Endoscopic methods and devices for transnasal procedures

• US 9,089,258 B2
• Filed: 03/15/2007
• Issued: 07/28/2015
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Goldfarb, Eric, Jenkins, Thomas R., Kim, Isaac J., Vo, Tom T., Wisted, Thomas J.
• Primary Examiner(s): KASZTEJNA, MATTHEW JOHN
• Application Number:
  US11/725,151
• Publication Number:
  US 20070249896A1
• Time in Patent Office: 3,057 Days
• Field of Search: 600/115, 600121-125, 600/151
• US Class Current: 1/1
• CPC Class Codes: A61B 1/0014 Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• 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 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61M 2025/09083 having a coil around a core

Abstract

Medical devices, systems and methods that are useable to facilitate transnasal insertion and positioning of guidewires and various other devices and instruments at desired locations within the ear, nose, throat, paranasal sinuses or cranium. Direct viewing of such placements via an endoscope.

Claims

1. A method for locating a sinus ostium, said method comprising the steps of:

(a) inserting a sinus guide and an endoscope through a nostril of a patient;

(b) advancing the sinus guide toward a location of the sinus ostium under the guidance of the endoscope;

(c) inserting an illuminating guidewire through the sinus guide and into the nostril and advancing a distal end portion of the illuminating guidewire distally of a distal end of the endoscope and distally of a distal end of the sinus guide, wherein the distal end of the illuminating guidewire includes a light emitting feature;

(d) viewing, through the endoscope, the advancement of the distal end portion of the illuminating guidewire to facilitate guidance of the advancement of the illuminating guidewire along a desired path;

(e) identifying a location of the sinus ostium by observing a transillumination region, wherein the transillumination region is provided by illumination from the light emitting feature of the guidewire;

(f) advancing a working device through the sinus guide to position the working device through a distal end of the sinus guide and into the sinus ostium after identifying the location of the sinus ostium by observing the transillumination region; and

(h) actuating the working device to thereby perform a diagnostic or therapeutic function in one or both of the sinus ostium or an adjacent sinus cavity.

2. The method of claim 1, further comprising directing the distal end portion of the illuminating guidewire, under guidance facilitated by visualization of the distal end portion via the endoscope, into the sinus ostium.

3. The method of claim 2, wherein visualization through the endoscope is enhanced by light emitted by the illuminating guidewire.

4. The method of claim 2, further comprising confirming that the distal end portion of the illuminating guidewire has been inserted into a desired sinus by observing transillumination effects produced by the illumination from the distal end portion of the illuminating guidewire having been inserted through the sinus ostium and into the sinus.

5. A method for locating a sinus ostium, said method comprising the steps of:

(a) inserting a guide catheter and an endoscope through a nostril of a patient;

(b) advancing the guide catheter using the endoscope to guide the guide catheter toward a location of the sinus ostium;

(c) inserting an illuminating guidewire through the guide catheter and into the nostril and advancing a distal end portion of the illuminating guidewire distally of a distal end of the endoscope, wherein the illuminating properties of the guidewire are provided by an illuminating tip on the distal end of the illuminating guidewire;

(d) advancing the illuminating guide wire relative to the guide catheter such that at least a portion of the illuminating guidewire extends out of the distal end of the guide catheter and into the sinus ostium;

(e) viewing, through the endoscope, the advancement of the distal end portion of the illuminating guidewire to facilitate guidance of the advancement of the illuminating guidewire into the sinus ostium;

(f) identifying a location of the sinus ostium by observing a transillumination region created by the illuminating tip of the illuminating guidewire; and

(g) inserting a working device through the guide catheter to position the working device inside the sinus ostium to perform a therapeutic procedure after identifying the location of the sinus ostium by observing the transillumination region.