Steerable Otology Instruments for Minimally Invasive Ear Access
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Solution Overview
Problem
Existing ear procedures are highly invasive, leading to prolonged recovery times, increased treatment costs, and potential complications due to extensive bone removal and limited instrument maneuverability.
Innovation Solution
Development of minimally invasive instruments and techniques using small gauge, flexible, steerable, and angulated shafts that allow access to the middle and inner ear through trans-canal and trans-tympanic approaches, combined with advanced tools like ultrasonic, laser, and diathermy instruments for precise treatment and visualization.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional invasive surgical approaches are used to access the middle and inner ear, then adequate instrument maneuverability and access are achieved, but bone removal is extensive and recovery time is prolonged
Solution Approach 1:
The instrument shaft is divided into multiple articulated segments that can be independently positioned and angled. This segmentation allows the distal tip to reach deep ear structures through the narrow trans-canal approach while the proximal segments remain maneuverable outside the ear canal, resolving the contradiction between access depth and maneuverability without requiring extensive bone removal
Solution Approach 2:
The instrument employs multi-planar angulation capabilities, allowing the shaft to bend in multiple dimensions (e.g., 30 degrees in one plane, 15 degrees in another). This dimensional flexibility enables the instrument to navigate the complex three-dimensional anatomy of the ear canal and middle ear space through a minimally invasive trans-canal approach, achieving adequate maneuverability without extensive mastoidectomy
2Object-affected harmful factors
If trans-canal and trans-tympanic approaches are used, then invasiveness is reduced and bone removal is minimized, but instrument access and maneuverability are limited
Solution Approach 1:
The instrument shaft incorporates dynamic articulation with multiple joints that can be actively adjusted during the procedure. The shaft can be bent at various angles (e.g., 30 degrees at first joint, 15 degrees at second joint) to adapt to the specific anatomical configuration of each patient's ear, providing adequate maneuverability through the constrained trans-canal approach without requiring invasive bone removal
Solution Approach 2:
The instrument employs a flexible, slender shaft design that can bend and conform to the narrow ear canal passage. This flexible construction allows the instrument to navigate the tight trans-canal space while maintaining structural integrity and delivering therapeutic energy to the target site, achieving minimally invasive access without sacrificing operational capability
3Object-affected harmful factors
If small gauge instruments are used for minimally invasive access, then invasiveness is reduced, but instrument strength and therapeutic energy delivery are compromised
Solution Approach 1:
The instrument replaces traditional mechanical cutting and drilling mechanisms with ultrasonic vibration technology. The ultrasonic tip can precisely ablate bone and tissue with minimal mechanical force, enabling effective therapeutic action through a small-gauge shaft that would be insufficient for conventional mechanical instruments, thus maintaining minimally invasive benefits while ensuring adequate therapeutic energy delivery
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Reduces procedural invasiveness, shortens recovery times, lowers treatment costs, and minimizes complications by enabling precise and efficient treatment of ear disorders with reduced bone removal and improved procedural efficacy.
Implementation Method 1
The instrument may be an ultrasonic instrument. The delivering the therapeutic treatment may include applying ultrasonic energy to the cholesteatoma or the soft tissue lesion from the ultrasonic instrument to emulsify at least a portion of the cholesteatoma or the soft tissue lesion.
Implementation Method 2
The instrument may be a laser instrument. The delivering the therapeutic treatment may include applying laser energy to the cholesteatoma or the soft tissue lesion.
Implementation Method 3
The instrument may be a diathermy instrument. The delivering the therapeutic treatment may include applying thermal energy to the cholesteatoma or the soft tissue lesion from the diathermy instrument to remove at least a portion of the cholesteatoma or the soft tissue lesion.
Data Source
AI summary
Devices, systems, and methods can be employed to facilitate performing procedures in the outer, middle, and/or inner ear in order to diagnose and/or treat disorders including, but not limited to, hearing loss and other ear disorders. For example, this document describes devices, systems and methods that include instruments and techniques to minimize the invasiveness and/or to enhance the efficacy of procedures that are performed in the outer, middle, and/or inner ear spaces such as mastoidectomy, tympanoplasty, cholesteatoma treatments, otosclerosis treatments, and Eustachian tube treatments.