Anatomically, the human ear is divided into three distinct regions: the outer ear, the middle ear, and the inner ear. The outer ear and middle ear are divided by the tympanic membrane (i.e., the eardrum). The outer ear portion of the ear includes the pinna, or auricle, and the external auditory canal or tube (i.e., the ear canal). The middle ear, also known as the tympanic cavity, includes the ossicles and the eustachian tube. Meanwhile, the inner ear portion of the ear includes the cochlea, vestibule, and semicircular canals.
An ear speculum is typically used to assist in viewing and examining the ear canal and ear drum, which may be carried out prior to performing a neurotologic surgical procedure. An ear speculum is typically utilized in combination with an otoscope or other ear viewing device. One of the reasons for utilizing an ear speculum when examining the ear is to assist in providing a direct and clear view of the ear drum, which often times may be obstructed by hair (among other things) in the ear canal.
Transcanal endoscopic ear surgeries (TEES) are neurotologic procedures performed within the middle ear portion of the human ear. Such procedures are minimally invasive and differ from traditional ear procedures in that surgeons access the middle ear through the ear canal rather than through an incision behind ear. TEES procedures can be used to treat conditions such as acoustic neuroma, cholesteatoma, cholesterol granuloma, congenital or acquired ossicular chain fixation, congenital or acquired ossicular chain discontinuity, paraganglioma, ruptured eardrum, tympanosclerosis, and other otolaryngology conditions.
In a TEES procedure, an endoscope is inserted through the ear canal to access the middle ear. While using the endoscope to visualize the surgical area in the middle ear, the surgeon uses microsurgical instruments to perform the operation. One of the risks associated with TEES procedures is the risk of ear canal hairs dislodging or inadvertently being cut during the procedure and entering into the middle ear. Since hair in the ear canal is used to block dirt and debris from the ear drum, such hairs entering into the middle ear can cause infection and/or inflammation thereof.
Due to the size of conventional endoscopes and the dimensions of the average ear canal, it is not feasible for an ear speculum to be used in combination with an endoscope and any associated surgical instruments in order to pin down the hairs in the ear canal. Moreover, the addition of a speculum will cause there to be at least three or more instruments simultaneously used at one or more points during a TEES procedure (e.g., an endoscope, speculum, and microsurgical instrument), whereas the surgeon only has two hands to perform the procedure.
To minimize the risks associated with TEES procedures, pre-op procedures are often performed to cut and remove hair in the ear canal. Conventionally, the cutting and removing of ear canal hair is manually carried out using scissor shears, which can be both time consuming and taxing. Furthermore, the manual removal of the trimmed hair may not always be thorough, thereby increasing the chance that a trimmed hair may be missed and accidentally advanced into the middle ear during the surgical procedure.
The present disclosure generally relates to instruments for neurotologic surgical procedures, and more particularly, instruments for shearing ear canal hairs and having combined trimming, illuminating, and vacuuming functions.
In certain embodiments, a rotary trimmer is provided. The rotary trimmer includes a base unit configured to be held by a user. The base unit has an opening at a distal end and a cover coupled to the opening. The cover has a plurality of slits formed near a distal end of the cover. The rotary trimmer includes a shearing assembly disposed within the base unit. The shearing assembly includes a blade at least partially disposed within the cover, a rotor coupled to the blade, and a driver configured to rotate the rotor, wherein rotating the rotor causes rotation of the blade. The rotary trimmer also includes one or more optical fibers disposed within the base unit and a port disposed at a proximal end of the base unit. The optical fibers may be configured for use in visualization of an external space distal to the cover. The port may be configured to be in fluid communication with a vacuum line. In certain embodiments, the vacuum line fluidly couples the port of the rotary trimmer to a vacuum source.
In certain embodiments, at least one the one or more optical fibers in the rotary trimmer is configured to project an illumination light. In other embodiments, at least one of the one or more optical fibers in the rotary trimmer is optically coupled with a camera at a distal end of the at least one optical fiber.
