Devices, systems and methods for diagnosing and treating sinusitis and other disorders of the ears, nose and/or throat

Patent metadata

Field	Value
Publication number	US-10492810-B2
Application number	US-201715443319-A
Country	US
Kind code	B2
Filing date	Feb 27, 2017
Priority date	Apr 21, 2004
Publication date	Dec 3, 2019
Grant date	Dec 3, 2019

Abstract

Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

First claim

What is claimed is:

1. A method of removing polyps or other tissue from the nose, nasopharynx or paranasal sinus using an apparatus comprising:
(a) a flexible catheter, wherein the flexible catheter has a first distal end and a first lumen, wherein the first distal end comprises a first opening configured to connect an exterior area with the first lumen, wherein the first opening is configured to receive matter from an area exterior to the flexible catheter;
(b) a flexible tube, wherein the flexible tube has a second distal end and a second lumen, wherein the flexible tube is disposed within the first lumen and rotatable therein, wherein the second distal end comprises a second opening wherein the flexible tube further includes:
(i) a pull member, wherein the pull member has a third distal end, wherein the third distal end extends distally from the second distal end of the flexible tube within the flexible catheter; and
(ii) a retractor head coupled to the third distal end of the pull member, wherein the retractor head is moveable by retracting or advancing the pull member within the flexible tube; and

(c) a rotating cutter, wherein the rotating cutter is positioned within the first lumen and on the second distal end, and wherein the rotating cutter is configured to cut matter received in the first opening,
the method comprising:
(a) advancing the flexible catheter into a passageway within a patient's head;
(b) positioning the first opening of the first distal end toward a matter to be removed;
(c) rotating the second distal end to align the second opening with the first opening;
(d) retracting the retractor head proximally from an initial position to a retracted position to move the matter toward the rotating cutter, and pressing the rotating cutter against the matter; and
(e) actuating the rotating cutter to sever the matter, and receiving the matter within the second lumen.

2. The method of claim 1 , wherein the passageway comprises a nostril, nasal cavity, meatus, ostium, or interior of a sinus.

3. The method of claim 1 , wherein the matter comprises a polyp, lesion, piece of debris, tissue, or blood clot.

4. The method of claim 1 , wherein the lumen of the flexible tube is connected to a source of negative pressure.

5. The method of claim 4 , wherein the method further comprises suctioning the severed matter from the second opening of the flexible tube and through the lumen of the flexible tube.

6. The method of claim 1 , wherein the first opening of the flexible catheter is formed on a side of the first distal end, and wherein the pull member and the retractable head are configured to traverse a portion of the first opening.

7. The method of claim 6 , wherein the flexible catheter further comprises a stabilizing balloon on a side of the first distal end opposite the first opening.

8. The method of claim 7 , wherein the method further comprises inflating the stabilizing balloon for pressing the first and second opening against the matter.

9. The method of claim 1 , wherein the rotating cutter comprises a linear slicer, pincher, laser beam, or electrosurgical cutter.

10. The method of claim 1 , wherein the flexible catheter further comprises a deflectable tip or curved distal end on the open distal end, wherein the method further comprises using the deflectable tip or curved distal end to force the first distal end against the matter to be removed.

11. The method of claim 10 , wherein one or more bearings are disposed between the flexible catheter and the flexible tube.

12. The method of claim 1 , wherein the flexible tube further comprises a scope extending through the second lumen toward the second distal end.

13. The method of claim 12 , wherein the method further comprises viewing the first opening through the scope while the flexible catheter is inserted in the passageway.

14. The method of claim 1 , wherein the retractor head traverses the first opening of the flexible catheter as the retractor head is retracted to move the matter toward the rotating cutter.

15. The method of claim 1 , wherein the method further comprises advancing the retractor head back to the initial position after the matter has been received within the second lumen.

16. A method of removing polyps from a passageway in a patient's body, the method comprising:
(a) inserting a device into a passageway selected from the group consisting of a nostril, nasal cavity, meatus, ostium, and interior of a sinus;
(b) advancing the device to a location where a distal end of the device is positioned adjacent a polyp;
(c) rotating a flexible inner tube and a cutter positioned on a distal end of the flexible inner tube, wherein the flexible inner tube comprises a retractor head coupled to a distal end of a pull member, wherein the pull member extends from the distal end of the flexible inner tube and is retractable for moving the retractor head and repositioning the polyp to a position adjacent the cutter;
(d) retracting the retractorhead to reposition the polyp adjacent the cutter; and
(e) contacting and severing the polyp as the device is simultaneously advanced toward the polyp and the flexible inner tube and cutter are rotated;
wherein the flexible inner tube is coaxially and rotatably disposed within a flexible outer tube.

17. The method of claim 16 , wherein the method further comprises suctioning the polyp severed by the cutter through a lumen of the flexible inner tube or flexible outer tube.

18. The method of claim 16 , wherein the flexible outer tube further comprises an opening on a distal end, wherein the method further comprises rotating to a position proximal to the opening for severing the polyp.

19. A method of severing polyps from the nasal cavity, paranasal sinus, nasopharynx, or middle ear to perform diagnostic or therapeutic procedures, the method comprising:
(a) positioning an open distal end of a flexible catheter at an opening of a passageway within a patient's head;
(b) advancing the open distal end into the passageway until reaching a target site within the patient's head;
(c) rotating a flexible inner tube disposed within a lumen of the flexible catheter to align a blade apparatus on a distal end of the flexible inner tube with the open distal end, wherein the flexible inner tube comprises a retractor head coupled to a distal end of a pull member, wherein the pull member extends from the distal end of the flexible inner tube and is retractable for moving the retractor head and repositioning a matter;
(d) retracting the retractor head to reposition the matter to a position adjacent the blade apparatus;
(e) cutting the matter at the target site by actuating the blade apparatus;
(f) receiving the matter in the open distal end; and
(g) transferring the matter through a lumen of the flexible inner tube.

Assignees

• Acclarent Inc

Inventors

• Chang John Y
• Makower Joshua

Classifications

• A61B10/06

  Biopsy forceps {, e.g. with cup-shaped jaws} · CPC title

• A61N1/0541

  Cochlear electrodes · CPC title

• A61B18/18

  by applying electromagnetic radiation, e.g. microwaves · CPC title

• A61B2017/22061

  for spreading elements apart · CPC title

• A61F2/82

  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) · CPC title