Devices and methods for minimally invasive access to sinuses and treatment of sinusitis

摘要

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 The properly placed dilator is expanded to allow drainage of the inflamed sinus and then withdrawn.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.

主权项

1. A method of retracting a middle turbinate prior to a sinus procedure comprising:
advancing a middle turbinate retractor in a compressed state into an axilla of a middle meatus between the middle turbinate and a lateral wall of a nose; and expanding the middle turbinate retractor to retract the middle turbinate and reveal a relevant anatomy around an obstructed sinus cavity using an expandable frame having two parallel sides and a rounded portion between the two parallel sides, the expansion also achieved using an intervening pliable frame between the two parallel sides of the expandable frame which enables expansion and compression of the expandable frame, wherein the expandable frame expands to a width of greater than 3 mm and less than 10 mm.