Cochlear fenestration burrs

Abstract

Specialized surgical burrs ( 122, 124, 162, 164 ) permit safely fenestrating the otic capsule bone adjacent to the scala tympani ( 44 ) of the cochlea ( 34 ) without damaging the basilar membrane ( 52 ) or organ of cordi. The invention disclosed herein may also be adopted for safely fenestrating other areas of the inner ear such as the scala vestibuli ( 42 ), bony labyrinth of semicircular canals, or walls of the vestibule, or perhaps even the oval or round windows thereof.

1 : A unitary initial fenestration burr adapted for use for conjunction with a microdrill in forming a cylindrically-shaped fenestration through a wall of a cochlea of a subject, the fenestration including an outer section that is called a well and an inner section which is smaller in diameter than the outer section, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, the initial fenestration burr comprising: 
 an elongated shaft one end of which is adapted to be secured to the microdrill for rotating the initial fenestration burr during use thereof in forming the fenestration;    a cutting burr that is located at a distal end of said shaft furthest from the microdrill during use of the initial fenestration burr in forming the fenestration;    a cylindrically-shaped outer section polishing burr that is located along said shaft near said cutting burr and which, during use of the initial fenestration burr in forming the fenestration, forms the outer section thereof, said outer section polishing burr having a diameter that is larger in a direction orthogonal to said shaft than a diameter of said cutting burr in a direction orthogonal to said shaft; and    a washer-shaped initial burr collar that is:    a) larger in diameter in a direction orthogonal to said shaft than a diameter of said outer section polishing burr in a direction orthogonal to said shaft;    b) located along said shaft juxtaposed with a side of said outer section polishing burr that is furthest from said cutting burr; and    c) adapted to contact an outer surface of the wall of the cochlea during use of the initial fenestration burr in forming the fenestration to thereby limit penetration of the initial fenestration burr into the wall of the cochlea.    
   
   
       2 : The initial fenestration burr of  claim 1  wherein said cutting burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.4 mm.  
   
   
       3 : The initial fenestration burr of  claim 1  wherein said outer section polishing burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.8 mm.  
   
   
       4 : The initial fenestration burr of  claim 1  wherein said outer section polishing burr is located 0.5 mm from said cutting burr along said shaft.  
   
   
       5 : The initial fenestration burr of  claim 1  wherein said outer section polishing burr is located 0.5 mm from said cutting burr along said shaft and extends 0.5 mm along said shaft.  
   
   
       6 : The initial fenestration burr of  claim 1  wherein said outer section polishing burr is diamond studded.  
   
   
       7 : The initial fenestration burr of  claim 1  wherein said initial burr collar has a diameter in a direction orthogonal to said shaft that does not exceed 2.0 mm.  
   
   
       8 : The initial fenestration burr of  claim 1  wherein: 
 said cutting burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.4 mm;    said outer section polishing burr: 
 has a diameter in a direction orthogonal to said shaft that does not exceed 1.8 mm;  
 is located 0.5 mm from said cutting burr along said shaft;  
 extends 0.5 mm along said shaft; and  
 is diamond studded; and  
   said initial burr collar has a diameter in a direction orthogonal to said shaft that does not exceed 2.0 mm.    
   
   
       9 : A unitary fenestration polishing burr adapted for use in conjunction with a microdrill in forming a cylindrically-shaped fenestration through a wall of a cochlea of a subject, the fenestration including an outer section that is called a well and an inner section which is smaller in diameter than the outer section, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, the fenestration polishing burr comprising: 
 an elongated shaft one end of which is adapted to be secured to the microdrill for rotating the fenestration polishing burr during use thereof in forming the fenestration;    an inner section polishing burr that is located at a distal end of said shaft furthest from the microdrill during use of the fenestration polishing burr in forming the fenestration; and    a washer-shaped polishing burr collar that:    a) has a diameter in a direction orthogonal to said shaft which: 
 i. is larger than a diameter of said inner section polishing burr in a direction orthogonal to said shaft; and  
 ii. does not exceed a diameter of said outer section of the fenestration in a direction orthogonal to said shaft;  
   b) is located along said shaft a short distance from said inner section polishing burr; and    c) is adapted to contact the well floor of the well during use of the inner section polishing burr in forming the fenestration to thereby limit penetration of said fenestration polishing burr into the wall of the cochlea.    
   
   
       10 : The fenestration polishing burr of  claim 9  wherein the diameter of said polishing burr collar in a direction orthogonal to said shaft is the same as the diameter of the outer section of the fenestration in a direction orthogonal to said shaft.  
   
