CN115379819A - 用于耳科和其他用途的可视化装置、系统和方法 - Google Patents
用于耳科和其他用途的可视化装置、系统和方法 Download PDFInfo
- Publication number
- CN115379819A CN115379819A CN202180018432.3A CN202180018432A CN115379819A CN 115379819 A CN115379819 A CN 115379819A CN 202180018432 A CN202180018432 A CN 202180018432A CN 115379819 A CN115379819 A CN 115379819A
- Authority
- CN
- China
- Prior art keywords
- lens
- distal
- distal lens
- stereoscopic
- inverting
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 238000000034 method Methods 0.000 title claims abstract description 61
- 238000012800 visualization Methods 0.000 title claims abstract description 24
- 210000000959 ear middle Anatomy 0.000 claims abstract description 53
- 210000003454 tympanic membrane Anatomy 0.000 claims abstract description 14
- 210000000613 ear canal Anatomy 0.000 claims description 26
- 230000003287 optical effect Effects 0.000 claims description 9
- 230000000087 stabilizing effect Effects 0.000 claims description 6
- 239000013307 optical fiber Substances 0.000 claims description 4
- 210000000883 ear external Anatomy 0.000 abstract description 13
- 210000003027 ear inner Anatomy 0.000 abstract description 11
- 238000001356 surgical procedure Methods 0.000 abstract description 10
- 206010011878 Deafness Diseases 0.000 abstract description 5
- 231100000888 hearing loss Toxicity 0.000 abstract description 5
- 230000010370 hearing loss Effects 0.000 abstract description 5
- 208000016354 hearing loss disease Diseases 0.000 abstract description 5
- 239000012528 membrane Substances 0.000 abstract description 3
- 230000008901 benefit Effects 0.000 description 9
- 238000012384 transportation and delivery Methods 0.000 description 8
- 230000006641 stabilisation Effects 0.000 description 7
- 238000011105 stabilization Methods 0.000 description 7
- 210000001595 mastoid Anatomy 0.000 description 6
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 5
- 238000002405 diagnostic procedure Methods 0.000 description 5
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 5
- 210000001519 tissue Anatomy 0.000 description 5
- 206010008642 Cholesteatoma Diseases 0.000 description 4
- 238000013459 approach Methods 0.000 description 4
- 210000004204 blood vessel Anatomy 0.000 description 4
- 239000003814 drug Substances 0.000 description 4
- 239000012530 fluid Substances 0.000 description 4
- 238000005286 illumination Methods 0.000 description 4
- 238000002347 injection Methods 0.000 description 4
- 239000007924 injection Substances 0.000 description 4
- 239000000463 material Substances 0.000 description 4
- 230000001225 therapeutic effect Effects 0.000 description 4
- 206010011891 Deafness neurosensory Diseases 0.000 description 3
- 208000027530 Meniere disease Diseases 0.000 description 3
- 206010028980 Neoplasm Diseases 0.000 description 3
- 206010033078 Otitis media Diseases 0.000 description 3
- 208000009966 Sensorineural Hearing Loss Diseases 0.000 description 3
- 210000003484 anatomy Anatomy 0.000 description 3
- 210000000988 bone and bone Anatomy 0.000 description 3
- -1 but not limited to Substances 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 239000007788 liquid Substances 0.000 description 3
- 229920000642 polymer Polymers 0.000 description 3
- 231100000879 sensorineural hearing loss Toxicity 0.000 description 3
- 208000023573 sensorineural hearing loss disease Diseases 0.000 description 3
- 238000001228 spectrum Methods 0.000 description 3
- 229940124597 therapeutic agent Drugs 0.000 description 3
- ZGXJTSGNIOSYLO-UHFFFAOYSA-N 88755TAZ87 Chemical compound NCC(=O)CCC(O)=O ZGXJTSGNIOSYLO-UHFFFAOYSA-N 0.000 description 2
- 208000012639 Balance disease Diseases 0.000 description 2
- 208000000781 Conductive Hearing Loss Diseases 0.000 description 2
- 206010010280 Conductive deafness Diseases 0.000 description 2
- 206010023567 Labyrinthitis Diseases 0.000 description 2
- 208000009205 Tinnitus Diseases 0.000 description 2
- 206010045210 Tympanic Membrane Perforation Diseases 0.000 description 2
- 208000012886 Vertigo Diseases 0.000 description 2
- 229960002749 aminolevulinic acid Drugs 0.000 description 2
- 230000003115 biocidal effect Effects 0.000 description 2
- 150000001875 compounds Chemical class 0.000 description 2
- 208000023563 conductive hearing loss disease Diseases 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 208000035475 disorder Diseases 0.000 description 2
- 210000002388 eustachian tube Anatomy 0.000 description 2
- 239000000835 fiber Substances 0.000 description 2
- 238000001476 gene delivery Methods 0.000 description 2
- 239000011521 glass Substances 0.000 description 2
- 235000011187 glycerol Nutrition 0.000 description 2
- 239000007943 implant Substances 0.000 description 2
- 208000022760 infectious otitis media Diseases 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 239000003381 stabilizer Substances 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- 231100000886 tinnitus Toxicity 0.000 description 2
- 231100000889 vertigo Toxicity 0.000 description 2
- 201000000200 vestibular neuronitis Diseases 0.000 description 2
- 241001631457 Cannula Species 0.000 description 1
- 206010061819 Disease recurrence Diseases 0.000 description 1
- 206010018691 Granuloma Diseases 0.000 description 1
- 206010019196 Head injury Diseases 0.000 description 1
- 208000026350 Inborn Genetic disease Diseases 0.000 description 1
- 206010033109 Ototoxicity Diseases 0.000 description 1
- 239000004696 Poly ether ether ketone Substances 0.000 description 1
- 208000034189 Sclerosis Diseases 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 238000009825 accumulation Methods 0.000 description 1
- 208000004064 acoustic neuroma Diseases 0.000 description 1
- NIXOWILDQLNWCW-UHFFFAOYSA-N acrylic acid group Chemical group C(C=C)(=O)O NIXOWILDQLNWCW-UHFFFAOYSA-N 0.000 description 1
- 229920000122 acrylonitrile butadiene styrene Polymers 0.000 description 1
