Devices And Methods For Minimally Invasive Access To Sinuses And Treatment of Sinusitis

• US 20110098659A1
• Filed: 01/04/2011
• Published: 04/28/2011
• Est. Priority Date: 07/21/2009
• Status: Abandoned Application

• Current Assignee: Leonard V. Covello
• Original Assignee: Leonard V. Covello
• Inventors: Covello, Leonard V.
• Application Number:
  US12/984,354
• Publication Number:
  US 20110098659A1
• Time in Patent Office: Days
• US Class Current: 604/227
• 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 17/295 combined with cutting implements
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• 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 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/0817 Spatulas or spatula like extensions
• CPC Class Codes: A61B 90/08 Accessories or related features not otherwise provided for
• CPC Class Codes: A61M 2205/04 implanted
• CPC Class Codes: A61M 2210/0681 Sinus (maxillaris)
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

The present invention provides minimally invasive devices and methods for accessing the sinuses and their surrounding structures for surgery and other treatments. The anterior ethmoid and maxillary sinuses are accessed and treated under minimal anesthesia with little or no postoperative limitation of activity or adverse symptoms. Direct visual verification of the sinuses and their natural ostia is utilized. Other paranasal sinuses may be treated by this method as well. The sinuses, in particular the maxillary and anterior ethmoid, are accessed via a direct anterior to posterior axis and the natural ostia of those sinuses is directly visualized for placement of a guide-free dilator, in the desired location within the natural ostia. That access to the maxillary ostium is accomplished by the anterior transuncinate “keyhole” approach in which a hole is punched in the uncinate process with the described devices according to the described methods. The properly placed dilator is expanded to allow drainage of the inflamed sinus and then withdrawn. An analogous ethmoid bulla “keyhole” approach and subsequent dilation are used for the anterior ethmoid sinus ostia. Pharmaceutical agents may be placed at desired locations in the sinuses using the same access technique.

Claims

1. A drug insertion device for delivery of a drug into a sinus cavity comprising:

i. a rigid shaft containing a lumen, said rigid shaft angled distally at an angle between about 55 degrees to about 60 degrees;

ii. a piston slidedly connected to said lumen of said rigid shaft;

iii. a receptacle for holding a drug or drug delivery device, said receptacle mounted at the distal end of the rigid shaft; and

iv. a means for moving the piston through the lumen of the rigid shaft to the receptacle, causing release of the drug or drug delivery device.

2. The drug insertion device of claim 1, wherein the length of the receptacle is between about 1.0 cm and about 2.0 cm.

3. The drug insertion device of claim 1, wherein the width of the receptacle is about 5 mm.

4. The drug insertion device of claim 1, wherein the receptacle comprises flexible flanges which grip the drug or drug delivery device.

5. The drug insertion device of claim 1, wherein the receptacle comprises a sleeve which wholly encompasses the drug or drug delivery device.

6. The drug insertion device of claim 1, further comprising a plunger on attached to the rear end of said piston to accommodate the thumb of a surgeon.

7. The drug insertion device of claim 1, wherein the piston is composed of flexible plastic.

8. The drug insertion device of claim 1, wherein the piston is composed of malleable metal.