   
       11 : The fenestration polishing burr of  claim 9  wherein the diameter of said polishing burr collar in a direction orthogonal to said shaft does not exceed 1.8 mm.  
   
   
       12 : A unitary outer-section grooving burr adapted for use in conjunction with a microdrill for forming an outer fenestration section groove that encircles an outer section, that is called a well, of a cylindrically-shaped fenestration that pierces a wall of a cochlea of a subject; the fenestration further including an inner section which is smaller in diameter than the outer section thereof, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, the outer-section grooving burr comprising: 
 a) an elongated outer section grooving shaft one end of which is adapted to be secured to the microdrill for rotating the outer-section grooving burr during use thereof for forming the outer fenestration section groove;    b) a washer-shaped outer fenestration groove collar that is located at a distal end of said shaft furthest from the microdrill for contacting the well floor during use of the outer-section grooving burr for forming the outer fenestration section groove to thereby locate the outer fenestration section groove at a precise distance above the well floor, the outer fenestration groove collar having a diameter that is; 
 i. larger than a diameter of said inner section; and  
 ii. smaller than a diameter of said outer section; and  
   c) an outer section groove cutting wheel that: 
 i. has a diameter in a direction orthogonal to said shaft which: 
 1) is larger than a diameter of said outer fenestration groove collar in a direction orthogonal to said shaft; and  
 2) does not exceed a diameter of said outer section of the fenestration in a direction orthogonal to said shaft; and  
 
 ii. is located along said outer section grooving shaft a short distance from said outer fenestration groove collar.  
   
   
   
       13 : The outer-section grooving burr of  claim 12  wherein the diameter of said outer section groove cutting wheel does not exceed 1.8 mm.  
   
   
       14 : A unitary inner-section grooving burr adapted for use in conjunction with a microdrill for forming an inner fenestration section groove that encircles an inner section of a cylindrically-shaped fenestration that pierces a wall of a cochlea of a subject; the fenestration further including an outer section, that is called a well, which is larger in diameter than the inner section thereof, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, the inner-section grooving burr comprising: 
 a) an elongated inner section grooving shaft one end of which is adapted to be secured to the microdrill for rotating the inner-section grooving burr during use thereof for forming the inner fenestration section groove;    b) an inner section groove cutting wheel that: 
 i. has a diameter in a direction orthogonal to said shaft which does not exceed a diameter of the inner section of said fenestration; and  
 ii. is located at a distal end of said shaft furthest from the microdrill; and  
   c) a washer-shaped inner fenestration groove collar: 
 i. having a diameter that is: 
 1) larger than a diameter of said inner section; and  
 2) smaller than a diameter of said outer section; and  
 
 ii. that is located along said inner section grooving shaft a short distance from said inner section groove cutting wheel for contacting the well floor during use of the inner-section grooving burr for forming the inner fenestration section groove to thereby locate the inner fenestration section groove at a precise distance below the well floor.  
   
   
   
       15 : The inner-section grooving burr of  claim 14  wherein the diameter of said inner section groove cutting wheel does not exceed 1.4 mm.  
   
   
       16 : A sequence of unitary fenestration polishing burrs adapted for use in conjunction with a microdrill in forming a cylindrically-shaped fenestration through a wall of a cochlea of a subject, the fenestration including an outer section that is called a well and an inner section which is smaller in diameter than the outer section, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, each of the fenestration polishing burrs in the sequence comprising: 
 an elongated shaft one end of which is adapted to be secured to the microdrill for rotating the fenestration polishing burr during use thereof in forming the fenestration;    an inner section polishing burr that is located at a distal end of said shaft furthest from the microdrill during use of the fenestration polishing burr in forming the fenestration; and    a washer-shaped polishing burr collar that:    a) has a diameter in a direction orthogonal to said shaft which: 
 i. is larger than a diameter of said inner section polishing burr in a direction orthogonal to said shaft; and  
 ii. does not exceed a diameter of said outer section of the fenestration in a direction orthogonal to said shaft;  
   b) is located along said shaft a short distance from said inner section polishing burr; and    c) is adapted to contact the well floor of the well during use of the inner section polishing burr in forming the fenestration to thereby limit penetration of said fenestration polishing burr into the wall of the cochlea; and    the distance between said polishing burr collar and a distal end of said inner section polishing burr increasing progressively for each successive fenestration polishing burr in the sequence of fenestration polishing burrs.    
   
   
       17 : The sequence of fenestration polishing burrs of  claim 16  wherein the diameter of said polishing burr collar in a direction orthogonal to said shaft for each successive fenestration polishing burr in the sequence of fenestration polishing burrs is the same as the diameter of the outer section of the fenestration in a direction orthogonal to said shaft.  
   