- 239000004676 acrylonitrile butadiene styrene Substances 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 229910052782 aluminium Inorganic materials 0.000 description 1
- XAGFODPZIPBFFR-UHFFFAOYSA-N aluminium Chemical compound [Al] XAGFODPZIPBFFR-UHFFFAOYSA-N 0.000 description 1
- 238000000149 argon plasma sintering Methods 0.000 description 1
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 210000003030 auditory receptor cell Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- JUPQTSLXMOCDHR-UHFFFAOYSA-N benzene-1,4-diol;bis(4-fluorophenyl)methanone Chemical compound OC1=CC=C(O)C=C1.C1=CC(F)=CC=C1C(=O)C1=CC=C(F)C=C1 JUPQTSLXMOCDHR-UHFFFAOYSA-N 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 239000003153 chemical reaction reagent Substances 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 210000003477 cochlea Anatomy 0.000 description 1
- 210000000860 cochlear nerve Anatomy 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000007435 diagnostic evaluation Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000012377 drug delivery Methods 0.000 description 1
- 239000000975 dye Substances 0.000 description 1
- 239000013536 elastomeric material Substances 0.000 description 1
- 230000005284 excitation Effects 0.000 description 1
- 239000005308 flint glass Substances 0.000 description 1
- GNBHRKFJIUUOQI-UHFFFAOYSA-N fluorescein Chemical compound O1C(=O)C2=CC=CC=C2C21C1=CC=C(O)C=C1OC1=CC(O)=CC=C21 GNBHRKFJIUUOQI-UHFFFAOYSA-N 0.000 description 1
- 230000006870 function Effects 0.000 description 1
- 239000000499 gel Substances 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 208000016361 genetic disease Diseases 0.000 description 1
- 210000002768 hair cell Anatomy 0.000 description 1
- 229920001903 high density polyethylene Polymers 0.000 description 1
- 239000004700 high-density polyethylene Substances 0.000 description 1
- MOFVSTNWEDAEEK-UHFFFAOYSA-M indocyanine green Chemical compound [Na+].[O-]S(=O)(=O)CCCCN1C2=CC=C3C=CC=CC3=C2C(C)(C)C1=CC=CC=CC=CC1=[N+](CCCCS([O-])(=O)=O)C2=CC=C(C=CC=C3)C3=C2C1(C)C MOFVSTNWEDAEEK-UHFFFAOYSA-M 0.000 description 1
- 229960004657 indocyanine green Drugs 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 239000003589 local anesthetic agent Substances 0.000 description 1
- 229960005015 local anesthetics Drugs 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000005499 meniscus Effects 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 150000002739 metals Chemical class 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 208000007538 neurilemmoma Diseases 0.000 description 1
- 206010033072 otitis externa Diseases 0.000 description 1
- 206010033103 otosclerosis Diseases 0.000 description 1
- 231100000262 ototoxicity Toxicity 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 229920002530 polyetherether ketone Polymers 0.000 description 1
- 229920000139 polyethylene terephthalate Polymers 0.000 description 1
- 239000005020 polyethylene terephthalate Substances 0.000 description 1
- 238000002271 resection Methods 0.000 description 1
- 238000005070 sampling Methods 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 238000012549 training Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
- 230000001720 vestibular Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Images
Classifications
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/0004—Microscopes specially adapted for specific applications
- G02B21/0012—Surgical microscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/227—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for ears, i.e. otoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/20—Surgical instruments, devices or methods, e.g. tourniquets for vaccinating or cleaning the skin previous to the vaccination
- A61B17/205—Vaccinating by means of needles or other puncturing devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3201—Scissors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
- A61F11/20—Ear surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
- A61F11/20—Ear surgery
- A61F11/202—Surgical middle-ear ventilation or drainage, e.g. permanent; Implants therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
- A61M31/002—Devices for releasing a drug at a continuous and controlled rate for a prolonged period of time
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
- A61M37/0015—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/0004—Microscopes specially adapted for specific applications
- G02B21/002—Scanning microscopes
- G02B21/0024—Confocal scanning microscopes (CSOMs) or confocal "macroscopes"; Accessories which are not restricted to use with CSOMs, e.g. sample holders
- G02B21/0032—Optical details of illumination, e.g. light-sources, pinholes, beam splitters, slits, fibers
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/18—Arrangements with more than one light path, e.g. for comparing two specimens
- G02B21/20—Binocular arrangements
- G02B21/22—Stereoscopic arrangements
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2476—Non-optical details, e.g. housings, mountings, supports
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00318—Steering mechanisms
- A61B2017/00323—Cables or rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00318—Steering mechanisms
- A61B2017/00331—Steering mechanisms with preformed bends
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00738—Aspects not otherwise provided for part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00787—Surgery of the ear
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
- A61B2017/00907—Material properties transparent or translucent for light
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/305—Tweezer like handles with tubular extensions, inner slidable actuating members and distal tools, e.g. microsurgical instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
