RU2011107229A - Устройство и способы обнаружения устья околоносовой пазухи - Google Patents
Устройство и способы обнаружения устья околоносовой пазухи Download PDFInfo
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- 238000000034 method Methods 0.000 title claims 16
- 239000004020 conductor Substances 0.000 claims abstract 26
- 239000000523 sample Substances 0.000 claims abstract 15
- 239000000463 material Substances 0.000 claims abstract 6
- 210000004086 maxillary sinus Anatomy 0.000 claims 15
- 210000003928 nasal cavity Anatomy 0.000 claims 6
- 238000004891 communication Methods 0.000 claims 4
- 238000002347 injection Methods 0.000 claims 4
- 239000007924 injection Substances 0.000 claims 4
- 210000003484 anatomy Anatomy 0.000 claims 2
- 238000005452 bending Methods 0.000 claims 1
- 210000000988 bone and bone Anatomy 0.000 claims 1
- 238000006073 displacement reaction Methods 0.000 claims 1
- 210000001031 ethmoid bone Anatomy 0.000 claims 1
- 210000003016 hypothalamus Anatomy 0.000 claims 1
- 210000004877 mucosa Anatomy 0.000 claims 1
- 210000001944 turbinate Anatomy 0.000 claims 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/233—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/24—Surgical instruments, devices or methods for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22042—Details of the tip of the guide wire
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
- A61B2017/320048—Balloon dissectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
- A61M2029/025—Dilators made of swellable material characterised by the guiding element
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
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- Animal Behavior & Ethology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Molecular Biology (AREA)
- Otolaryngology (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
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- Physics & Mathematics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Dentistry (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
Abstract
1. Устройство для обнаружения устья пазухи, включающее: ! ствол, имеющий дистальный конец, проксимальный конец, изогнутую часть, расположенную между дистальным и проксимальным концами, и внутренний канал; ! выдвигаемый и втягиваемый проводник, подвижно установленный во внутреннем канале; ! наконечник зонда, присоединенный к проводнику. ! 2. Устройство для обнаружения устья пазухи по п.1, в котором проводник выполнен с возможностью реверсивного движения между втянутым положением, когда наконечник зонда примыкает к дистальному концу, и выдвинутым положением, когда наконечник зонда отделен от дистального конца. ! 3. Устройство для обнаружения устья пазухи по п.1, в котором наконечник зонда является съемным и сменным. ! 4. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее надувной баллон, соединенный по меньшей мере либо со стволом, либо с проводником. ! 5. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее рукоятку, присоединенную к проксимальному концу ствола. ! 6. Устройство для обнаружения устья пазухи по п.1, в котором ствол дополнительно включает наружную оболочку и внутренний элемент, при этом внутренний канал проходит через внутренний элемент. ! 7. Устройство для обнаружения устья пазухи по п.6, в котором внутренний элемент выполнен из жесткого материала, а наружная оболочка выполнена из гибкого материала. ! 8. Устройство для обнаружения устья пазухи по п.6, в котором внутренний элемент является съемным и сменным. ! 9. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее приводной элемент, механически соединенный с проводником. ! 10. Устройство для обна�
Claims (56)
1. Устройство для обнаружения устья пазухи, включающее:
ствол, имеющий дистальный конец, проксимальный конец, изогнутую часть, расположенную между дистальным и проксимальным концами, и внутренний канал;
выдвигаемый и втягиваемый проводник, подвижно установленный во внутреннем канале;
наконечник зонда, присоединенный к проводнику.
2. Устройство для обнаружения устья пазухи по п.1, в котором проводник выполнен с возможностью реверсивного движения между втянутым положением, когда наконечник зонда примыкает к дистальному концу, и выдвинутым положением, когда наконечник зонда отделен от дистального конца.
3. Устройство для обнаружения устья пазухи по п.1, в котором наконечник зонда является съемным и сменным.
4. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее надувной баллон, соединенный по меньшей мере либо со стволом, либо с проводником.
5. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее рукоятку, присоединенную к проксимальному концу ствола.
6. Устройство для обнаружения устья пазухи по п.1, в котором ствол дополнительно включает наружную оболочку и внутренний элемент, при этом внутренний канал проходит через внутренний элемент.
7. Устройство для обнаружения устья пазухи по п.6, в котором внутренний элемент выполнен из жесткого материала, а наружная оболочка выполнена из гибкого материала.
8. Устройство для обнаружения устья пазухи по п.6, в котором внутренний элемент является съемным и сменным.
9. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее приводной элемент, механически соединенный с проводником.
