APPARATUS AND METHOD FOR TREATMENT OF ETHMOID SINUSITIS

• US 20140276328A1
• Filed: 03/15/2013
• Published: 09/18/2014
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Kesten, Randy J., Levine, Howard, White, John W., Jenkins, Thomas R., Liberatore, Jessica M., Nayak, Jayakar V.
• Granted Patent: US 9,433,437 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61B 17/12104 in an air passage
• 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 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/12004 for haemostasis, for prevention of bleeding
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/3454 Details of tips
• CPC Class Codes: A61F 13/20 Tampons, e.g. catamenial tampons; Accessories therefor
• CPC Class Codes: A61F 13/2022 characterised by the shape
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32
• CPC Class Codes: A61M 2210/0618 Nose
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Fluid communication may be improved for an ethmoid sinus by installing a port or wick in the wall of the ethmoid sinus to provide a fluid passageway across the wall of the ethmoid sinus. Fluid communication for an ethmoid sinus may also be improved by inflating a balloon in a retrobullar space, remodeling the posterior wall of the ethmoid bulla to expand the transition area in the retrobullar space. In addition, a wall defining the retrobullar space may be pierced to provide a passageway for fluid communication.

Claims

1. A method of treating a sinus cavity, the method comprising

(a) piercing at least one wall of the sinus cavity;

and

(b) inserting at least one fluid transfer member in the at least one wall of the sinus cavity, wherein the fluid transfer member is configured to provide a fluid communication path between the interior of the sinus cavity and a region external to the sinus cavity.

2. The method of claim 1, wherein the sinus cavity comprises an ethmoid sinus cell.

3. The method of claim 2, wherein the sinus cavity comprises an ethmoid bulla.

4. The method of claim 1, wherein the act of piercing at least one wall of the sinus cavity comprises:

(i) piercing the sinus cavity in a first wall location, and

(ii) piercing the sinus cavity in a second wall location.

5. The method of claim 4, wherein the act of inserting the at least one fluid transfer member comprises:

(i) inserting a first portion of a first fluid transfer member in the first wall location, and

(ii) inserting a second portion of the first fluid the second wall location.

6. The method of claim 5, wherein the first wall location provides a path to an anterior space within the paranasal cavity, wherein the second wall location provides a path to an adjacent sinus cavity.

7. The method of claim 1, wherein the at least one fluid transfer member comprises a port defining a fluid passageway.

8. The method of claim 7, wherein the port has at least one outwardly extending retention feature configured to engage a wall of the sinus cavity.

9. The method of claim 7, wherein the port has a body defining at least one transverse opening in fluid communication with the fluid passageway.

10. The method of claim 7, wherein the at least one fluid transfer member has a length absorbing feature.

11. The method of claim 1, wherein the at least one fluid transfer member comprises a wick, wherein the wick is configured to transfer fluid through a capillary action.

12. The method of claim 11, wherein the wick includes a resilient clip feature.

13. The method of claim 12, further comprising securing the resilient clip feature to a middle turbinate.

14. The method of claim 13, further comprising positioning the wick to extend between an ethmoid sinus cell and the middle turbinate.

15. The method of claim 1, wherein the fluid transfer member comprises a bioabsorbable material.

16. A method of expanding a retrobullar space, the method comprising:

(a) positioning a balloon in a retrobullar space between a posterior wall of an ethmoid bulla and a middle turbinate vertical basal lamella; and

(b) inflating the balloon, wherein the act of inflating the balloon expands the retrobullar space.

17. The method of claim 16, wherein the act of inflating the balloon comprises driving a balloon wall against the posterior wall of the ethmoid bulla to remodel the posterior wall of the ethmoid bulla without driving a balloon wall against the middle turbinate vertical basal lamella.

18. A method of creating a passageway in the ethmoid sinus, the method comprising:

(a) positioning a piercing element adjacent to either the posterior wall of an ethmoid bulla or the middle turbinate vertical basal lamella; and

(b) piercing the posterior wall of the ethmoid bulla or the middle turbinate vertical basal lamella, wherein the act of piercing the posterior wall of the ethmoid bulla or the middle turbinate vertical basal lamella comprises driving the piercing element into the posterior wall of the ethmoid bulla or the middle turbinate vertical basal lamella, thereby creating a passageway in the posterior wall of the ethmoid bulla or the middle turbinate vertical basal lamella.

19. The method of claim 18, wherein the piercing element is associated with a catheter, wherein the catheter has at least one support balloon, the method further comprising inflating the support balloon within a retrobullar space defined between the posterior wall of an ethmoid bulla and the middle turbinate vertical basal lamella, wherein the inflated balloon provides support to the piercing element.

20. The method of claim 18, wherein the act of driving the piercing element into the posterior wall of the ethmoid bulla or the middle turbinate vertical basal lamella comprises redirecting the piercing element with a ramp or with a bent conduit.