- A61B2017/3447—Linked multiple cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/345—Cannulas for introduction into a natural body opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00321—Head or parts thereof
- A61B2018/00327—Ear, nose or throat
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/18—Internal ear or nose parts, e.g. ear-drums
- A61F2002/183—Ear parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
- A61M37/0015—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
- A61M2037/0023—Drug applicators using microneedles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
- A61M37/0015—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin by using microneedles
- A61M2037/0046—Solid microneedles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/04—General characteristics of the apparatus implanted
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/06—Head
- A61M2210/0662—Ears
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/06—Head
- A61M2210/0662—Ears
- A61M2210/0668—Middle ear
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physics & Mathematics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Otolaryngology (AREA)
- Biophysics (AREA)
- Vascular Medicine (AREA)
- Psychology (AREA)
- Acoustics & Sound (AREA)
- Chemical & Material Sciences (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- General Physics & Mathematics (AREA)
- Analytical Chemistry (AREA)
- Radiology & Medical Imaging (AREA)
- Plasma & Fusion (AREA)
- Mechanical Engineering (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dentistry (AREA)
- Ophthalmology & Optometry (AREA)
- Dermatology (AREA)
- Medicinal Chemistry (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Electromagnetism (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Astronomy & Astrophysics (AREA)
Abstract
可以采用装置、系统和方法来促进间接观察腔体,例如但不限于中耳空间。一些实施例具有以下用途,例如但不限于促进外耳、中耳和/或内耳中的可视化和手术,以便诊断和/或治疗病症,包括但不限于听力损失和其他耳部病症。在特定实施方式中,手术显微镜结合倒相透镜和远端透镜使用。在一些情况下,远端透镜横穿膜或隔膜,例如但不限于鼓膜。在一些实施例中,远端透镜可以是组合两个或更多个透镜的组件。例如,在一些情况下,广角透镜、变焦透镜、其它各种形状的透镜和/或棱镜可用于远端透镜中。
Description
相关申请的交叉引用
本申请要求2020年1月24日提交的美国临时申请号62/965,481、2020年5月13日提交的美国临时申请号63/024,183(其通过引用完全并入本文)、2020年6月17日提交的美国临时申请号63/040,495(其通过引用完全并入本文)、2020年7月14日提交的美国临时申请号63/051,568(其通过引用完全并入本文)、2020年9月11日提交的美国临时申请号63/077,448(其通过引用完全并入本文)、2020年9月14日提交的美国临时申请号63/078,141(其通过引用完全并入本文)、2020年9月18日提交的美国临时申请号63/080,510(其通过引用完全并入本文)、2020年9月21日提交的美国临时申请号63/081,015(其通过引用完全并入本文)和2020年9月24日提交的美国临时申请号63/082,996(其通过引用完全并入本文)的优先权益。
技术领域
本文件涉及用于促进外耳、中耳和内耳中的可视化和手术的设备、系统和方法,以便诊断和/或治疗包括但不限于听力损失和其他耳部疾病的疾病。在一些示例中,系统和方法包括有助于间接观察腔体(例如但不限于中耳空间)的仪器和技术。
背景技术
人耳朵经受各种病症,包括但不限于听力损失、耳鸣、平衡障碍(包括眩晕)、梅尼埃病、前庭神经炎、前庭神经鞘瘤、迷路炎、耳硬化症、听骨链脱位、胆脂瘤、外耳感染、中耳感染、神经鞘瘤和鼓膜穿孔,以提供几个示例。
在一个示例中,传导性听力损失(CHL)涉及声音到达耳蜗中的毛细胞的正常机械途径的损失,例如由于畸形、中耳中的流体积聚、鼓膜的破坏、肿瘤的存在和/或听小骨的损伤。感音神经性听力损失(SNHL)是由于耳蜗毛细胞缺失或受损或者听神经缺失或受损所致。SNHL通常与暴露于大噪声、头部创伤、衰老、感染、梅尼埃病、肿瘤、耳毒性、遗传疾病(如Usher病)等相关。
虽然内窥镜的使用在过去几年中增加了,并且在很大程度上具有吸引力,因为它允许对中耳和邻近空间进行广角观察,但内窥镜的使用需要外科医生的一只手来操作,并且通常不能双眼视觉,这使得难以评估深度,这随后使得手术更具挑战性,并且考虑到中耳的精细结构而具有潜在的破坏性。
发明内容
本文件描述用于例如但不限于促进外耳、中耳和内耳中的可视化和外科手术的设备、系统和方法,以便诊断和/或治疗包括但不限于听力损失和其他耳部疾病的疾病。例如,本文档描述了设备、系统和方法,包括有助于间接观察腔体(例如但不限于中耳空间)的仪器和技术。
在特定实施方式中,手术显微镜与倒相透镜(其可包括一个或多个透镜)和远端透镜(其可包括一个或多个透镜)结合使用。在一些实施例中,倒相透镜位于身体的外部,例如耳朵的外部。在特定实施例中,倒相透镜位于身体内,例如耳道内。在某些实施例中,倒相透镜的一部分位于身体外部,并且倒相透镜的另一部分位于身体内。
在一些情况下,远端透镜穿过膜或隔膜,例如但不限于鼓膜(“TM”)。在特定情况下,远端透镜定位成能够通过膜或隔膜(例如但不限于TM)中的开口进行可视化。在一些实施例中,远端透镜可以是结合两个或更多个透镜的组件。例如,在一些情况下,广角透镜、变焦透镜、各种形状的透镜和/或棱镜可用于远端透镜中,如下文进一步描述。此外,在一些实施例中,光纤可用于传输图像。
虽然本文在经由外耳使中耳和/或内耳可视化的示例性上下文中描述了用于促进可视化和手术的装置、系统和方法,但是应理解,本文描述的本发明概念不限于这种用途。例如,在一些实施例中,本文描述的用于促进可视化和手术的装置、系统和方法可用于其他中耳和/或内耳通道,例如但不限于经乳突入路、经鼓室皮瓣经耳道、耳内、耳后(retroaural)、耳廓后点(postaural)等。此外,除了中耳和/或内耳可视化之外,本文描述的用于促进可视化和手术的装置、系统和方法非常适合用于身体中的其他腔体或空间以及其他通道。例如,装置、系统和方法非常适合于和与咽鼓管、乳突窦间隙等相关的可视化手术。
本文的装置、系统和方法可与另外的治疗技术结合使用。例如,本文的装置、系统和方法可以结合治疗技术使用,治疗技术例如但不限于治疗剂递送(其可以呈凝胶、液体或固体的形式)、抗生素递送、基因递送、装置或植入物递送、诊断手术和外科手术等。
在一些方面,本公开涉及一种手术显微镜系统,其包括手术显微镜、立体倒相透镜系统和远端透镜。
这种手术显微镜系统可以可选地包括以下特征中的一个或多个。远端透镜可被设定尺寸用于放置在鼓膜中以促进中耳区域的可视化。远端透镜可包括在远端透镜的近端处的棱镜。远端透镜可包括在远端透镜的远端处的宽场透镜。远端透镜可包括设置在棱镜与宽场透镜之间的变焦透镜或物镜。远端透镜可限定腰部,腰部具有小于远端透镜的紧邻近端部分和远端部分的外径。在一些实施例中,远端透镜包括位于远端透镜的近端处的第一棱镜和位于远端透镜的远端处的第二棱镜。这种远端透镜还可包括设置在第一棱镜与第二棱镜之间的变焦透镜或物镜。在一些实施例中,远端透镜包括从远端透镜的主体径向向外延伸的两个或更多个稳定臂。在特定实施例中,远端透镜包括在远端透镜的近端处并且联接到壳体的聚光透镜,以及在远端透镜的远端处并且联接到壳体的第二透镜。壳体可限定聚光透镜与第二透镜之间的内部空间。内部空间可填充有气体。内部空间可填充有液体。壳体可包括径向延伸的凸缘或臂。在一些实施例中,系统还包括附接到远端透镜的端口装置。在一些实施例中,立体倒相透镜系统的至少一部分安装在窥镜内。在特定实施例中,安装在窥镜内的立体倒相透镜系统的部分可相对于窥镜进行位置调整。可在窥镜内和安装在窥镜内的立体倒相透镜系统的部分的侧面限定开放空间。在一些实施例中,系统还包括联接到远端透镜的光管。远端透镜可包括细长管状构件和联接到管状构件的多个透镜,以限定穿过管状构件的光路。这种管状构件可包括多个区段,这些区段允许区段之间有角度。在一些实施例中,远端透镜包括封闭光纤的细长管状构件,光纤被配置来将图像从远端透镜的远端中继到远端透镜的近端透镜。
在另外的方面,本公开涉及一种用于间接观察到患者的中耳空间的方法。该方法包括提供手术显微镜系统,手术显微镜系统包括:(i)手术显微镜;(ii)立体倒相透镜系统;和(iii)远端透镜。该方法还包括将远端透镜放置成与患者的鼓膜接触,以及观察由远端透镜捕获并通过立体倒相透镜系统中继到手术显微镜的中耳空间的图像。
用于间接观察到患者的中耳空间的这种方法可任选地包括以下特征中的一个或多个。立体倒相透镜系统可以位于患者的耳朵外部。立体倒相透镜系统可在患者的耳道内。该方法可包括以任何组合使用具有本文的任何实施例和/或特征的手术显微镜系统。
本文描述的一些实施例或所有实施例可提供以下优点中的一个或多个。首先,中耳空间、内耳和附近区域的当前可视化由于访问路径的限制而具有挑战性,访问路径通常或直接经由耳道、经由通过侵入性地抬起耳廓产生的耳后经乳突通道的通道,或通过使用骨钻和其他仪器产生的高侵入性乳突通道。在这种情况下,围绕复杂和微妙的结构进行观察是很困难的,这些结构会产生阴影和盲角,而这些阴影和盲角仍然需要在许多手术中进行导航。另外,或由于耳道的天然尺寸和曲率,或由于例如在经乳突进入期间希望使骨和组织的去除最小化,进入路径的直径较小。如本文的手术显微镜系统的使用具有允许由外科医生进行双目观察和基本上免手操作的益处。
其次,如本文的用于可视化中耳和/或内耳的手术显微镜系统的使用提供另外的优点,即允许外科医生利用他们熟悉的手术显微镜,以便能够以手术显微镜通常使用的方式容易地向下观察耳道,并且容易地切换到中耳内的宽场视图(例如,以实现视图内的视图)。此外,本文所述的手术显微镜系统在外围提供大聚焦深度和高分辨率。
第三,本文所述的装置、系统和方法有利地允许将仪器传递到操作场的能力,以及除了在充满空气的空间之外还在充满流体的空间中运作的能力。
第四,本文描述的装置、系统和方法促进以微创方式进行治疗。此类微创技术可能倾向于减少恢复时间、患者不适、疾病复发、手术并发症和治疗成本。此外,本文所述的方法可以使用局部麻醉剂而不需要全身麻醉来进行。因此,治疗成本、患者风险和恢复时间进一步有利地减少。
第五,本文所述的系统也可用于诊断目的。这些用途有助于手术规划,改变护理部位,并可能改善患者治疗效果。
在附图和下面的描述中阐述了本发明的一个或多个实施例的细节。本发明的其他特征、目的和优点将从说明书和附图以及权利要求书中变得显而易见。
附图说明
图1是根据一些实施例使用示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
图2示出示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图3示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图4示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图5示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括,远端透镜组件被示出为横穿TM。
