Devices and Method for Maxillary Sinus Lavage

Abstract

A lavage catheter for the treatment of a maxillary sinus is described. The catheter comprises a proximal portion and a distal portion. The distal portion comprises an irrigation tip. The irrigation tip has a tip opening through which fluid may be delivered by one handed operation of the catheter. A method for lavaging the maxillary sinus includes inserting the lavage catheter into a patient's anatomy and advancing the irrigation tip into the maxillary sinus using one hand.

What is claimed is:  
     
         1 . A catheter for the lavage of a maxillary sinus comprising:
 a distal portion comprising:   an elongate shaft with a bend angle of between about 90 degrees and 140 degrees,   a distal irrigation tube in coaxial arrangement with said elongate shaft,   a distal hub,   a proximal hub, and   an actuator between said distal hub and said proximal hub for advancing the distal irrigation tube into the maxillary sinus; and   a proximal portion comprising an irrigation luer and irrigation tubing.   
     
     
         2 . The catheter of  claim 1  wherein the irrigation tip comprises a distal tip opening. 
     
     
         3 . The catheter of  claim 2  wherein the irrigation tip further comprises one or more radially facing openings. 
     
     
         4 . The catheter of  claim 1  wherein the distal irrigation tube comprises a flexible material selected from the group consisting of nylon, polyethylene, polyether ether ketone or polyether block amides. 
     
     
         5 . The catheter of  claim 4  wherein the distal irrigation tube is a polyether block amide. 
     
     
         6 . The catheter of  claim 1  further comprising one or more direct visualization markers. 
     
     
         7 . The catheter of  claim 1  further comprising one or more radiographic markers. 
     
     
         8 . The catheter of  claim 1  wherein the distal irrigation tube surrounds the elongate shaft. 
     
     
         9 . The catheter of  claim 1  wherein the distal irrigation tube is surrounded by the elongate shaft. 
     
     
         10 . The catheter of  claim 1  further comprising an illuminating fiber. 
     
     
         11 . The catheter of  claim 1  wherein the distal irrigation tip has a tapered configuration. 
     
     
         12 . The catheter of  claim 1  further comprising a pulsation device. 
     
     
         13 . The catheter of  claim 12  wherein the pulsation device comprises a valve assembly. 
     
     
         14 . A catheter for the lavage of a maxillary sinus comprising:
 a distal portion comprising:   an elongate shaft with a bend angle of between about 90 degrees and 140 degrees,   a distal irrigation tube in coaxial arrangement with said elongate shaft, and   a handle comprising an actuator, and   a proximal portion comprising an irrigation luer and irrigation tubing,   wherein the actuator is useful for advancing the distal irrigation tube into the maxillary sinus.   
     
     
         15 . The catheter of  claim 14  wherein the actuator comprises a light access port and wherein the distal portion further comprises an illuminating fiber. 
     
     
         16 . A kit for the lavage of a maxillary sinus, said kit comprising a catheter and an endoscope,
 wherein the catheter comprises a distal portion and a proximal portion,   said distal portion comprising:
 an elongate shaft with a bend angle of between about 90 degrees and 140 degrees, 
 a distal irrigation tube in coaxial arrangement with said elongate shaft, 
 an illuminating fiber, and 
 a handle comprising an actuator, said actuator having a light access port and 
 said proximal portion comprising an irrigation luer and irrigation tubing, 
 wherein the actuator is useful for advancing the distal irrigation tube into the maxillary sinus; and 
 an endoscope for insertion into the light access port. 
   
     
     
         17 . A method for lavaging a maxillary sinus, said method comprising:
 positioning an lavage catheter comprising a proximal portion, and a distal portion in the nasal anatomy of a patient, wherein the distal portion comprises an irrigation tip;   connecting a fluid source to the irrigation catheter;   with one hand, advancing the irrigation tip into the maxillary sinus; and   delivering fluid to the maxillary sinus from the fluid source though the lavage catheter.   
     
     
         18 . The method of  claim 17  wherein the delivering the fluid occurs at a flow rate of between 50 ml/min and 250 ml/min. 
     
     
         19 . The method of  claim 17  wherein the fluid is selected from the group consisting of water, saline, contrast agents, antimicrobial agents anti-inflammatory agents, decongestants, mucous thinning agents, anesthetic agents, analgesic agents, anti-allergenic agents, allergens, anti-proliferative agents, hemostatic agents, cytotoxic agents, and biological agents or combinations of any of the above. 
     
     
         20 . A kit for the lavage of a maxillary sinus, said kit comprising a maxillary lavage catheter,
 wherein the catheter comprises a distal portion and a proximal portion,   said distal portion comprising:
 an elongate shaft with a bend angle of between about 90 degrees and 140 degrees, 
 a distal irrigation tube in coaxial arrangement with said elongate shaft, 
 an illuminating fiber, and 
 a handle comprising an actuator, 
 said proximal portion comprising an irrigation luer and irrigation tubing, 
 wherein the actuator is useful for advancing the distal irrigation tube into the maxillary sinus; and 
 a illuminating fiber connector for connecting said illuminating fiber to a light source, wherein the illuminating fiber connector allows for rotation of the catheter while the catheter is connected to the light source. 
   
     
     
         21 . A kit for the lavage of a maxillary sinus, said kit comprising a catheter and fluid delivery system,
 wherein the catheter comprises a distal portion and a proximal portion,   said distal portion comprising:
 an elongate shaft with a bend angle of between about 90 degrees and 140 degrees, 
 a distal irrigation tube in coaxial arrangement with said elongate shaft, 
 an illuminating fiber, and 
 a handle comprising an actuator, 
 said proximal portion comprising an irrigation luer and irrigation tubing, 
 wherein the actuator is useful for advancing the distal irrigation tube into the maxillary sinus; and 
 a fluid delivery system for providing continuous fluid delivery to the catheter. 
   
     
     
         22 . The kit of  claim 21  wherein the fluid delivery system comprises:
 a syringe; 
 a fluid reservoir; 
 a first one-way valve for directing fluid from the syringe into the catheter when pressure is applied to the syringe and a second one-way valve for directing fluid from the fluid reservoir into the catheter when pressure is released from the syringe.