In certain embodiments, the one or more optical fibers comprise one or more illumination fibers configured to propagate illumination light and one or more image fibers configured to capture light and propagate images to a visualization system.
In certain embodiments, at least one of the one or more optical fibers is configured as a proximity sensor to detect one or more sensitive surfaces inside an ear canal space and to monitor a distance between the distal end of the cover and the one or more detected sensitive surfaces.
In certain embodiments, the rotary trimmer comprises a safety feedback feature to provide an audible and/or a visual notification to a user upon the proximity sensor detecting that the distal end of the cover is within a minimum threshold distance to the one or more sensitive surfaces inside the ear canal space. In some other embodiments, the rotary trimmer comprises a safety feedback feature to disable the shearing assembly upon the proximity sensor detecting that the distal end of the cover is within a minimum threshold distance to the one or more sensitive surfaces inside the ear canal space.
In certain embodiments, the cover further comprises one or more sections formed of a translucent or transparent material to facilitate transmission of light therethrough.
In certain embodiments, the blade of the rotary trimmer comprises a cylindrical body having a proximal end and a distal end, wherein the proximal end of the cylindrical body is coupled to the rotor, and wherein the distal end of the cylindrical body comprises a cutting surface formed along a circumference of an opening at the distal end of the cylindrical body. In certain embodiments, the blade further comprises a hollow cavity extending from the proximal end of the cylindrical body to the opening at the distal end of the cylindrical body, and wherein the one or more optical fibers are concentrically disposed within the hollow cavity relative to the cutting surface of the cylindrical body.
In certain embodiments, the blade of the rotary trimmer comprises a cylindrical body and one or more lateral blades extending laterally from an exterior surface of the cylindrical body, wherein each of the one or more lateral blades includes a lateral cutting surface disposed parallel with the exterior surface of the cylindrical body. In certain embodiments, each of the one or more lateral blades further comprise a distal cutting surface at a distal end of each of the one or more lateral blades, wherein the distal cutting surface extends perpendicular with the exterior surface of the cylindrical body.
So that the manner in which the above recited features of the present disclosure can be understood in detail, a more particular description of the disclosure, briefly summarized above, may be had by reference to embodiments, some of which are illustrated in the appended drawings. It is to be noted, however, that the appended drawings illustrate only exemplary embodiments and are therefore not to be considered limiting of its scope, and may admit to other equally effective embodiments.
To facilitate understanding, identical reference numerals have been used, where possible, to designate identical elements that are common to the figures. It is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without further recitation.
The present disclosure generally relates to instruments for neurotologic surgical procedures, and more particularly, instruments for shearing ear canal hairs and having combined shearing, illuminating, and vacuuming functions.
In certain embodiments, a rotary trimmer includes a base unit comprising a shearing assembly, a vacuum source coupled to a port at a proximate end of the base unit, and a cover disposed at a distal end of the base unit and having a plurality of slits for ingress of ear canal hairs for shearing by the shearing assembly. In certain embodiments, the base unit may further include a semi-rigid flexing shaft near the distal end of the base unit to enable conformation of the distal end to a plurality of varying diameters and angles of an ear canal. In certain embodiments, the base unit further comprises one or more optical fibers. In certain embodiments, the one or more optical fibers may comprise an image fiber having a camera or other image sensor at a distal end thereof to facilitate imaging inside the ear. In certain embodiments, the one or more optical fibers may comprise an illumination fiber configured to project an illumination light into the outer ear (e.g. ear canal) of the patient.
According to certain aspects of the present disclosure, the rotary trimmer may be inserted by a user into the ear canal of a patient to shear and remove hair in the ear canal leading to the tympanic membrane. In certain embodiments, the one or more optical fibers provide otoscopic (e.g., imaging) functions for viewing the ear canal when the rotary trimmer is inserted therein. In certain embodiments, the one or more optical fibers may also transmit illumination light into the ear canal to provide enhanced visualization thereof during inspection and hair removal. Thus, the one or more optical fibers may facilitate improved guidance of the distal end of the rotary trimmer through the ear canal by the user when shearing ear canal hairs.