图6示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图7示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图8示出另一示例性远端透镜组件,其可作为图1的手术显微镜系统的一些实施例的一部分而被包括,该远端透镜组件被示出为邻近TM中的开口。
图9是另一示例性远端透镜组件的纵向横截面图,该远端透镜组件可作为图1的手术显微镜系统的一些实施例的一部分而被包括。
图10是从另一个示例性远端透镜组件的外耳的透视的平面图,该远端透镜组件可以作为图1的手术显微镜系统的一些实施例的一部分被包括。该远端透镜组件被示出为处于TM上的位置,并且包括连接的TM端口装置,各种类型的仪器可穿过该端口装置进入中耳。
图11是根据一些实施例使用另一示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
图12是根据一些实施例使用另一示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
图13示出结合使用图12的手术显微镜系统使用手术器械。
图14示出相对于TM使用示例性远端透镜组件、光源和手术器械。
图15是根据一些实施例使用另一示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
图16是图15的远端透镜组件的纵向横截面图。
图17是图15的远端透镜组件的近端视图,其具有用于将远端透镜组件支撑在外耳内的外围结构。
图18是根据一些实施例使用另一示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
图19是根据一些实施例使用另一示例性手术显微镜系统可视化中耳区域的医疗手术的示意图。
各附图中的相同附图标记表示相同的元件。
具体实施方式
现在参考图1的示意图,用于治疗患者10的装置、系统和方法的特定实施例可包括示例性手术显微镜系统100。手术显微镜系统100可用于促进观察凹陷空间中的结构,凹陷空间例如但不限于中耳40。
在所描述的实施例中,手术显微镜系统100包括手术显微镜110(和/或照相机)、立体倒相透镜系统120和远端透镜130。中耳区域40中的图像由远端透镜130捕获,在该实施例中,远端透镜130定位在TM 30中的开口中。从远端透镜130,经由耳道20将图像传递到立体倒相透镜系统120。手术显微镜110从立体倒相透镜系统120接收图像并且呈现图像以供外科医生12观察。手术显微镜110允许由外科医生12进行双眼观察或立体观察,并且基本上免手操作。
在这个实施例中,立体倒相透镜系统120位于耳道20的外部。在一些实施例中,立体倒相透镜系统120是棱镜式倒相,棱镜式倒相也可以是立体对角倒相器器(stereoscopicdiagonal inverter)或立体倒相器(stereo reinverter)。其倒转图像以使得外科医生或临床医生更容易将可视化的方向性与所观察的对象相关联(例如,将仪器向右移动在系统中被视为向右移动)。在特定实施例中,立体倒相透镜系统120可包括多个部分,例如分束器、立体倒相器和物镜等。
在一些实施例中,手术显微镜系统100包括安装件112,通过安装件112,立体倒相透镜系统120可调整地安装到手术显微镜110(或相机)的框架。因此,立体倒相透镜系统120可与手术显微镜110的物镜相分离(alienable)。另外,在一些实施例中,安装件112可被调整以允许纵向调整。
用于使用手术显微镜系统100可视化的光可通过以下进一步描述的光管或其他光源外部提供,或者可通过系统同轴投射。此手术显微镜系统100具有以下优点:允许外科医生在治疗或诊断手术期间使用两只手,具有双眼观察或立体观察,并且能够像典型的手术显微镜那样容易地向下观察耳道20。此外,手术显微镜系统100允许外科医生在中耳40内容易地切换到宽场视图(例如,以实现视图内的视图),同时在外围仍然具有大聚焦深度和高分辨率。此外,手术显微镜系统100允许外科医生能够传递用于治疗或诊断手术的仪器(如下文进一步描述的),仍然利用外科医生熟悉的手术显微镜,并且在充满流体或充满空气的空间中起作用等优点。这个手术显微镜系统100促进了使用微创方法治疗患者10的治疗方法和装置。
虽然本文提供的这些示例性实施例中许多事与手术显微镜组合来描述或一起使用,但可以设想这些概念也适用于数字观察模态或外窥镜。数字观察非常适合在外部显示器上平视显示图像,外部显示器可以是高清、3D、弯曲等。平视观察还非常适于同时显示外耳道的画中画,同时显示例如来自前述组件之一的远端的宽场视图。这将是出人意料地有利的,因为它将增强组件在耳道上的导航以及仪器在耳道上的通过,同时允许将宽场视图进入中耳空间(作为示例)。
当本文公开的概念与能够平视显示的数字观看系统一起使用时,透镜系统实施例可促进与辅助人员的交互和新外科医生的培训。平视显示器、虚拟现实(“VR”)、3D和类似系统可以显著改进人体工程学。
本文所描述的系统和概念还与导航跟踪和其他机器人辅助手术模式相组合而很好地工作。
在一些实施例中,与本文描述的系统一起使用的光源可从典型的视觉光谱源取代为红外光谱或其他特定光谱。红外线等特定光谱本身可用于组织或血管识别。红外线有助于识别血管和脉管系统。较长波长的红外线(>700nm)能够比可见光更容易地穿透组织,并且能够实现通过鼓膜对中耳的优质照明,其中较短波长的反射和散射可能是有问题的。荧光染色剂和其他染料或染色剂(例如ICG)与特定波长光源和/或特定过滤器组合可用于鉴定血管和特定组织。示例是适用于血管鉴定的ICG(哚氰酸绿;近红外,激发峰接近810nm)和用于肿瘤鉴定的5-氨基乙酰丙酸(5-ALA)或荧光素。作为示例,在中耳中,这些非标准光源将特别有利于识别生长在骨结构顶部的胆脂瘤或其它软组织病变。
图2–10示出远端透镜130的各种非限制性示例。如图中的一些所示,远端透镜130允许经由TM 30可视化中耳。远端透镜130中的任一个可被配置来横穿TM 30(例如,如图5所示)和/或邻近TM 30中的开口定位(例如,如图8所示)。
远端透镜130可以是简单的或复合的透镜组件,并且可以单独地或以任何组合地具有宽场或广角透镜、变焦透镜、棱镜或反射元件、聚光透镜。在一些实施例中,远端透镜130是具有棱镜元件的透镜,棱镜元件与透镜直接邻近或间隔开。构成远端透镜130的一个或多个透镜可以是任何组合的双凸透镜、双凹透镜、平凸透镜、平凹透镜、弯月面、消色差透镜、多透镜、聚光镜等。包括远端透镜130的透镜可由例如但不限于火石玻璃、硬化玻璃、聚碳酸酯、丙烯酸或其它材料及其组合的材料构造。在一些实施例中,包括远端透镜130的透镜或组件可以是注射模制聚合物光学器件。将有益的是使远端透镜130由一次性部件制成,以消除与透镜的灭菌和维护相关联的困难以及减少OR周转时间。在一些实施例中,透镜包括涂层以降低雾化的可能性。
远端透镜130可以制成各种尺寸和焦距以适应每个患者的耳道的长度。例如,但不限于,可为19-23mm、23-27mm和27-31mm的耳道长度提供三种尺寸,以维持一致的显微镜定位,从而实现最佳的仪器操纵性和外科医生舒适性。
图2示出示例性远端透镜组件130a。在所描述的实施例中,远端透镜组件130a在其最远端处具有宽场透镜132a,并且随后具有1-2mm气隙至变焦透镜或物镜134a,并且随后具有棱镜元件136a以重定向近端输出图像角度,上述所有都为机械联接。透镜132a和134a的外径的范围可以是大约1mm至3mm、或1mm至5mm、或1mm至7mm、或3mm至8mm、或2mm至4mm、或3mm至6mm,但不限于此。这些外径尺寸可应用于本文所述的任何远端透镜组件。棱镜136a可具有大约42度角(相对于远端透镜组件130a的中心纵向轴线)以匹配鼓膜相对于耳道的主要纵向轴线的典型角度。在一些实施方案中,棱镜136a的角度在约40度至50度、或30度至60度、或20度至70度的范围内,但不限于此。这些角度参数可应用于本文描述的任何棱镜。主要物镜134a可以是远端组件130a的一部分并且可以是例如双凸透镜(例如,60-120D)。对于这些示例性透镜,在一些情况下,优选的是它们与所关注对象的距离小于约10mm。
图3示出另一示例性远端透镜组件130b。在所描述的实施例中,远端透镜组件130b在其最远端处具有宽场透镜132b,并且随后具有棱镜元件136b以重定向近端输出图像角度。在一些实施例中,远端透镜组件130b的大小和其他参数可以与远端透镜组件130a相同。
图4示出另一示例性远端透镜组件130c。在所描述的实施例中,远端透镜组件130c在其最远端处具有宽场透镜132c,并且随后具有1-2mm气隙,并且随后具有棱镜元件136c以重定向近端输出图像角度。在一些实施例中,远端透镜组件130c的大小和其他参数可以与远端透镜组件130a相同。
图5示出定位成穿透鼓膜30的另一个示例性远端透镜组件130d。如这个示例中所描述的,本文描述的任何远端透镜130可具有形状元件/特征以促进在外科手术或诊断手术的持续时间内维持远端透镜130在TM 30中的位置。此类元件可包括具有腰部部分138d(或沙漏外轮廓形状),其允许远端透镜130在TM 30中的开口内摩擦配合并且由此提供纵向稳定性。
本文描述的任何远端透镜130可任选地包括其它元件以促进远端透镜130相对于TM 30的稳定。例如,远端透镜130可包括臂构件,例如如图5所示臂构件139da和39db。可替代地或另外地,本文描述的远端透镜130可任选地包括环、与其他元件的互连部和/或其他类型的稳定装置,但不限于此。此外,除了相对于如所示的TM 30而稳定之外,还设想本文所述的远端透镜130的稳定构件可抵靠耳道壁、鼓膜环、其他仪器或接入部位和/或其他相邻结构而稳定。还可以设想,这些臂构件139da和139db可以是可伸缩的或以其他方式可调节的,以允许从本文描述的任何远端透镜130微调近端“输出”图像的方向性和/或焦点。
图6示出另一个示例性远端透镜组件130e,其具有远端棱镜构件132e、变焦透镜或物镜134e和近端棱镜构件136e。棱镜构件132e和136e允许使鼓膜平面的远端和离轴的对象可视化,并且从远端透镜组件130e离轴地观察近端图像,如前所述。
图7示出另一个示例性远端透镜组件130f,其具有远端棱镜构件132f、变焦透镜或物镜134f和近端棱镜构件136f。此外,远端透镜组件130f包括延长构件133f以在中耳内侧的深度处提供视图。因此,远端透镜组件130f是潜望镜样式的(periscope-like)远端透镜组件,并且有可能看到中耳中会阻碍直接通过鼓膜观察的典型结构周围。
图8示出位于TM 30中的开口31或其他孔上方的示例性远端透镜组件130e。作为示例,开口31可以是在定位远端透镜组件130E之前对TM 30进行的穿刺或切口。在这种实施方式中,可设想将有利的是,具有臂构件139ea和139eb(如图所示)、环或其它稳定装置以促进远端透镜组件130e相对于表面或TM 30的稳定,因为远端透镜组件130e不具有与穿透TM 30相关联的稳定(例如,与图5所示相反)。
图9示出另一示例性远端透镜组件130g。在这个实施例中,远端透镜组件130g的近端部分是强聚光透镜132g(例如,约60-130D)。在一些实施例中,聚光透镜132g的直径约为3mm。这个近端聚光透镜132g机械连接到壳体134g的端口,壳体134g限定强聚光透镜132g与最远端透镜136g(其可以是平面透镜、凹面透镜、凸面透镜等)之间的内部腔体室133g。在一些实施例中,最远端透镜136g的直径约为2mm。
在一些实施例中,内部腔体室133g可以是空气/气体填充的或液体填充的和密封的。在一些实施例中,并且内部腔体室133g本身可以是玻璃、聚合物等。内部腔体室133g内容物和聚光透镜132g的组合以及期望的观察结果(例如,例如宽场和/或变焦的程度)可决定哪个最远端透镜136g是最合适的。壳体134g可具有凸缘135g或翼作为示例性稳定构件,以保持远端透镜组件130g在TM中始终定位良好。
图10示出了TM 30(从外耳的角度)的自上而下(或平面图),其中另一个示例性远端透镜组件130h定位在其中。远端透镜组件130h包括透镜部分132h(其可以是本文的任何类型的远端透镜组件及其变化)。远端透镜组件130h还包括集成端口134h,集成端口134h用于使仪器、照明、治疗剂、针头等穿过TM 30并且进入中耳。透镜部分132h和端口134h由连接构件136h联接,连接构件136h可以是任何合适的长度。在一些实施例中,可包括两个或更多个端口134h。在一些实施例中,远端透镜组件130h可任选地包括一个或多个固定特征件,以将远端透镜组件130H附接到纤维鼓膜环32而增强稳定性。
在稳定特征件允许耳道内的稳固配合的情况下,本文描述的远端透镜130可以在外科手术中实现,其中已经形成鼓膜瓣以提供直接进入中耳腔的宽场可视化(例如,不仅仅是“经鼓室”观察)。类似地,可设想通过具有的稳固特征件来在经乳突手术中使用本文的远端透镜,该稳固特征件附接到与建立经乳突通道相关联的结构(例如乳突骨、管壁等)。在一些实施例中,可以设想具有近端向外延伸到耳道、外耳、显微镜、窥镜、倒相器、中继透镜或甚至手持的稳定构件。
图11示出另一个手术显微镜系统200,其包括手术显微镜110(和/或相机)、立体倒相透镜系统220和远端透镜130。中耳区域40中的图像由远端透镜130捕获,在该实施例中,远端透镜130定位在TM 30中的开口中。从远端透镜130,经由耳道20将图像传递到立体倒相透镜系统220。手术显微镜110从立体倒相透镜系统220接收图像并且呈现图像以供外科医生12观察。手术显微镜110允许由外科医生12进行双眼观察或立体观察,并且基本上免手操作。这个示意性示例示出立体倒相器透镜系统220(其可包括按所需的棱镜和/或其他透镜)可位于外耳20内的各种位置处,并且可存在零个、一个或多个立体倒相器透镜系统220。图像质量通常随着透镜或棱镜数量的增加而降低,因此优选地尽可能少。另外,每个立体倒相透镜系统220可以倒转图像(取决于功率),因此立体倒相透镜系统220的设计将被调整以补偿。