   
       18 : The sequence of fenestration polishing burrs of  claim 16  wherein the diameter of said polishing burr collar in a direction orthogonal to said shaft for each successive fenestration polishing burr in the sequence of fenestration polishing burrs does not exceed 1.8 mm.  
   
   
       19 : The sequence of fenestration polishing burrs of  claim 16  wherein: 
 there are five (5) fenestration polishing burr in the sequence of fenestration polishing burrs;    a shortest distance between said polishing burr collar and a distal end of said inner section polishing burr of one of the fenestration polishing burrs is 0.75 mm; and    the distance between said polishing burr collar and a distal end of said inner section polishing burr for other fenestration polishing burrs in the sequence of fenestration polishing burrs progressively increases:    from 0.75 mm to 1.00 mm;    from 1.00 mm to 1.25 mm;    from 1.25 mm to 1.50 mm; and    from 1.50 mm to 1.75 mm.    
   
   
       20 : A set of fenestration burrs adapted for use in conjunction with a microdrill in forming a cylindrically-shaped fenestration through a wall of a cochlea of a subject, the fenestration including an outer section that is called a well and an inner section which is smaller in diameter than the outer section, the fenestration also including an annularly-shaped well floor that spans between one edge of the outer section of the fenestration and one edge of the inner section thereof, the initial fenestration burr comprising: 
 a) a unitary initial fenestration burr that includes: 
 i. an elongated initial burr shaft one end of which is adapted to be secured to the microdrill for rotating the initial fenestration burr during use thereof in forming the fenestration;  
 ii. a cutting burr that is located at a distal end of said initial burr shaft furthest from the microdrill during use of the initial fenestration burr in forming the fenestration;  
 iii. a cylindrically-shaped outer section polishing burr that is located along said initial burr shaft near said cutting burr and which, during use of the initial fenestration burr in forming the fenestration, forms the outer section thereof, said outer section polishing burr having a diameter that is larger in a direction orthogonal to said initial burr shaft than a diameter of said cutting burr in a direction orthogonal to said initial burr shaft; and  
 iv. a washer-shaped initial burr collar that is: 
 1) larger in diameter in a direction orthogonal to said initial burr shaft than a diameter of said outer section polishing burr in a direction orthogonal to said initial burr shaft;  
 2) located along said initial burr shaft juxtaposed with a side of said outer section polishing burr that is furthest from said cutting burr; and  
 3) adapted to contact an outer surface of the wall of the cochlea during use of the initial fenestration burr in forming the fenestration to thereby limit penetration of the initial fenestration burr into the wall of the cochlea; and  
 
   b) a sequence of unitary fenestration polishing burrs, each of the fenestration polishing burrs in the sequence including: 
 i. an elongated polishing burr shaft one end of which is adapted to be secured to the microdrill for rotating the fenestration polishing burr during use thereof in forming the fenestration;  
 ii. an inner section polishing burr that is located at a distal end of said polishing burr shaft furthest from the microdrill during use of the fenestration polishing burr in forming the fenestration; and  
 iii. a washer-shaped polishing burr collar that: 
 1) has a diameter in a direction orthogonal to said polishing burr shaft which: 
 A. is larger than a diameter of said inner section polishing burr in a direction orthogonal to said polishing burr shaft; and  
 B. does not exceed a diameter of said outer section of the fenestration in a direction orthogonal to said polishing burr shaft;  
 
 2) is located along said polishing burr shaft a short distance from said inner section polishing burr; and  
 3) is adapted to contact the well floor of the well during use of the inner section polishing burr in forming the fenestration to thereby limit penetration of said fenestration polishing burr into the wall of the cochlea; and  
 
   the distance between said polishing burr collar and a distal end of said inner section polishing burr increasing  70  progressively for each successive fenestration polishing burr in the sequence of fenestration polishing burrs.    
   
   
       21 : The set of fenestration burrs of  claim 20  wherein said cutting burr of said initial fenestration burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.4 mm.  
   
   
       22 : The set of fenestration burrs of  claim 20  wherein said outer section polishing burr of said initial fenestration burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.8 mm.  
   
   
       23 : The set of fenestration burrs of  claim 20  wherein said outer section polishing burr of said initial fenestration burr is located 0.5 mm from said cutting burr along said shaft.  
   
   
       24 : The set of fenestration burrs of  claim 20  wherein said outer section polishing burr of said initial fenestration burr is located 0.5 mm from said cutting burr along said shaft and extends 0.5 mm along said shaft.  
   
   
       25 : The set of fenestration burrs of  claim 20  wherein said outer section polishing burr of said initial fenestration burr is diamond studded.  
   