10. Устройство для обнаружения устья пазухи по п.1, дополнительно включающее:
рукоятку, соединенную с проксимальным концом ствола; и
приводной элемент, размещенный на рукоятке и механически соединенный с проводником.
11. Устройство для обнаружения устья пазухи по п. 10, в котором приводной элемент подвижно установлен в пазу на рукоятке.
12. Устройство для обнаружения устья пазухи по п.10, в котором ствол дополнительно включает трубчатую внутреннюю оболочку и трубчатую внешнюю оболочку, при этом внутренняя оболочка размещена во внешней оболочке, а внутренний канал проходит во внутренней оболочке.
13. Устройство для обнаружения устья пазухи по п.12, в котором внутренняя оболочка может выдвигаться и втягиваться относительно внешней оболочки.
14. Устройство для обнаружения устья пазухи по п.1, в котором ствол дополнительно имеет паз, сообщающийся с внутренним каналом, при этом структура и конфигурация паза позволяют вставить проводник и извлечь его из внутреннего канала через паз.
15. Устройство для обнаружения устья пазухи по п.14, в котором внешняя оболочка имеет первый паз, а внутренняя оболочка имеет второй паз, при этом структура и конфигурация первого и второго пазов позволяют вставлять проводник и извлекать его из внутреннего канала через первый и второй пазы, когда первый и второй пазы совмещены друг с другом.
16. Устройство для обнаружения устья пазухи по п.1, в котором ствол дополнительно включает переднюю часть и заднюю часть, соединенную с передней частью, при этом передняя и задняя части формируют трубчатую конфигурацию, а внутренний канал располагается между передней и задней частями.
17. Устройство для обнаружения устья пазухи по п.16, в котором передняя часть дополнительно имеет паз, сообщающийся с внутренним каналом, при этом структура и конфигурация паза позволяют вставлять проводник и извлекать его из внутреннего канала через паз.
18. Устройство для обнаружения устья пазухи, включающее:
удлиненный ствол, имеющий дистальный конец, проксимальный конец и изогнутую часть, расположенную между дистальным и проксимальным концами;
рукоятку, присоединенную к проксимальному концу;
продольный внутренний канал, проходящий через ствол и рукоятку;
выдвигаемый и втягиваемый проводник, подвижно установленный внутри внутреннего канала;
наконечник зонда, присоединенный к концу проводника; и
приводной элемент, связанный с рукояткой и механически соединенный с проводником, выдвигаемым и втягиваемым в соответствии с регулировкой приводного элемента.
19. Устройство для обнаружения устья пазухи по п.18, в котором проводник выполнен с возможностью реверсивного движения между втянутым положением, когда наконечник зонда примыкает к дистальному концу, и выдвинутым положением, когда наконечник зонда отделен от дистального конца.
20. Устройство для обнаружения устья пазухи по п.18, в котором наконечник зонда является съемным и сменным.
21. Устройство для обнаружения устья пазухи по п.20, в котором ствол дополнительно имеет продолговатую внешнюю оболочку и продолговатый внутренний элемент, а также продольный внутренний канал, проходящий через внутренний элемент.
22. Устройство для обнаружения устья пазухи по п.21, в котором внутренний элемент выполнен из жесткого материала, а внешняя оболочка выполнена из гибкого материала.
23. Устройство для обнаружения устья пазухи по п.21, в котором внутренний элемент является съемным и сменным.
24. Устройство для обнаружения устья пазухи по п.18, в котором приводной элемент подвижно установлен в пазу на рукоятке.
25. Устройство для обнаружения устья пазухи по п.24, в котором ствол дополнительно имеет продолговатую трубчатую внутреннюю оболочку и продолговатую трубчатую внешнюю оболочку, при этом внутренняя оболочка размещена внутри внешней оболочки, а продольный внутренний канал проходит через внутреннюю оболочку.
26. Устройство для обнаружения устья пазухи по п.25, в котором внутренняя оболочка может выдвигаться и втягиваться относительно внешней оболочки.
27. Устройство для обнаружения устья пазухи по п.25, в котором внешняя оболочка имеет первый паз, а внутренняя оболочка имеет второй паз, при этом структура и конфигурация первого и второго пазов позволяют вставлять проводник и извлекать его из внутреннего канала через первый и второй пазы, когда первый и второй пазы совмещены друг с другом.
28. Устройство для обнаружения устья пазухи по п.18, в котором ствол дополнительно имеет паз, сообщающийся с внутренним каналом, при этом структура и конфигурация паза позволяют вставлять проводник и извлекать его из внутреннего канала через паз.
29. Устройство для обнаружения устья пазухи по п.28, в котором продольный паз имеет латеральный участок.