图12示出另一个手术显微镜系统300,其包括手术显微镜110(和/或相机)、立体倒相透镜系统320和远端透镜130。在所描述的实施例中,立体倒相透镜系统320安装到窥镜330或外耳稳定器。立体倒相透镜系统320可位于窥镜330或稳定器的中心,或安装在偏离中心或一侧。
在一些实施例中,臂构件、特征件或锚定件可以机械地将立体倒相器透镜系统320联接到窥镜300,并且此类特征件可以是可伸缩的或可调节的(如由箭头所表示),以便将来自立体倒相器透镜系统320的图像与显微镜110和/或远端透镜组件130对准。在一些实施例中,立体倒相透镜系统320可具有多个透镜或棱镜,以便促进与远端透镜组件130和显微镜110或相机同时对准,并且因此元件可单独地可调节。在一些实施例中,组件320可以是中继透镜和/或棱镜。可以理解,如果立体倒相中继透镜或棱镜系统320安装到窥镜330,那么如果需要,可以邻近显微镜110安装倒相透镜。
也参考图13,在一些实施例中,此类臂构件、特征或锚定件机械地将立体倒相透镜系统320联接到窥镜330,可提供足够的横向空间或端口,以允许一个或多个仪器、递送套管、光管、吊灯照明等同时进入外耳20,并且在一些情况下通过TM 30,并且在一些情况下进入中耳40(如图13通过示例性仪器400所广泛表示的)。
另外,在一些实施例中,光源或元件可以安装到窥镜330。在另一个实施例中,光管穿过窥镜330并且邻近TM 30或传入中耳腔40中。吊灯照明可以安装到TM 30。在一些实施例中,可以用溶液(例如甘油)处理TM 30,以增加透明度并且允许外部照明通过TM 30。在特定实施例中,远端透镜组件130自身可具有附接到其的光源(例如,参考图14),类似于内窥镜上看到的。
在一些实施例中,光源远离最远端收集透镜130,以最小化从通道壁和其他光源到立体倒相透镜系统320的光散射。这将理想地通过TM 30远端的吊灯光源或通过中耳40中的内照明仪器来实现。可替代地,立体倒相透镜系统320可以在管状构件内被屏蔽,其中光源定位在最近端立体倒相透镜系统320的远端。
在适当的中耳照明和TM 30的增强的透明度(例如通过用甘油或盐水溶液预处理或折射率匹配材料预处理实现)下,还可以理解,远端透镜组件130可位于TM 30的近端,而不需要TM 30中的额外切口或开口。这将具有改进图像稳定性的附加优点,其中远端透镜组件130锚定到通道壁或外部窥镜,使得在仪器通过期间TM 30的移动不传递到远端透镜组件130。使用精细(例如,25规格)或更小的光纤光源,这样的系统可以实现中耳40的基于诊室的微创双目可视化(目前不可实现),并且实现一系列基于诊室的手术。
图14示出根据一些实施例的手术显微镜系统的另一个实施方式的远端部分。也就是说,示例性远端透镜组件130在横穿TM 30的位置中示出。在所描述的实施例中,远端透镜组件130包括附接的光管132,附接的光管132可照亮中耳40和区域中的解剖结构。为了另外理解,还示出了可穿过TM 30中的端口或开口的示例性注射仪器410。这种注射仪器410可用于将各种治疗剂递送到各种解剖结构,例如但不限于圆形窗口位、椭圆形窗口、乳突窦的壁或入口、软组织病变处等。此外,还描述示例性灯管420。这样的光管420可以穿过TM 30中的端口或开口,并且可以用于照明中耳40和区域中的解剖结构。
图15-17示出另一个手术显微镜系统500,其包括手术显微镜110(和/或相机)、立体倒相透镜系统120和远端透镜组件530。在所描述的实施例中,立体倒相透镜系统120驻留在耳朵10的外部。远端透镜组件530包括管状构件,管状构件维持远端透镜组件530与立体倒相透镜系统120之间的位置和对准。
图16示出展示远端透镜组件530的远端端部处的对象的宽场视图的示例性光路或光线迹线,以及可通过手术显微镜110观察的远端透镜组件530的近端端部处的图像的输出。这种方法将具有维持透镜之间的光路对准并且防止仪器干扰可视化的优点。它还可以减少干扰或杂散光,并且可以具有其他特征件,如挡板、杆透镜或其他提高图像质量的特征件。远端透镜组件530的封闭系统或密封组件将具有最小化中间透镜表面的雾化/结垢的额外优点。它还将允许部分在水下执行手术,在水下远端透镜组件530被淹没并且耳道中的可变流体水平不干扰图像或光透射。这种远端透镜组件530还可具有附接或整合的光源,使得光被投射到所关注对象上,或者光可通过系统同轴投射。
远端透镜组件530的这个管状实施例还可具有锚定件、臂构件532和/或其他将其稳固在外耳20中的位置上并且帮助对准的特征件。例如,图15示出臂构件532沿着耳道20的长度将远端透镜组件530的管状外部构件或光学管保持在适当位置的示例性布置。
图17示出远端透镜组件530的示例性臂构件实施例的端面视图,其中三个臂构件532从远端透镜组件530径向延伸,以允许其他仪器通过/穿过。可以设想的是,可以存在端口或其它稳固特征件来帮助通过仪器而不干扰光学管,同时还提高仪器自身相对于耳道20的稳定性。在一些实施例中,臂构件532可固定地附接到柔性环534,作为最小化耳道20壁上的创伤或压力的示例性方式。可以设想,在一些实施例中,臂构件532是可伸缩的或以其他方式可调节的(例如可旋转地附接到光学管,同时具有可在柔性环534的螺纹部分内旋转的螺纹区段,使得旋转它们以缩短或延长光学管与柔性环534之间的距离)。远端透镜组件530的近端可以以中继透镜、棱镜、倒相器和/或类似物结束。
图18示出另一个手术显微镜系统600,其包括手术显微镜110(和/或相机)、立体倒相透镜系统120和远端透镜组件630。在所描述的实施例中,立体倒相透镜系统120驻留在耳朵10的外部。远端透镜组件630包括管状构件,管状构件维持远端透镜组件630与立体倒相透镜系统120之间的位置和对准。
在所描述的实施例中,远端透镜组件630包括光学管或外管状构件,光学管或外管状构件具有多个区段以及允许区段之间的存在角度的中继透镜或棱镜。在这种布置中,远端透镜组件630可包括一个或多个中间的中继透镜,并且可包括棱镜或其他反射构件以补偿区段之间角度。再次,一个或多个臂构件632可用于相对于耳道20的壁稳固或锚定远端透镜组件630的管状构件。这种实施例或可适应光路中存在角度的其他实施例可以是有利的,因为在例如经耳道进入的情况下频繁遇到存在角度。
图19示出另一个手术显微镜系统700,其包括手术显微镜110(和/或相机)、立体倒相透镜系统120和远端透镜组件730。在所描述的实施例中,立体倒相透镜系统120驻留在耳朵10的外部。
远端透镜组件730包括管状构件,管状构件利用光纤来将图像从远端透镜组件730的远端“中继”到近端透镜732,其中随后可通过立体倒相透镜系统120由手术显微镜110观察图像。
在一些实施例中,远端透镜组件730包括类似于典型内窥镜的整合光源。在特定实施例中,远端透镜组件730可使用如上的一个或多个臂构件或特征件在外耳20内稳固在位。例如这种成角度组件可潜在地增加空间和自由度,以用于更常规的直轴或稍微弯曲的仪器朝向横向地邻近远端透镜组件730的TM 30传递。
虽然本文公开的仪器主要是在耳科手术的背景下描述的,这些手术要么在外耳中,要么使用经耳道经鼓膜方法进入中耳或内耳,但是应理解,这些仪器不限于这些用途,并且可用于身体中的其他腔体或空间以及其他方法。例如,在一些实施例中,本文的仪器可用于针对中耳、内耳、咽鼓管、乳突腔空间(包括但不限于经乳突通路、经鼓室瓣经耳道、耳内、耳后、耳廓后点等)的其它方法和技术。此类系统和方法可用于药物递送、凝胶递送、抗生素递送、基因递送、移植物放置、装置或植入物递送、组织切除、诊断手术、取样手术、外科手术等。
应注意,本文描述的实施例或实施例的特征中的任一个可以以任何组合或任何排列组合,并且所有都在本公开的范围内。
本文所述的装置、系统和方法可用于治疗中耳和/或内耳的任何病症的过程中,包括但不限于听力损失、耳鸣、平衡病症(包括眩晕)、梅尼埃氏病、前庭神经元炎、前庭肉芽肿、迷路炎、耳硬化、小骨链脱位、胆脂瘤、中耳炎、中耳感染和鼓膜穿孔,以提供几个示例。在一些实施例中,本文所述的装置、系统和方法可用于将治疗剂精确递送至圆窗位点和/或其它靶位点(例如椭圆窗或中耳腔体的其它部分)的过程中,并且用于提供对中耳的其它特征或区域的通道。例如,本文所述的系统和方法可用于听小骨链的微创手术重建、用于去除胆脂瘤、用于诊断评估和其它手术。用于使用本文所述的系统和方法的任何和所有此类技术都包括在本公开的范围内。
本文所述的装置和系统可由金属(例如但不限于铝、不锈钢等)或聚合物(例如但不限于ABS、PEEK、PET、HDPE等)、注射模制部件等构造。例如柔性环的部件可由弹性材料、凝胶等构造。
本文所述的装置、系统、材料、化合物、组合物、制品和方法可通过参考所公开主题的具体方面的上述详细描述来理解。然而,应理解,上述方面不限于特定装置、系统、方法或特定试剂,因此可变化。还应当理解,本文使用的术语仅用于描述特定方面的目的,并不旨在限制。
已经描述了许多实施例。然而,应当理解,在不脱离本公开的范围的情况下,可以进行各种修改。因此,其他实施例在所附权利要求的范围内。
Claims (20)
1.一种手术显微镜系统,包括:
手术显微镜;
立体倒相透镜系统;以及
远端透镜,所述远端透镜的尺寸被设定为用于放置在鼓膜中,以促进中耳区域的可视化。
2.根据权利要求1所述的系统,其中,所述远端透镜包括:
棱镜,位于所述远端透镜的近端处;以及
宽场透镜,位于所述远端透镜的远端处。
3.根据权利要求2所述的系统,其中,所述远端透镜还包括设置在所述棱镜与所述宽场透镜之间的变焦透镜或物镜。
4.根据权利要求2所述的系统,其中,所述远端透镜限定腰部,所述腰部具有小于所述远端透镜的紧邻近端部分和远端部分的外径。
5.根据权利要求1所述的系统,其中,所述远端透镜包括:
第一棱镜,位于所述远端透镜的近端处;
第二棱镜,位于所述远端透镜的远端处;以及
变焦透镜或物镜,设置在所述第一棱镜与所述第二棱镜之间。
6.根据权利要求1所述的系统,其中,所述远端透镜包括从所述远端透镜的主体径向向外延伸的两个或更多个稳定臂。
7.根据权利要求1所述的系统,其中,所述远端透镜包括:
聚光透镜,位于所述远端透镜的近端处并且联接到壳体;以及
第二透镜,位于所述远端透镜的远端处并且联接到所述壳体,
其中,所述壳体限定所述聚光透镜与所述第二透镜之间的内部空间。
8.根据权利要求7所述的系统,其中,所述壳体包括径向延伸的凸缘或臂。
9.根据权利要求1-8中任一项所述的系统,还包括附接到所述远端透镜的端口装置。
10.根据权利要求1-9中任一项所述的系统,其中,所述立体倒相透镜系统的至少一部分安装在窥镜内。
11.根据权利要求10所述的系统,其中,所述立体倒相透镜系统安装在所述窥镜内的所述部分相对于所述窥镜是位置可调的。
12.根据权利要求10所述的系统,其中,在所述窥镜内并且在所述立体倒相透镜系统安装在所述窥镜内的所述部分的侧面限定开放空间。
13.根据权利要求1–12中任一项所述的系统,还包括联接到所述远端透镜的光管。
14.根据权利要求1-13中任一项所述的系统,其中,所述远端透镜包括细长管状构件和联接到所述管状构件的多个透镜,以限定穿过所述管状构件的光路,并且其中,所述管状构件包括允许区段之间存在角度的多个区段。
15.根据权利要求1-14中任一项所述的系统,其中,所述远端透镜包括封闭光纤的细长管状构件,所述光纤被配置为将图像从所述远端透镜的远端中继到所述远端透镜的近端透镜。
16.一种用于间接观察患者的中耳空间的方法,所述方法包括:
提供手术显微镜系统,所述手术显微镜系统包括:
手术显微镜;
立体倒相透镜系统;以及
远端透镜:
将所述远端透镜放置成与所述患者的鼓膜接触;以及
观察由所述远端透镜捕获并通过所述立体倒相透镜系统中继到所述手术显微镜的中耳空间的图像。
17.根据权利要求16所述的方法,其中,所述立体倒相透镜系统在所述患者的耳朵外部。
18.根据权利要求16所述的方法,其中,所述立体倒相透镜系统在所述患者的耳道内。
19.根据权利要求16-18中任一项所述的方法,其中,所述远端透镜还包括:
棱镜,位于所述远端透镜的近端处;以及
宽场透镜,位于所述远端透镜的远端处。
20.根据权利要求16–19中任一项所述的方法,其中,所述立体倒相透镜系统的至少一部分安装在窥镜内。
Applications Claiming Priority (19)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US202062965481P | 2020-01-24 | 2020-01-24 | |
US62/965,481 | 2020-01-24 | ||
US202063024183P | 2020-05-13 | 2020-05-13 | |
US63/024,183 | 2020-05-13 | ||
US202063040495P | 2020-06-17 | 2020-06-17 | |
US63/040,495 | 2020-06-17 | ||
US202063051568P | 2020-07-14 | 2020-07-14 | |
US63/051,568 | 2020-07-14 | ||
US202063077448P | 2020-09-11 | 2020-09-11 | |
US63/077,448 | 2020-09-11 | ||