In certain embodiments, the one or more optical fibers may be a component of a safety or feedback mechanism for preventing inadvertent contacting or damaging of the tympanic membrane. For example, in certain embodiments, which may be combined with other embodiments herein, the one or more optical fibers may comprise a fiber optic proximity sensor for detecting (e.g., via light) sensitive surfaces of the ear, such as the tympanic membrane, and alerting the user when the distal end of the rotary trimmer is within a predetermined distance of the detected sensitive surface. In certain embodiments, upon detecting that the distal end of the rotary trimmer is within a minimum threshold distance of a detected sensitive surface, the blade of the rotary trimmer may be automatically disabled by a controller or actuator in communication therewith. In certain embodiments, the rotary trimmer may be further configured to automatically reactivate upon detecting that the distal end of the rotary trimmer has been repositioned outside of the minimum threshold distance of the detected sensitive surface.
According to some embodiments, when (e.g., as soon as) hair in the ear canal is cut by the blades of the rotary trimmer, the hair is suctioned away to prevent cut and loose strands of hair from falling towards the tympanic membrane. After hair is cut by the rotating blades in the rotary trimmer, the cut hair may be suctioned towards the base unit by a vacuum source coupled to the rotary trimmer.
Turning now to
In certain embodiments, the base unit 120 comprises a hand piece near the distal end having an outer surface 128 configured to be held by a user, such as a surgeon or members of a surgical staff. For example, the base unit 120 may be ergonomically contoured to substantially fit and/or be held by the user. In certain embodiments, the outer surface may be textured or have one or more gripping features formed thereon, such as one or more grooves and/or ridges. The base unit may further comprise a switch 133 or toggle for activating the rotary trimmer 100. The base unit 120 may be made from any materials commonly used for such instruments and suitable for neurotologic surgical procedures. For example, the base unit 120 may be formed of a lightweight metallic material such as aluminum, a thermoplastic polymeric material, or other suitable material. In certain embodiments, the base unit 120 and/or components attached thereto may be sterilized and used in more than one surgical procedure. In other embodiments, the base unit 120 and/or components attached thereto may be single-use devices or components. In certain aspects, the cover 110 comprises a disposable single-use component that may be replaced every time the rotary trimmer 100 is used.
In certain embodiments, the base unit 120 may further comprise one or more ports 123 (e.g., one port 123 is depicted in
The shaft 119 and the cover 110 removably coupled thereto may be sized and configured to be inserted into the ear canal of a patient to trim any hair therein. For example, the elongated shaft 119 and the cover 110 may together comprise a longitudinal length 127 sized to substantially match or be greater than the typical depth of the outer ear. When the shaft 119 and the cover 110 are inserted into the outer ear, the length 127 may be sufficient for the shaft 119 to extend throughout the ear canal such that the cover 110 may be positioned adjacent to the tympanic membrane of the patient. In certain embodiments, the longitudinal length 127 of the shaft 119 and the cover 110 may be sized between about 3 cm and about 15 cm, such as between about 3 cm and about 8 cm, and between about 9 cm and about 15 cm. In certain embodiments, the shaft 119 and/or cover 110 may further have cross-sectional dimensions (e.g., diameter(s)) sized to be slightly less than the typical diameter of the ear canal in the outer ear. In certain embodiments, the shaft 119 may have a diameter 131 between about 2 mm (millimeters) and about 6 mm, such as between about 2 mm and about 4 mm, between about 4 mm and about 5 mm, and between about 5 mm and about 6 mm. In other embodiments, the rotary trimmer 100 may have a larger or smaller lengths 127 and diameters 131 capable of still being inserted into the ear canal of a patient.
In certain embodiments, the elongated shaft 119 may be formed with a semi-ridged flexible construction to enable the elongated shaft 119 to conform to the diameter and nonlinear path of the ear canal in the outer ear. For example, the elongated shaft 119 may comprise a low density plastic, a medium density plastic, a polyurethane elastomer, a polyester elastomers, a polyimide, or a flexible metallic material such as nitinol.