   
       26 : The set of fenestration burrs of  claim 20  wherein said initial burr collar of said initial fenestration burr has a diameter in a direction orthogonal to said shaft that does not exceed 2.0 mm.  
   
   
       27 : The set of fenestration burrs of  claim 20  wherein: 
 said cutting burr of said initial fenestration burr has a diameter in a direction orthogonal to said shaft that does not exceed 1.4 mm;    said outer section polishing burr of said initial fenestration burr: 
 has a diameter in a direction orthogonal to said shaft that does not exceed 1.8 mm;  
 is located 0.5 mm from said cutting burr along said shaft;  
 extends 0.5 mm along said shaft; and  
 is diamond studded; and  
   said initial burr collar of said initial fenestration burr has a diameter in a direction orthogonal to said shaft that does not exceed 2.0 mm.    
   
   
       28 : The set of fenestration burrs of  claim 20  wherein the diameter of said polishing burr collar of each fenestration polishing burr in the sequence of fenestration polishing burrs in a direction orthogonal to said shaft is the same as the diameter of the outer section of the fenestration in a direction orthogonal to said shaft.  
   
   
       29 : The set of fenestration burrs of  claim 20  wherein the diameter of said polishing burr collar of each fenestration polishing burr in the sequence of fenestration polishing burrs in a direction orthogonal to said shaft does not exceed 1.8 mm.  
   
   
       30 : The sequence of fenestration polishing burrs of  claim 20  wherein: 
 there are five (5) fenestration polishing burr in the sequence of fenestration polishing burrs;    a shortest distance between said polishing burr collar and a distal end of said inner section polishing burr of one of the fenestration polishing burrs is 0.75 mm; and    the distance between said polishing burr collar and a distal end of said inner section polishing burr for other fenestration polishing burrs in the sequence of fenestration polishing burrs progressively increases:    from 0.75 mm to 1.00 mm;    from 1.00 mm to 1.25 mm;    from 1.25 mm to 1.50 mm; and    from 1.50 mm to 1.75 mm.    
   
   
       31 : The set of fenestration burrs of  claim 20  further comprising a unitary outer-section grooving burr adapted for use in conjunction with a microdrill for forming an outer fenestration section groove that encircles the outer section of the fenestration, the outer-section grooving burr comprising: 
 a) an elongated outer section grooving shaft one end of which is adapted to be secured to the microdrill for rotating the outer-section grooving burr during use thereof for forming the outer fenestration section groove;    b) a washer-shaped outer fenestration groove collar that is located at a distal end of said shaft furthest from the microdrill for contacting the well floor during use of the outer-section grooving burr for forming the outer fenestration section groove to thereby locate the outer fenestration section groove at a precise distance above the well floor, the outer fenestration groove collar having a diameter that is; 
 i. larger than a diameter of said inner section; and  
 ii. smaller than a diameter of said outer section; and  
   c) an outer section groove cutting wheel that: 
 i. has a diameter in a direction orthogonal to said shaft which: 
 1) is larger than a diameter of said outer fenestration groove collar in a direction orthogonal to said shaft; and  
 2) does not exceed a diameter of said outer section of the fenestration in a direction orthogonal to said shaft; and  
 
 ii. is located along said outer section grooving shaft a short distance from said outer fenestration groove collar.  
   
   
   
       32 : The outer-section grooving burr of  claim 31  wherein the diameter of said outer section groove cutting wheel does not exceed 1.8 mm.  
   
   
       33 : The set of fenestration burrs of  claim 20  further comprising a unitary inner-section grooving burr adapted for use in conjunction with a microdrill for forming an inner fenestration section groove that encircles the inner section of the fenestration that pierces the cochlea, the inner-section grooving burr comprising: 
 a) an elongated inner section grooving shaft one end of which is adapted to be secured to the microdrill for rotating the inner-section grooving burr during use thereof for forming the inner fenestration section groove;    b) an inner section groove cutting wheel that: 
 i. has a diameter in a direction orthogonal to said shaft which does not exceed a diameter of the inner section of said fenestration; and  
 ii. is located at a distal end of said shaft furthest from the microdrill; and  
   c) a washer-shaped inner fenestration groove collar: 
 i. having a diameter that is: 
 1) larger than a diameter of said inner section; and  
 2) smaller than a diameter of said outer section; and  
 
 ii. that is located along said inner section grooving shaft a short distance from said inner section groove cutting wheel for contacting the well floor during use of the inner-section grooving burr for forming the inner fenestration section groove to thereby locate the inner fenestration section groove at a precise distance below the well floor.  
   
   
   
       34 - 49 . (canceled)