US202063078141P | 2020-09-14 | 2020-09-14 | |
US63/078,141 | 2020-09-14 | ||
US202063080510P | 2020-09-18 | 2020-09-18 | |
US63/080,510 | 2020-09-18 | ||
US202063081015P | 2020-09-21 | 2020-09-21 | |
US63/081,015 | 2020-09-21 | ||
US202063082996P | 2020-09-24 | 2020-09-24 | |
US63/082,996 | 2020-09-24 | ||
PCT/US2021/014609 WO2021150887A1 (en) | 2020-01-24 | 2021-01-22 | Visualization devices, systems, and methods for otology and other uses |
Publications (1)
Publication Number | Publication Date |
---|---|
CN115379819A true CN115379819A (zh) | 2022-11-22 |
Family
ID=76969550
Family Applications (6)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN202180025640.6A Pending CN115551449A (zh) | 2020-01-24 | 2021-01-22 | 用于治疗听力损失的系统和方法 |
CN202180023707.2A Pending CN115426991A (zh) | 2020-01-24 | 2021-01-22 | 用于治疗耳部疾病的装置、系统和方法 |
CN202180023120.1A Pending CN115515542A (zh) | 2020-01-24 | 2021-01-22 | 用于耳科的装置、系统和方法 |
CN202180021055.9A Pending CN115426989A (zh) | 2020-01-24 | 2021-01-22 | 耳科学的装置、系统和方法 |
CN202180023110.8A Pending CN115426990A (zh) | 2020-01-24 | 2021-01-22 | 通过鼓膜进入中耳和内耳的微创工具和方法 |
CN202180018432.3A Pending CN115379819A (zh) | 2020-01-24 | 2021-01-22 | 用于耳科和其他用途的可视化装置、系统和方法 |
Family Applications Before (5)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN202180025640.6A Pending CN115551449A (zh) | 2020-01-24 | 2021-01-22 | 用于治疗听力损失的系统和方法 |
CN202180023707.2A Pending CN115426991A (zh) | 2020-01-24 | 2021-01-22 | 用于治疗耳部疾病的装置、系统和方法 |
CN202180023120.1A Pending CN115515542A (zh) | 2020-01-24 | 2021-01-22 | 用于耳科的装置、系统和方法 |
CN202180021055.9A Pending CN115426989A (zh) | 2020-01-24 | 2021-01-22 | 耳科学的装置、系统和方法 |
CN202180023110.8A Pending CN115426990A (zh) | 2020-01-24 | 2021-01-22 | 通过鼓膜进入中耳和内耳的微创工具和方法 |
Country Status (7)
Country | Link |
---|---|
US (10) | US11662561B2 (zh) |
EP (6) | EP4093352A4 (zh) |
JP (6) | JP2023512990A (zh) |
CN (6) | CN115551449A (zh) |
AU (6) | AU2021210956A1 (zh) |
CA (6) | CA3165914A1 (zh) |
WO (6) | WO2021150858A1 (zh) |
Families Citing this family (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11541215B2 (en) * | 2018-09-25 | 2023-01-03 | Triton Systems, Inc. | Multimodal endoscope and methods of use |
WO2021150858A1 (en) | 2020-01-24 | 2021-07-29 | Spiral Therapeutics Inc. | Minimally-invasive tools and methods for accessing the middle and inner ear through the tympanic membrane |
WO2022047234A1 (en) * | 2020-08-28 | 2022-03-03 | President And Fellows Of Harvard College | Drug combination kits and methods of drug delivery |
KR20240055879A (ko) * | 2021-09-17 | 2024-04-29 | 보스톤 싸이엔티픽 싸이메드 인코포레이티드 | 스텐트 시스템 |
CA3233538A1 (en) * | 2021-09-29 | 2023-04-06 | Signe Erickson | Cochlea injection devices, systems, and methods for otology |
US20230200637A1 (en) * | 2021-12-29 | 2023-06-29 | Dorna Hakimimehr | Devices and methods for endoscopic neuroablation in the tympanic cavity |
WO2023147535A2 (en) * | 2022-01-28 | 2023-08-03 | The Trustees Of Columbia University In The City Of New York | Microneedle apparatus and system for perforation of the round window membrane |
US11679704B1 (en) * | 2022-03-04 | 2023-06-20 | GRA-MAG Truck Interior Systems, L.L.C. | Device and method for setting or removing seat trim |
US20240108407A1 (en) * | 2022-10-03 | 2024-04-04 | Kairos Lasers Llc | Therapeutic laser system and method of use for activating the tissue stem cell niche for the treatment of medical conditions |
CN116098762B (zh) * | 2023-02-06 | 2024-02-20 | 哈尔滨工业大学 | 一种用于耳科手术机器人的内耳注射-采样执行器 |
Family Cites Families (71)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS55110528A (en) | 1979-02-20 | 1980-08-26 | Olympus Optical Co | Endoscope |
DE3539009A1 (de) * | 1985-11-02 | 1987-05-07 | Moeller J D Optik | Vorsatz fuer ein stereoskopisches operationsmikroskop fuer die augenchirurgie |
ES2121021T3 (es) * | 1992-10-23 | 1998-11-16 | Avi Grinblat | Sistema de microscopio estereoscopico optico. |
US5421818A (en) | 1993-10-18 | 1995-06-06 | Inner Ear Medical Delivery Systems, Inc. | Multi-functional inner ear treatment and diagnostic system |
US5707383A (en) * | 1995-10-05 | 1998-01-13 | Xomed Surgical Products, Inc. | Method of removing soft tissue in the middle ear |
US5849008A (en) * | 1996-04-26 | 1998-12-15 | Anthony; Phillip F. | Method for destruction of the inner ear special sensory epithelium to relieve positional vertigo |
US6045528A (en) | 1997-06-13 | 2000-04-04 | Intraear, Inc. | Inner ear fluid transfer and diagnostic system |
US6093150A (en) * | 1997-12-31 | 2000-07-25 | Acuson Corporation | Ultrasound otoscope |
US6440102B1 (en) | 1998-07-23 | 2002-08-27 | Durect Corporation | Fluid transfer and diagnostic system for treating the inner ear |
US6024726A (en) | 1998-08-25 | 2000-02-15 | Hill; Frank C | Middle ear fluid aspirator |
US8197461B1 (en) | 1998-12-04 | 2012-06-12 | Durect Corporation | Controlled release system for delivering therapeutic agents into the inner ear |
US6120484A (en) | 1999-02-17 | 2000-09-19 | Silverstein; Herbert | Otological implant for delivery of medicament and method of using same |
US9089450B2 (en) * | 2000-11-14 | 2015-07-28 | Cochlear Limited | Implantatable component having an accessible lumen and a drug release capsule for introduction into same |
US20040181185A1 (en) * | 2003-03-14 | 2004-09-16 | Yi-Chang Lee | Device for removing diseased surface tissues |
US6770080B2 (en) | 2001-04-26 | 2004-08-03 | Fenestra Medical, Inc. | Mechanically registered videoscopic myringotomy/tympanostomy tube placement system |
EP1441799B1 (en) | 2001-06-18 | 2006-10-11 | Durect Corporation | Device for delivering microdoses of agent to the ear |
US6648873B2 (en) | 2001-09-21 | 2003-11-18 | Durect Corp. | Aural catheter system including anchor balloon and balloon inflation device |
US7179238B2 (en) * | 2002-05-21 | 2007-02-20 | Medtronic Xomed, Inc. | Apparatus and methods for directly displacing the partition between the middle ear and inner ear at an infrasonic frequency |