In certain embodiments, the distal tip 111 of the cover 110 may comprise a blunted or rounded end face 118 (e.g., the distal-most exterior surface) to protect the surfaces of the outer ear and tympanic membrane from inadvertent puncturing by the distal tip 111 when the rotary trimmer 100 is used inside the ear. As discussed above, the cover 110 is generally sized to navigate the rotary trimmer 100 through the ear canal. The cover 110 may therefore, like the shaft 119, have a diameter 131 between about 2 mm and about 5 mm, such as between about 2 mm and about 3 mm, between about 3 mm and about 4 mm, and between about 4 mm and about 5 mm. In other embodiments, the cover 110 may have a larger or smaller diameter while still coverable of being inserted into the ear canal of a patient.
The cover 110 includes a plurality of slits 112 formed near the distal tip 111 to receive hairs for cutting by the rotary trimmer 100 inside the cover 110. Each of the plurality of slits 112 may extend from substantially near the distal tip 111 to the proximal end 117 of the cover 110. In certain embodiments, the plurality of slits 112 may be incrementally disposed along an entire circumference of the cover 110 to receive hairs for cutting from all sides and angles of the cover 110 without having to reorient the position of the rotary trimmer 100. In certain embodiments, each of the plurality of slits 112 may include a width 114 sized between about 200 μm (micrometers) and about 500 μm, such as about 300 μm and about 400 μm. Each of the plurality of slits 112 may also include a length 115 sized between about 1 mm to about 3 mm. In one aspect, the plurality of slits 112 may be disposed between about 1 mm to about 3 mm from the distal tip 111 of the cover 110.
As shown in
In certain embodiments, the optical fiber 302 may be operably coupled to a camera 304 or other image sensor of a visualization system at a proximal end thereof and be fitted with a lens or window at a distal end 303 thereof to enable digital image visualization of the ear canal for the user while the rotary trimmer 100 is in use. In certain embodiments, the optical fiber 302 and camera 304 (or other image sensor) may comprise components of a videoscope or an endoscope for facilitating live video feed of the exterior space in front of (e.g., distal to) the distal tip 111, such as the space inside the ear canal of the patient. Accordingly, in such embodiments, the optical fiber 302 and camera 304 enable the user to find and direct the distal end 121 of the rotary trimmer 100 towards hair in the ear canal for shearing. After the ear canal hair is cut, the camera 304 may also be used to inspect the cleared space to ensure that there is not any uncut or loose hair remaining.
In certain embodiments, the optical fiber 302 may be an illumination fiber coupled to a light source 306 and configured to relay illumination light. The illumination light may be used to enhance visualization of the ear canal for the user when utilizing the rotary trimmer 100. In certain embodiments, the optical fiber 302 is configured to function as both an illumination fiber and an image fiber, wherein illumination light relayed by the optical fiber 302 is utilized to enhance the imaging function thereof. In certain other embodiments, the optical fiber 302 is configured to function as only one of an illumination fiber or an image fiber. For example, since hair growth in the ear canal is somewhat accessible and can be seen by the naked eye under some circumstances, only illumination of the ear canal may be needed. In still other embodiments, the rotary trimmer 100 may comprise more than one optical fiber 302 for imaging, illumination, or performing both functions simultaneously by separate or the same fibers.
