker Corporation)
• Inventors: Keith, Peter T., Ressemann, Thomas V., Truitt, Theodore O.
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): GILBERT, ANDREW M
• Application Number:
  US11/782,617
• Publication Number:
  US 20080015544A1
• Time in Patent Office: 2,310 Days
• Field of Search: 604/890.1, 604/891.1, 604/891.2, 604/500, 604506-510, 604/514, 604/516, 606/196, 606/199, 128/204.12, 128/898, 424/434, 600/309, 600/310, 600/249, 600/342, 600/101, 600/160, 600/178, 600/179, 600/182, 600/183, 600/585, 385/117
• US Class Current: 606/196
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• 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 17/3421 Cannulas
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61M 2029/025 characterised by the guiding element
• CPC Class Codes: A61M 2210/0618 Nose
• 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

A method of confirming the location of an elongate member configured for placement within a patient'"'"'s sinus cavity comprises introducing the elongate member through a nasal passageway to place a distal tip of the elongate member in a test position, the elongate member configured to emit illuminating light via the distal end of the elongate member. The location of the light is then viewed through the patient'"'"'s skin to confirm the positioning of the elongate member.

Claims

1. A method of confirming a location of a distal tip of a device placed within a sinus cavity of a patient comprising:

introducing a directable endoscope into a nasal passageway of the patient and placing a distal end of the endoscope superior to a uncinate process;

directing a viewing field of the endoscope in a retrograde direction and towards a sinus ostium;

advancing a guide catheter into the nasal passageway, wherein a proximal end of the guide catheter is removably secured to a distal end of a handle, and wherein the handle defines a steering device recess that opens along an axial length of a side surface of the handle, and wherein a steering device is positioned within the steering device recess and disposed on a wire guide, and wherein the steering device is configured to advance with the wire guide by sliding within the steering device recess and along the axial length of the handle, and wherein the steering device is configured to provide rotation of the wire guide through complete revolutions while the steering device is positioned within the steering device recess;

advancing the wire guide into the sinus cavity, wherein advancing the wire guide comprises sliding the wire guide within the steering device recess and rotating the steering device relative to the handle;

inputting light to the sinus cavity via a proximal light port disposed external to the patient; and

viewing the location of the emitted light to confirm the location of the wire guide.

2. The method of claim 1, further comprising advancing distally a balloon catheter into the sinus cavity if the distal tip of the wire guide is correctly located in the sinus cavity.

3. The method of claim 1, further comprising distal advancement of a light emitting elongate member over the wire guide.

4. The method of claim 1, further comprising advancing a working device across an ostium of the sinus cavity.

5. The method of claim 4, wherein the working device comprises the wire guide.

6. The method of claim 1, wherein the guide catheter is removably secured to the handle with a friction fit.

7. The method of claim 1, wherein the handle includes at least one feature for receiving the wire guide.

8. The method of claim 7, wherein the proximal end of the guide catheter includes a hub and the hub is removably secured to the distal end of the handle.

9. The method of claim 8, wherein viewing the location of the emitted light includes viewing the light through the patient'"'"'s skin.

10. The method of claim 1, wherein an operator grips the handle with a first hand while advancing the guide catheter into the nasal passageway while simultaneously the operator grips the endoscope with a second hand.

11. The method of claim 1, wherein the handle defines a hub recess and the proximal end of the guide catheter includes a hub that is removably secured within the hub recess.

12. The method of claim 11, wherein the hub recess is located at a position that is distal relative to the steering device recess.

13. The method of claim 12, wherein the handle defines a wire recess at a position that is distal relative to the steering device recess and proximal to the hub recess.

14. The method of claim 13, where the wire guide extends through the steering device recess, the wire recess, the hub recess, and the guide catheter.

15. The method of claim 1 further comprising distal advancement of a light emitting elongate member.

16. The method of claim 1, wherein the wire guide extends distally with respect to a distal end of the guide catheter.

17. The method of claim 1, wherein the wire guide extends proximally with respect to the handle.

18. A method of confirming the location of a distal tip of a device placed within a sinus cavity of a patient, the method comprising:

releasably securing a distal end of a handle to a proximal end of a guide catheter, wherein the handle defines a steering device recess that opens along an axial length of a side surface of the handle, and wherein a steering device is positioned within the steering device recess and disposed on a wire guide, wherein the steering device is configured to allow rotation of the wire guide through complete revolutions;

gripping the handle with a first hand of an operator and directing the guide catheter into a nasal passageway of the patient;

advancing a distal portion of the wire guide out of a distal end of the guide catheter and into a desired sinus cavity of the patient, wherein the advancing comprises sliding the steering device axially within the steering device recess and rotation of the steering device relative to the handle;

emitting light into the sinus cavity;

viewing a location of the emitted light;

advancing a balloon catheter out of the distal end of the guide catheter and across an ostium of the desired sinus cavity if the location of the emitted light is confirmed to be in a desired location; and

dilating the ostium of the desired sinus cavity with the balloon catheter.

19. The method of claim 18, further comprising distal advancement of a light emitting elongate member.

20. The method of claim 18, wherein a proximal end of the guide catheter is releasably secured to a distal end of the handle with a frictional fit.

21. The method of claim 20, wherein the proximal end of the guide catheter includes a hub and the hub is releasably secured to a distal end of the handle with the frictional fit.

22. The method of claim 21, wherein the handle includes at least one feature for receiving the wire guide.

23. The method of claim 22, wherein viewing a location of the emitted light includes viewing the light through the patient'"'"'s skin.

24. The method of claim 18, wherein the handle defines a hub recess and the proximal end of the guide catheter includes a hub that is removably secured within the hub recess.

25. The method of claim 24, wherein the hub recess is located at a position that is distal relative to the steering device recess.

26. The method of claim 25, wherein the handle defines a wire recess at a position that is distal relative to the steering device recess and proximal to the hub recess.

27. The method of claim 26, where the wire guide extends through the steering device recess, the wire recess, the hub recess, and the guide catheter.