WO2004066975A1 (en) | 2002-12-18 | 2004-08-12 | Hough Ear Institute | Otologic nanotechnology |
DE10316242A1 (de) | 2003-04-09 | 2004-10-28 | Carl Zeiss | Umlenksystem für eine Beobachtungseinrichtung sowie Beobachtungseinrichtung |
US7351246B2 (en) | 2004-01-20 | 2008-04-01 | Epley John M | Minimally invasive, sustained, intra-tympanic drug delivery system |
US20070167682A1 (en) * | 2004-04-21 | 2007-07-19 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
EP2069000A2 (en) * | 2006-09-20 | 2009-06-17 | University Of Virginia Patent Foundation | Tube, stent and collar insertion device |
US20080154343A1 (en) * | 2006-12-21 | 2008-06-26 | Li Kasey K | Eustachian tube treatment systems |
US20080167527A1 (en) * | 2007-01-09 | 2008-07-10 | Slenker Dale E | Surgical systems and methods for biofilm removal, including a sheath for use therewith |
EP2712614B1 (en) * | 2007-02-08 | 2017-11-29 | Medtronic Xomed, Inc. | Solvating system and sealant for medical use |
US8052693B2 (en) * | 2007-04-19 | 2011-11-08 | Acclarent, Inc. | System and method for the simultaneous automated bilateral delivery of pressure equalization tubes |
US20090270894A1 (en) * | 2008-04-25 | 2009-10-29 | Joshua David Rubin | Surgical instrument with internal irrigation |
PT104131B (pt) * | 2008-07-14 | 2010-10-20 | Univ Do Porto | Dispositivo para a medição e análise da cor do ouvido externo e canal auditivo |
US8945142B2 (en) * | 2008-08-27 | 2015-02-03 | Cook Medical Technologies Llc | Delivery system for implanting nasal ventilation tube |
WO2010045432A2 (en) | 2008-10-15 | 2010-04-22 | Med-El Elektromedizinische Geraete Gmbh | Inner ear drug delivery device and method |
EP2443843A4 (en) * | 2009-06-18 | 2013-12-04 | SoundBeam LLC | DEVICES IMPLANTABLE IN THE TYMPAN MEMBRANE FOR HEARING AID SYSTEMS AND METHODS |
US20120203200A1 (en) | 2009-10-15 | 2012-08-09 | Entratympanic, Llc | Device and method for delivering medicine into the tympanic cavity |
US8685052B2 (en) * | 2010-06-30 | 2014-04-01 | Laurimed, Llc | Devices and methods for cutting tissue |
WO2012094666A1 (en) * | 2011-01-07 | 2012-07-12 | Preceptis Medical, Inc. | Stabilization system and aspiration device with protected cutting edge |
US9352084B2 (en) | 2011-08-05 | 2016-05-31 | Unitract Syringe Pty Ltd | Injectable drug delivery arrangement with controlled delivery cannula position relative to point of delivery |
US20130060131A1 (en) | 2011-09-02 | 2013-03-07 | The Texas A&M University System | Method and apparatus for examining inner ear |
AU2012304772B2 (en) * | 2011-09-08 | 2015-11-26 | Arthrocare Corporation | Systems, devices and methods for providing therapy to an anatomical structure |
US10130514B2 (en) | 2011-09-26 | 2018-11-20 | Incube Labs, Llc | System and method for delivery of a therapeutic agent to the inner ear |
US20130245569A1 (en) | 2012-03-15 | 2013-09-19 | Med-El Elektromedizinische Geraete Gmbh | Accessory Device for Inner Ear Drug Delivery |
US9198560B2 (en) * | 2012-03-19 | 2015-12-01 | Welch Allyn, Inc. | Medical diagnostic instrument |
US20130274715A1 (en) * | 2012-04-13 | 2013-10-17 | Acclarent, Inc. | Method and System for Eustachian Tube Dilation |
WO2014052595A2 (en) * | 2012-09-26 | 2014-04-03 | University Of Virginia | Devices and methods for protecting an internal channel of a subject |
JP6490586B2 (ja) * | 2012-11-15 | 2019-03-27 | コーク・インスティチュート・オブ・テクノロジー | 鼓膜チューブおよび挿入装置 |
CA2932540A1 (en) * | 2012-12-14 | 2014-06-19 | The Trustees Of Columbia University In The City Of New York | System and method to locally deliver therapeutic agent to inner ear |
US10821276B2 (en) * | 2012-12-14 | 2020-11-03 | The Trustees Of Columbia University In The City Of New York | System and method to locally deliver therapeutic agent to inner ear |
US9629684B2 (en) * | 2013-03-15 | 2017-04-25 | Acclarent, Inc. | Apparatus and method for treatment of ethmoid sinusitis |
US20150151095A1 (en) * | 2013-11-29 | 2015-06-04 | Muaaz Tarabichi | Combined balloon dilation catheter and introducer for dilation of eustachian tube |
US9616207B2 (en) | 2014-06-26 | 2017-04-11 | Cochlear Limited | Treatment of the ear |
EP3160406A4 (en) | 2014-06-27 | 2018-02-21 | The Trustees of Columbia University in the City of New York | Apparatus for perforation and aspiration of inner ear |
JP5908195B1 (ja) * | 2014-06-30 | 2016-04-26 | オリンパス株式会社 | 穿刺用処置具 |
US9833360B2 (en) * | 2014-08-12 | 2017-12-05 | Tusker Medical, Inc. | Tympanostomy tube delivery device with replaceable shaft portion |
US20160346511A1 (en) | 2015-06-01 | 2016-12-01 | Webb Medical LLC | Middle ear surgical attachments for suction catheters and suction catheters including the same |
US10098529B2 (en) * | 2015-10-28 | 2018-10-16 | Ricoh Company, Ltd. | Optical design of a light field otoscope |
EP3422965B1 (en) * | 2016-03-04 | 2019-12-11 | Aerin Medical, Inc. | Device for eustachian tube modification |
JP2019527571A (ja) | 2016-08-05 | 2019-10-03 | タスカー メディカル,インコーポレイテッド | 治療物質を中耳及び/又は内耳へ送達するためのシステム、装置及び方法 |
JP6951000B2 (ja) * | 2017-04-20 | 2021-10-20 | レズネント,エルエルシー | 軟性−硬性ハイブリッド内視鏡および器具アタッチメント |
EP3654821A2 (en) | 2017-07-17 | 2020-05-27 | 3NT Medical Ltd. | Ear visualization system |
CN111386095B (zh) * | 2017-09-26 | 2022-11-04 | 延世大学校原州产学协力团 | 中耳炎治疗仪 |
IL308159A (en) | 2017-11-02 | 2023-12-01 | Aventamed Designated Activity Company | tympanic tube and positioning device |
GB2569325B (en) * | 2017-12-13 | 2020-05-06 | Imperial Innovations Ltd | Ear examination apparatus |
EP3746018A1 (en) | 2018-02-02 | 2020-12-09 | Tusker Medical, Inc. | Systems, apparatus, and methods for transport and delivery of therapeutic substance to middle ear |
CA3101056A1 (en) | 2018-04-13 | 2019-10-17 | Stryker European Holdings I, Llc | Systems and methods of performing transcanal ear surgery |
AU2019256527A1 (en) * | 2018-04-19 | 2020-11-12 | Spiral Therapeutics, Inc. | Inner ear drug delivery devices and methods of use |