In certain embodiments where the optical fiber 302 is coupled to the camera 304, the camera 304 and optical fiber 302 may function as components of a safety feedback mechanism for preventing inadvertent contact with, and/or puncturing of, sensitive surfaces of the ear canal, including surfaces of the tympanic membrane. For example, the camera 304 and optical fiber 302 may together comprise an optical proximity sensor for automatically detecting, based on images captured by the camera 304, when the distal tip 111 of the cover 110 is within a minimum threshold distance of a sensitive surface in the ear canal. In certain embodiments, when the distal tip 111 is within the minimum threshold distance, an audible or visual warning notification or alert may be provided to the user, and/or the shearing assembly 200 may be automatically inactivated, in order to prevent contact of the rotary trimmer 100 with the sensitive surface(s) and any damage caused thereto. In certain embodiments, the feedback mechanism may be further configured to automatically reactivate the shearing assembly 200 once the rotary trimmer 100 is repositioned by the user such that the distal tip 111 is no longer within the minimum threshold distance of the detected sensitive surface(s) in the ear canal.
In certain embodiments, as shown in
In certain embodiments, the optical fiber 302 may be fixed or slidably coupled within the base unit 120. For example, the optical fiber 302 may be slidably coupled relative to the base unit 120 such that optical fiber 302 may extend from and retract into the base unit 120. Accordingly, a user may selectively adjust the distance between a distal end 303 of the optical fiber 302 and the distal tip 111 of the cover 110. In certain aspects, the adjustability of the position of the distal end 303 of the optical fiber 302 may be used to dispose the distal end 303 of the optical fiber 302 in contact with an interior surface of the cover 110 proximate to the distal tip 111.
In embodiments having the optical fiber 302, the cover 110 may include one or more sections formed of a translucent or transparent material to enable the projecting of light and/or imaging from optical fiber 302 through the cover 110. In certain embodiments, the distal tip 111 of the cover 110 may be formed of a translucent or transparent material while the remaining portion of the cover 110 is formed of an opaque metal or plastic material. In other embodiments, the cover 110 may be entirely formed of a translucent or transparent material.
In further embodiments, as shown in
At least a portion of the shearing body 202 extends into an interior portion of the cover 110 when the cover 110 is affixed over the base unit 120. As described above, in certain embodiments, the shearing body 202 may comprise a generally tubular geometry. In such embodiments, the shearing body 202 may have an annular cutting surface 203 disposed around an opening 207 at a distal end 209 of the shearing body 202. The cutting surface 203 may extend perpendicular to the longitudinal axis of the shearing body 202 (e.g., parallel with the axis X). The cutting surface 203 may in certain embodiments, include one or more teeth or sharpened edges shaped for cutting/shearing strands of hair as the cutting surface 203 is rotated.
While, or after, ear hairs 240 are sheared by the shearing body 202, the resulting loose (e.g., cut) hair pieces may be collected by the rotary trimmer 100 to prevent such hair pieces from entering into the middle ear of the patient in subsequent surgical procedures. In certain embodiments, the hair pieces may be collected via application of vacuum suction by the rotary trimmer 100. In such embodiments and as previously discussed with reference to
When activated, the vacuum source 129 may create a vacuum force that may act upon loose hair pieces through the base unit 120 and the cover 110, resulting in the hair pieces being pulled through the cover 110 and/or the interior of the base unit 120, through the one or more ports 123, and through the vacuum line 301 to the vacuum source 129 for removal. In certain embodiments, the loose hair strands may be suctioned and collected by a catch disposed within the base unit 120. In such embodiments, the catch may comprise a removable collection chamber.
As shown in
Turning now to
In certain embodiments, the optical fiber 302 may extend through the one or more ports 123 of the base unit 120 for connection with the illumination light source 306. Alternatively, the optical fiber 302 may be connected to the illumination light source 306 via a second optical fiber disposed within an optical cable and connected to the optical fiber 302 at, e.g., the one or more ports 123. In certain other embodiments, the illumination light source 306 may be integrated within the base unit 120. The illumination light source 306 may comprise any suitable type of illumination light source, including a violet light source, a blue light source, a white light source, or any other type of light source generating visible light. For example, an LED-based (Light Emitting Diode based) illumination light source 306 may be utilized. In further examples, a xenon-or halogen-based illumination light source 306 may be utilized.
In certain embodiments, the optical fiber 302 has a diameter between about 20 μm and about 120 μm, such as a diameter between about 40 μm and about 100 μm. For example, the optical fiber 302 has a diameter between about 50 μm and about 80 μm. However, smaller or larger diameters are also contemplated.