30. Устройство для обнаружения устья пазухи по п.18, в котором ствол дополнительно имеет переднюю часть и заднюю часть, соединенную с передней частью, при этом передняя и задняя части формируют трубчатую конфигурацию, а внутренний канал располагается между передней и задней частями.
31. Устройство для обнаружения устья пазухи по п.30, в котором передняя часть дополнительно имеет паз, сообщающийся с внутренним каналом, при этом структура и конфигурация паза позволяют вставлять проводник и извлекать его из внутреннего канала через паз.
32. Способ обнаружения местоположения устья пазухи, включающий следующий этапы:
обеспечение устройства для обнаружения устья пазухи, имеющего ствол с дистальным концом, проксимальным концом и изогнутой частью, расположенной между дистальным и проксимальным концами, внутренний канал с выдвигаемым и втягиваемым проводником, подвижно установленным внутри внутреннего канала, и наконечник зонда, присоединенный к проводнику;
введение ствола устройства для обнаружения устья пазухи в околоносовую полость пациента;
регулировку положения дистального конца ствола; и
регулировку положения проводника и наконечника зонда до обнаружения целевого устья.
33. Способ по п.32, дополнительно включающий извлечение ствола из околоносовой полости, при этом оставляя проводник и наконечник зонда в отрегулированном положении.
34. Способ по п.33, дополнительно включающий введение хирургического устройства по проводнику по направлению к целевому устью.
35. Устройство для обнаружения местоположения и расширения естественного устья верхнечелюстной пазухи, включающее:
удлиненный ствол, включающий:
по существу жесткую проксимальную часть;
изогнутую дистальную часть;
атравматический дистальный наконечник на конце изогнутой дистальной части, при этом изогнутая дистальная часть имеет размер и форму, позволяющие дистальной части проходить в полость носа для размещения атравматического дистального наконечника внутри нее или в непосредственной близости от устья верхнечелюстной пазухи; и
полость для вдувания, проходящую по меньшей мере через часть ствола;
по меньшей мере один расширяемый дилататор, соединенный с дистальной частью ствола и сообщающийся с полостью для вдувания.
36. Устройство по п.35, в котором расширяемый дилататор включает надувной баллон.
37. Устройство по п.36, в котором по меньшей мере часть баллона расположена проксимально к изгибу в дистальной части ствола.
38. Устройство по п. 37, в котором баллон проходит от проксимального положения относительно изгиба к дистальному положению относительно изгиба вдоль ствола.
39. Устройство по п.36, в котором дилататор включает два баллона, один из которых расположен проксимально к изгибу дистальной части ствола, а другой расположен дистально к изгибу.
40. Устройство по п.36, в котором баллон раздувается асимметрично в направлении наружу от внутреннего радиуса изгиба изогнутой дистальной части ствола.
41. Устройство по п.35, дополнительно включающее рукоятку, содержащую привод, при этом дилататор может продвигаться и втягиваться вдоль ствола при помощи привода.
42. Устройство по п.35, в котором атравматический дистальный наконечник представляет собой шаровой наконечник для улучшения тактильной обратной связи при обнаружении местоположения устья верхнечелюстной пазухи.
43. Устройство для обнаружения местоположения и расширения естественного устья верхнечелюстной пазухи, включающее:
удлиненный внутренний ствол, включающий:
по существу жесткую проксимальную часть;
изогнутую дистальную часть;
атравматический дистальный наконечник на конце изогнутой дистальной части, при этом изогнутая дистальная часть имеет размер и форму, позволяющие дистальной части проходить в полость носа для размещения атравматического дистального наконечника внутри нее или в непосредственной близости от устья верхнечелюстной пазухи; и
внешний ствол, подвижно размещенный поверх внутреннего ствола и имеющий устье для вдувания; и
по меньшей мере один расширяемый дилататор, соединенный с дистальной частью ствола и сообщающийся с полостью для вдувания.
44. Устройство по п.43, дополнительно включающее рукоятку с приводом для продвижения и втягивания внешнего ствола вдоль внутреннего ствола.
45. Устройство по п.43, в котором дилататор включает надувной баллон.
46. Устройство по п.43, в котором атравматический дистальный наконечник представляет собой шаровой наконечник для улучшения тактильной обратной связи при обнаружении местоположения устья верхнечелюстной пазухи.
47. Способ определения местоположения и расширения устья верхнечелюстной пазухи, включающий следующие этапы:
продвижение изогнутой дистальной части устройства для верхнечелюстной пазухи в полости носа, где проксимальная часть устройства имеет по существу жесткую конфигурацию;
прохождение атравматического дистального наконечника дистальной части через естественное устье верхнечелюстной пазухи с использованием тактильной обратной связи для подтверждения прохождения дистального конца через устье; и
расширение по меньшей мере одного расширяемого дилататора, соединенного с изогнутой дистальной частью устройства для верхнечелюстной пазухи, чтобы расширить естественное устье верхнечелюстной пазухи.
