Methods and apparatus for treating disorders of the ear, nose and throat

Abstract

Methods and apparatus for treating disorders of the ear, nose, throat or paranasal sinuses, including methods and apparatus for dilating ostia, passageways and other anatomical structures, endoscopic methods and apparatus for endoscopic visualization of structures within the ear, nose, throat or paranasal sinuses, navigation devices for use in conjunction with image guidance or navigation system and hand held devices having pistol type grips and other handpieces.

1 - 151 . (canceled) 
     
     
         152 . An apparatus comprising:
 (a) an elongate shaft assembly having:
 (i) a proximal end, 
 (ii) a distal end, 
 (iii) a first lumen, wherein the first lumen distally terminates at a first distal end, and 
 (iv) a second lumen, wherein the second lumen distally terminates at a second distal end; 
   (b) a first port located at the proximal end of the elongate shaft assembly, wherein the first port is in fluid communication with the first lumen;   (c) a second port located at the proximal end of the elongate shaft assembly, wherein the second port is in fluid communication with the second lumen; and   (d) an inflatable member positioned proximal to the first distal end, wherein the inflatable member is in fluid communication with the second lumen such that the inflatable member is in fluid communication with the second port via the second lumen,   wherein the inflatable member is sized and configured to transition between a first state and a second state, wherein the inflatable member is sized to fit in an anatomical passageway associated with a paranasal sinus in the first state,   wherein the inflatable member is configured to dilate an anatomical passageway associated with a paranasal sinus in which the inflatable member is position in the second state.   
     
     
         153 . The apparatus of  claim 152 , wherein the second distal end is located within the inflatable member. 
     
     
         154 . The apparatus of  claim 152 , wherein the shaft assembly further comprises a first tubular member and a second tubular member. 
     
     
         155 . The apparatus of  claim 154 , wherein the first and second tubular members are laterally offset from each other such that the first and second tubular members extend along offset parallel axes. 
     
     
         156 . The apparatus of  claim 152 , wherein the first distal end is open. 
     
     
         157 . The apparatus of  claim 152 , wherein the distal end of the shaft assembly includes a navigational marker configured to provide visibility through an electromagnetic image guidance system. 
     
     
         158 . The apparatus of  claim 152 , wherein the shaft assembly includes a bent region. 
     
     
         159 . The apparatus of  claim 152 , wherein the shaft assembly defines a longitudinal axis, wherein the longitudinal axis passes through the first port, wherein the second port is positioned distal to the first port, wherein at least a portion of the second port is oriented transversely relative to the longitudinal axis. 
     
     
         160 . An apparatus comprising:
 (a) a handle assembly, wherein the handle assembly comprises:
 (i) a body, and 
 (ii) an actuator, wherein the actuator is movable relative to the body; 
   (b) a guide member extending distally from the handle assembly, wherein the guide member has a distal end; and   (c) a dilation catheter coaxially disposed with respect to the guide member, wherein the dilation catheter comprises a dilator, wherein the dilator is sized and configured to transition between a non-expanded state and an expanded state, wherein the dilator is sized to fit in an anatomical passageway associated with a paranasal sinus in the non-expanded state, wherein the dilator is configured to dilate an anatomical passageway associated with a paranasal sinus in which the dilator is position in the expanded state;   wherein the dilation catheter is coupled with the actuator such that the actuator is operable to drive the dilation catheter relative to the guide member from a proximal position to a distal position, wherein the dilation catheter is configured such that the dilator is positioned distal to the distal end of the guide member when the dilation catheter is in the distal position.   
     
     
         161 . The apparatus of  claim 160 , wherein the guide member comprises a guide catheter. 
     
     
         162 . The apparatus of  claim 161 , wherein the dilation catheter is slidably disposed within the guide catheter. 
     
     
         163 . The apparatus of  claim 160 , further comprising a guidewire, wherein the guidewire is slidably disposed through the dilation catheter. 
     
     
         164 . The apparatus of  claim 163 , further comprising a guidewire actuator secured to the guidewire, wherein the guidewire actuator is operable to translate and rotate the guidewire relative to the dilation catheter. 
     
     
         165 . The apparatus of  claim 164 , wherein the guidewire actuator is positioned proximal to the body of the handle assembly. 
     
     
         166 . The apparatus of  claim 160 , further comprising an inflation port in fluid communication with the dilator, wherein a portion of the inflation port protrudes from the body of the handle assembly, wherein the portion of the inflation port protruding from the body of the handle assembly is slidable relative to the handle assembly. 
     
     
         167 . The apparatus of  claim 160 , wherein the actuator comprises a trigger, wherein the trigger is pivotable relative to the body of the handle assembly. 
     
     
         168 . The apparatus of  claim 160 , further comprising a hub secured to the proximal end of the guide member, wherein the hub is removably coupled with the body of the handle assembly. 
     
     
         169 . A method of using an apparatus to dilate an anatomical passageway associated with a paranasal sinus in a patient, the method comprising:
 (a) grasping a handle assembly of the apparatus, wherein the handle assembly comprises a body and an actuator;   (b) inserting a guide member of the apparatus through a nostril of the patient, wherein the guide member extends distally from the handle assembly;   (c) moving the actuator in a first direction relative to the body of the handle assembly, thereby advancing a dilation catheter distally relative to the guide member, wherein the act of advancing the dilation catheter distally results in a dilator of the dilation catheter being positioned in an anatomical passageway associated with a paranasal sinus in the patient; and   (d) expanding the dilator in the anatomical passageway, thereby dilating the anatomical passageway.   
     
     
         170 . The method of  claim 169 , further comprising moving the actuator in a second direction relative to the body of the handle assembly, thereby retracting the dilation catheter proximally relative to the guide member. 
     
     
         171 . The method of  claim 169 , further comprising advancing a guidewire into a paranasal sinus associated with the anatomical passageway, wherein the act of advancing the dilation catheter distally comprises advancing the dilation catheter distally along the guidewire.