In the example in
In certain embodiments, as depicted in
In certain embodiments, the first optical fiber 440a and the second optical fiber 440b may be the same size (e.g. have the same diameter). An example of the first optical fiber 440a and the second optical fiber 440b formed to be substantially the same size is shown in
In certain embodiments, the optical fibers 440a, 440b may be coupled together within the base unit 120, such as by being bonded with an adhesive. In other embodiments, the optical fibers 440a, 440b may be separate and isolated from each other within the base unit 120. As shown in
As depicted in
In the exemplary arrangement of
In certain embodiments, dimensions of each of the second optical fibers 540 may be smaller than that of the first optical fiber 550 to enable the optical fibers 540, 550 to fit within the space inside the shearing body 202. In another embodiment, the plurality of second optical fibers 540 may be disposed outside of the shearing body 202, such as along the interior surface 124 of the base unit 120. In further embodiments, an optional sleeve 548 may be disposed around the plurality of second optical fibers 540 and configured to tightly hold the second optical fibers 540 against the first optical fiber 550. The sleeve 548 may have any suitable thickness and dimensions to ensure that the second fibers 540 are tightly packed together with no room for the second fibers 540 to be loose or move. The arrangements of the first optical fiber 550 and second optical fibers 540 depicted in
In addition to utilizing different arrangements and numbers of optical fibers within the base unit 120 of the rotary trimmer 100, the relaying of illumination light into the ear canal space of the patient through the cover 110 by illumination fibers and/or the clarity of the imaging obtained by image fibers disposed within the rotary trimmer 100 thereof may be modified by the utilization of different materials for the cover 110. In one aspect, the cover 110 may be formed of materials suitable for insertion into the human ear. As discussed above, the cover 110 may include one or more sections formed of a translucent or transparent material to enable the projecting of light and/or imaging through the cover 110. In certain embodiments, the distal tip 111 of the cover 110 may be formed of a translucent or transparent material while the remaining portion of the cover 110 is formed of an opaque metal or plastic material. In other embodiments, the cover 110 may be entirely formed of a translucent or transparent material.
In summary, embodiments of the present disclosure include instruments for use with neurotologic surgical procedures, and more particularly, shearing instruments for shearing ear canal hairs and having combined shearing, illuminating, and vacuuming functions. In particular, the instruments described above are configured to shear and vacuum ear canal hair, and may be used prior to the performance of a TEES procedure to avoid the risk of ear canal hairs entering into the middle ear during the TEES procedure and causing infection and/or inflammation of the middle ear. Furthermore, the propagating of illumination light by the described instruments enables enhanced visualization of the ear canal during inspection and removal of hair therefrom. Still further, in certain embodiments described herein, the instruments may facilitate digital visualization and imaging functions to assist in the inspection and removal of hair from the ear canal. Digital visualization and imaging functions may also be implemented as part of a safety or feedback mechanism in the instrument to prevent inadvertent contacting and damage to the tympanic membrane when using the shearing instrument in patients.
Utilization of the instruments described herein therefore allows hairs to be efficiently, safely, and thoroughly removed from the ear canal prior to TEES procedures, as well as enable surgeons to perform TEES procedures without the need of an ear speculum. Eliminating the need for an ear speculum reduces the number of instruments needing to be held by the surgeon during TEES procedures and also provides the surgeon more space in the ear canal to work. Accordingly, the described embodiments enable the performance of more efficient, less invasive, and safer neurotologic surgical procedures.
Although neurotologic surgery is discussed as an example of a surgical procedure that may benefit from the described embodiments, the advantages of the instrument described herein may benefit other surgical procedures as well.
While the foregoing is directed to embodiments of the present disclosure, other and further embodiments of the disclosure may be devised without departing from the basic scope thereof, and the scope thereof is determined by the claims that follow.
Number | Date | Country | |
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63483780 | Feb 2023 | US |