48. Способ по п.47, в котором прохождение атравматического дистального конца и использование тактильной обратной связи включает прощупывание с помощью шарового дистального наконечника устройства.
49. Способ по п.47, дополнительно включающий продвижение внешнего ствола устройства для верхнечелюстной пазухи перед расширением, при этом расширяемый дилататор соединен с внешней оболочкой.
50. Способ по п.47, в котором расширение дилататора включает надувание по меньшей мере одного надувного баллона.
51. Способ по п.47, в котором расширение по меньшей мере одного баллона включает:
расширение первого баллона, размещенного в устье верхнечелюстной пазухи; и
расширение второго баллона, размещенного за пределами верхнечелюстной пазухи в полости носа.
52. Способ по п.47, в котором расширение дилататора приводит к коррекции или разлому костной структуры под слизистой, образующей естественное устье.
53. Способ по п.47, в котором расширение дилататора приводит по меньшей мере либо к расширению анатомического пространства или к смещению анатомической структуры в полости носа рядом с устьем пазухи.
54. Способ по п.53, в котором анатомическое пространство относится к группе, состоящей из воронки гипоталамуса и срединного отверстия.
55. Способ по п.53, в котором анатомическая структура относится к группе, включающей крючковидный отросток, среднюю носовую раковину и переднюю решетчатую ячейку решетчатой кости.
56. Способ по п.47, дополнительно включающий оттягивание устройства для верхнечелюстной пазухи перед этапом расширения для отведения назад крючковидного отростка носовой полости.
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2009
- 2009-07-30 ES ES09790994T patent/ES2700863T3/es active Active
- 2009-07-30 CA CA2732769A patent/CA2732769A1/en not_active Abandoned
- 2009-07-30 EP EP13180296.9A patent/EP2664350B1/en active Active
- 2009-07-30 AU AU2009276553A patent/AU2009276553B2/en not_active Ceased
- 2009-07-30 US US12/512,420 patent/US8979888B2/en active Active
- 2009-07-30 EP EP09790994.9A patent/EP2306886B1/en not_active Not-in-force
- 2009-07-30 CN CN200980130717.5A patent/CN102112040B/zh not_active Expired - Fee Related
- 2009-07-30 MX MX2011001099A patent/MX2011001099A/es active IP Right Grant
- 2009-07-30 WO PCT/US2009/052236 patent/WO2010014799A1/en active Application Filing
- 2009-07-30 JP JP2011521316A patent/JP5676446B2/ja not_active Expired - Fee Related
- 2009-07-30 RU RU2011107229/14A patent/RU2500337C2/ru not_active IP Right Cessation
- 2009-07-30 KR KR1020117004167A patent/KR101653180B1/ko not_active Expired - Fee Related
-
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- 2014-07-30 US US14/446,537 patent/US9750401B2/en active Active
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Also Published As
| Publication number | Publication date |
|---|---|
| JP2011529743A (ja) | 2011-12-15 |
| RU2500337C2 (ru) | 2013-12-10 |
| CN102112040B (zh) | 2015-04-01 |
| EP2664350B1 (en) | 2019-08-28 |
| US20170347869A1 (en) | 2017-12-07 |
| ES2700863T3 (es) | 2019-02-19 |
| WO2010014799A1 (en) | 2010-02-04 |
| US20140343498A1 (en) | 2014-11-20 |
| US8979888B2 (en) | 2015-03-17 |
| US11116392B2 (en) | 2021-09-14 |
| KR101653180B1 (ko) | 2016-09-01 |
| US20100030113A1 (en) | 2010-02-04 |
| EP2306886B1 (en) | 2018-10-31 |
| JP5676446B2 (ja) | 2015-02-25 |
| AU2009276553B2 (en) | 2015-02-05 |
| MX2011001099A (es) | 2011-03-15 |
| US10271719B2 (en) | 2019-04-30 |
| US20190167089A1 (en) | 2019-06-06 |
| AU2009276553A1 (en) | 2010-02-04 |
| CA2732769A1 (en) | 2010-02-04 |
| KR20110055564A (ko) | 2011-05-25 |
| EP2306886A1 (en) | 2011-04-13 |
| CN102112040A (zh) | 2011-06-29 |
| EP2664350A1 (en) | 2013-11-20 |
| US9750401B2 (en) | 2017-09-05 |
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