Devices and Methods for Minimally Invasive Access to Sinuses and Treatment of Sinusitis

Abstract

The present invention provides minimally invasive devices and methods for accessing the sinuses and their surrounding structures for surgery and other treatments. The anterior ethmoid and maxillary sinuses are accessed and treated under minimal anesthesia with little or no postoperative limitation of activity or adverse symptoms. Direct visual verification of the sinuses and their natural ostia is utilized. Other paranasal sinuses may be treated by this method as well. The sinuses, in particular the maxillary and anterior ethmoid, are accessed via a direct anterior to posterior axis and the natural ostia of those sinuses is directly visualized for placement of a guide-free dilator, in the desired location within the natural ostia. That access to the maxillary ostium is accomplished by the anterior transuncinate “keyhole” approach in which a hole is punched in the uncinate process with the described devices according to the described methods. The properly placed dilator is expanded to allow drainage of the inflamed sinus and then withdrawn. An analogous ethmoid bulla “keyhole” approach and subsequent dilation are used for the anterior ethmoid sinus ostia. Pharmaceutical agents may be placed at desired locations in the sinuses using the same access technique.

1 . A medial ethmoid probe comprising:
 i. a handle having a top portion and a bottom portion; and   ii. a shaft having a proximal segment and a distal segment, said proximal segment comprising a rigid material mounted on the top portion and the bottom portion of the handle and said distal segment comprising a semirigid material with a curved tip to engage an ostium in the ethmoid bulla, wherein the distal segment of the shaft curves to an angle ranging from about 30 degrees to about 60 degrees.   
     
     
         2 . The medial ethmoid probe of  claim 1 , wherein the distal segment is wedge-shaped. 
     
     
         3 . The medial ethmoid probe of  claim 1 , wherein the length of the distal segment ranges from about 0.7 cm to about 1.5 cm. 
     
     
         4 . The medial ethmoid probe of  claim 1 , wherein the length of the distal segment is about 1.2 cm. 
     
     
         5 . The medial ethmoid probe of  claim 1 , wherein the angle at the distal segment of the shaft at the bottom portion of the handle and at the top portion of the handle are identical. 
     
     
         6 . The medial ethmoid probe of  claim 1 , wherein the angle at the distal segment of the shaft at the bottom portion of the handle and at the top portion of the handle are different. 
     
     
         7 . The medial ethmoid probe of  claim 1 , wherein the angle at the distal segment of the shaft at the bottom portion is about 30 degrees and the angle of the distal segment of the shaft at the top portion of the handle is about 60 degrees. 
     
     
         8 . The medial ethmoid probe of  claim 1 , wherein the distal segment is comprised of a material selected from the group consisting of silicone rubber, polyurethane, polyethylene terephthalate, polyethylene, polypropylene, polyvinyl chloride, polymethyl methacrylate, and polytetrafluoroethylene.