AU2019261271B2 (en) * | 2018-04-23 | 2022-02-24 | Med-El Elektromedizinische Geraete Gmbh | Patient specific adjustment of cochlear implant insertion trajectories |
CA3098625C (en) * | 2018-05-18 | 2022-12-06 | Vascular Technology, Incorporated | Articulating microsurgical instrument |
US11801362B2 (en) * | 2018-05-21 | 2023-10-31 | The Texas A&M University System | Surgical cannulas and related methods |
US11541215B2 (en) | 2018-09-25 | 2023-01-03 | Triton Systems, Inc. | Multimodal endoscope and methods of use |
US20220032020A1 (en) | 2018-12-05 | 2022-02-03 | Cochlear Limited | Therapeutic substance storage and delivery |
US10492670B1 (en) | 2018-12-18 | 2019-12-03 | 3Nt Medical Ltd. | Ear visualization and treatment system |
WO2021150858A1 (en) | 2020-01-24 | 2021-07-29 | Spiral Therapeutics Inc. | Minimally-invasive tools and methods for accessing the middle and inner ear through the tympanic membrane |
-
2021
- 2021-01-22 WO PCT/US2021/014561 patent/WO2021150858A1/en unknown
- 2021-01-22 CN CN202180025640.6A patent/CN115551449A/zh active Pending
- 2021-01-22 AU AU2021210956A patent/AU2021210956A1/en active Pending
- 2021-01-22 CN CN202180023707.2A patent/CN115426991A/zh active Pending
- 2021-01-22 EP EP21744191.4A patent/EP4093352A4/en active Pending
- 2021-01-22 AU AU2021211707A patent/AU2021211707A1/en active Pending
- 2021-01-22 US US17/155,800 patent/US11662561B2/en active Active
- 2021-01-22 US US17/155,575 patent/US20210228411A1/en active Pending
- 2021-01-22 EP EP21744962.8A patent/EP4093355A4/en active Pending
- 2021-01-22 JP JP2022545410A patent/JP2023512990A/ja active Pending
- 2021-01-22 CA CA3165914A patent/CA3165914A1/en active Pending
- 2021-01-22 JP JP2022545415A patent/JP2023512194A/ja active Pending
- 2021-01-22 CA CA3165925A patent/CA3165925A1/en active Pending
- 2021-01-22 WO PCT/US2021/014609 patent/WO2021150887A1/en unknown
- 2021-01-22 CN CN202180023120.1A patent/CN115515542A/zh active Pending
- 2021-01-22 JP JP2022545409A patent/JP2023512989A/ja active Pending
- 2021-01-22 EP EP21744487.6A patent/EP4093354A4/en active Pending
- 2021-01-22 EP EP21744103.9A patent/EP4093351A4/en active Pending
- 2021-01-22 JP JP2022545408A patent/JP2023512988A/ja active Pending
- 2021-01-22 US US17/155,589 patent/US11906719B2/en active Active
- 2021-01-22 CN CN202180021055.9A patent/CN115426989A/zh active Pending
- 2021-01-22 CA CA3165933A patent/CA3165933A1/en active Pending
- 2021-01-22 AU AU2021209675A patent/AU2021209675A1/en active Pending
- 2021-01-22 CN CN202180023110.8A patent/CN115426990A/zh active Pending
- 2021-01-22 EP EP21744192.2A patent/EP4093353A4/en active Pending
- 2021-01-22 WO PCT/US2021/014601 patent/WO2021150881A1/en unknown
- 2021-01-22 WO PCT/US2021/014610 patent/WO2021150888A1/en unknown
- 2021-01-22 JP JP2022545411A patent/JP2023512192A/ja active Pending
- 2021-01-22 CA CA3165938A patent/CA3165938A1/en active Pending
- 2021-01-22 US US17/155,585 patent/US20210228412A1/en active Pending
- 2021-01-22 US US17/155,580 patent/US11796781B2/en active Active
- 2021-01-22 US US17/155,564 patent/US20210228849A1/en active Pending
- 2021-01-22 EP EP21745163.2A patent/EP4093356A4/en active Pending
- 2021-01-22 AU AU2021210954A patent/AU2021210954A1/en active Pending
- 2021-01-22 AU AU2021209917A patent/AU2021209917A1/en active Pending
- 2021-01-22 CA CA3165918A patent/CA3165918A1/en active Pending
- 2021-01-22 WO PCT/US2021/014618 patent/WO2021150894A2/en unknown
- 2021-01-22 CN CN202180018432.3A patent/CN115379819A/zh active Pending
- 2021-01-22 WO PCT/US2021/014612 patent/WO2021150890A2/en unknown
- 2021-01-22 CA CA3165941A patent/CA3165941A1/en active Pending
- 2021-01-22 AU AU2021209911A patent/AU2021209911A1/en active Pending
- 2021-01-22 JP JP2022545412A patent/JP2023512193A/ja active Pending
-
2022
- 2022-03-30 US US17/708,581 patent/US11467386B2/en active Active
-
2023
- 2023-04-24 US US18/138,459 patent/US20230258915A1/en active Pending
- 2023-09-18 US US18/369,592 patent/US20240019674A1/en active Pending
-
2024
- 2024-01-19 US US18/417,612 patent/US20240176122A1/en active Pending
Also Published As
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN115379819A (zh) | 用于耳科和其他用途的可视化装置、系统和方法 | |
AU2014233486B2 (en) | Viewing trocar with integrated prism for use with angled endoscope | |
ES2487893T3 (es) | Aparato para observar una porción visualmente oscurecida de una cavidad | |
US10130515B2 (en) | Mechanically registered videoscopic myringotomy/tympanostomy tube placement system | |
Gaab | Instrumentation: endoscopes and equipment | |
US20030163030A1 (en) | Hollow endoscopy | |
US4414962A (en) | Operating arthroscope | |
US5957832A (en) | Stereoscopic percutaneous visualization system | |
US20100256450A1 (en) | Laparoscope and setting method thereof | |
WO1995010218A1 (en) | Stereoscopic percutaneous visualization system | |
US20140235946A1 (en) | Optical obturator visualization system | |
Nomura | A Needle Otoscope: An Instrument ofEndotoscopy of the Middle Ear | |
KR100947624B1 (ko) | 3차원 영상데이터를 제공하는 내시경 | |
JP2022520422A (ja) | 硬性内視鏡装置 | |
JPH0416812A (ja) | ステレオ内視鏡 | |
Peters et al. | Middle-ear endoscopy and trans-tympanic drug delivery using an interventional sialendoscope: feasibility study in human cadaveric temporal bones | |
Abou-Elhamd | Telescopic myringotomy and tube application | |
JPH06269474A (ja) | 耳鼻細径内視装置 | |
Fabinyi et al. | A minimally invasive technique for endoscopic middle ear surgery | |
JPH0680401U (ja) | 眼底内視鏡 | |
Poe | Clinical applications of endoscopy in otology | |
JP3704103B2 (ja) | 内視鏡用案内管 | |
Xiang et al. | The optical design of stereo endoscope | |
KR20220086331A (ko) | 시스 장치 및 이를 구비하는 내시경 시스템 | |
Lee | An alternative use of video-telescopic guidance for insertion of myringotomy tube |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination |