Abstract: A surgical instrument for cutting a first tissue and detecting a second tissue includes a shaft, a cutting member, and a tissue monitor system. The shaft extends along a longitudinal axis and includes a shaft lumen and a shaft opening. The cutting member is disposed within the shaft lumen and configured to cyclically move from a first position to a second position relative to the shaft. The cutting member is further configured to cut a tissue portion of the first tissue for removal therefrom. The tissue monitor system is associated with at least one of the shaft or the cutting member configured to detect the second tissue distinct from the first tissue for selectively cutting and removing the first tissue relative to the second tissue.

Abstract: An apparatus includes a body, a shaft assembly, and a shaft actuation assembly. The shaft assembly extends distally from the body and defines a longitudinal axis. A portion of the shaft assembly is configured to be inserted into an anatomical passageway associated with an ear, nose, or throat of a patient. The shaft assembly further defines a working passageway that is dimensioned to receive an instrument. An actuator of the body is operable to drive the instrument longitudinally relative to the shaft assembly. The shaft actuation assembly is operatively coupled with a proximal portion of the shaft assembly. Further, the shaft actuation assembly is translatable in a distal direction to extend the shaft assembly distally along the longitudinal axis and is translatable in a proximal direction to retract the shaft assembly proximally along the longitudinal axis.

Abstract: An apparatus such as a suction instrument includes a position sensor proximate to a distal tip of a malleable shaft. A sensor wire couples the position sensor to a processor of an image guided surgery system such that signals generated by the position sensor can be interpreted to determine the position of the surgical instrument. The malleable shaft includes a malleable outer shaft and a flexible inner tube. The flexible inner tube includes a primary lumen that can provide suction, fluid, or various deployable surgical tools, and an inner lumen that holds the sensor wire. Protected within the inner lumen, the sensor wire runs the length of the shaft and exits the inner lumen and passes through a slot in the outer shaft to reach the position sensor. A heat shrink cover wraps the distal tip, sealing the components together and providing an opening suitable for suction.

Abstract: A virtual camera may be positioned relative to a 3-D model of a patient anatomy in order to provide a virtual camera view of the surrounding anatomy and tracked surgical instruments being deployed to the anatomy. Visual context provided by the virtual camera may be limited in some cases, such as where a surgical instrument is being used within a very narrow anatomical passageway or cavity. To provide more placement flexibility, an IGS system providing a virtual camera receives inputs defining variable visual characteristics for different segments or regions of the 3-D model, which may include hiding certain segments or making certain segments semi-transparent. With such a system, the view of the 3-D model provided by the virtual camera view may be modified to remove or deemphasize less relevant segments, to display or emphasize more relevant segments (e.g., critical patient anatomy), or both.

Abstract: A guidewire includes a guidewire shaft and an inflatable element arranged at a distal end of the guidewire shaft. At least a portion of the guidewire shaft is formed of metal, and the guidewire shaft includes a lumen that fluidly communicates with an interior of the inflatable element. The inflatable element is operable to transition between a deflated state in which the inflatable element is configured to pass through an isthmus of a Eustachian tube (ET), and an inflated state in which the inflatable element is configured to dilate the ET.

Abstract: Apparatus, including a patient tracker, attached to a subject, having magnetic field sensors and optical landmarks with known spatial relationships to each other. A camera acquires a 3D optical image, in a first frame of reference (FOR), of the subject's face. A magnetic radiator assembly generates magnetic fields at the subject's head, thereby defining a second FOR. A processor: processes field sensor signals to acquire location coordinates of the sensors in the second FOR; segments a tomographic image of the subject, having a third FOR, to identify the subject's face in the third FOR; computes a first transformation between the third and first FORs to map the tomographic face image to the 3D optical image; maps the optical landmarks to the third FOR; maps the respective location coordinates of the sensors to the first FOR; and computes a second transformation between the second FOR and the third FOR.

Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: A surgical instrument for cutting a first tissue and detecting a second tissue includes a shaft, a cutting member, and a tissue monitor system. The shaft extends along a longitudinal axis and includes a shaft lumen and a shaft opening. The cutting member is disposed within the shaft lumen and configured to cyclically move from a first position to a second position relative to the shaft. The cutting member is further configured to cut a tissue portion of the first tissue for removal therefrom. The tissue monitor system is associated with at least one of the shaft or the cutting member configured to detect the second tissue distinct from the first tissue for selectively cutting and removing the first tissue relative to the second tissue.

Abstract: A surgical instrument and method of tracking the surgical instrument includes a shaft, a cutting member, and navigation system. The shaft has a shaft lumen, a shaft window, and a shaft edge. The cutting member is disposed within the shaft lumen and is configured to cyclically move from a first position to a second position relative to the shaft. The cutting member includes a cutting window opening, a cutting edge, and a suction lumen to cut the tissue portion with the cutting member in the first position. The navigation system includes a navigation sensor positioned on at least one of the shaft or the cutting member that is configured to be tracked within a patient for identifying a positional movement of the shaft or the cutting member within the patient.

Abstract: An apparatus includes a handle, an elongate shaft assembly, an adjustment feature, and a position sensor. The shaft assembly includes an outer tube and an inner shaft. The outer tube is slidably disposed within an elongate body of the handle. The outer tube extends distally from the elongate body to an outer tube distal end. The inner shaft is coaxially disposed within the outer tube and extends distally through the outer tube end to an inner shaft distal tip. The inner shaft is sized and configured to pass through passageways within an ear, nose, or throat of a patient. The adjustment feature is slidably disposed relative to the body of the handle and is configured to translate at least the outer tube relative to the handle. The position sensor is configured to generate signals indicating a real-time position of the distal tip of the inner shaft.

Abstract: A method is used to manufacture a surgical guidewire that includes an outer coil assembly, a position sensor, a communication wire, an adhesive, a core wire, a hollow tube, and an atraumatic tip. The outer coil assembly has an outer coil that extends distally from a proximal coil retainer to a distal coil retainer. The position sensor is located distally within the outer coil assembly and is configured to be in communication with a processor via the communication wire. The core wire is between an outer coil proximal portion and the hollow tube. A distal end of the hollow tube is bonded to the atraumatic tip. The method includes affixing the atraumatic tip to the distal end of the hollow tube with the adhesive. The adhesive is constructed of instant glue.

Abstract: A guidewire includes a guidewire shaft and an inflatable element arranged at a distal end of the guidewire shaft. At least a portion of the guidewire shaft is formed of metal, and the guidewire shaft includes a lumen that fluidly communicates with an interior of the inflatable element. The inflatable element is operable to transition between a deflated state in which the inflatable element is configured to pass through an isthmus of a Eustachian tube (ET), and an inflated state in which the inflatable element is configured to dilate the ET.

Abstract: A surgical instrument includes a handle assembly and a shaft assembly extending distally from the handle assembly and having a distal end sized to be inserted into the nasal cavity of a patient. The shaft assembly includes a cutting member configured to cut tissue within the nasal cavity, and a translating member slidably disposed over the cutting member. A navigation sensor is disposed within the distal end of the shaft assembly and is operable to generate a signal corresponding to a position of the distal end within the patient.

Abstract: A catheter system includes a body, a guide member assembly, an articulation assembly, and a partial sleeve. The guide member assembly extends distally from the body and includes a proximal rigid portion defining a longitudinal axis, a distal flexible portion, and an open distal end. The guide member assembly defines a lumen in communication with the body and the open distal end. The articulation section can flex the distal flexible portion and the open distal end relative to the longitudinal axis between a straight configuration and an articulated configuration. The partial sleeve is disposed within a portion of the lumen defined by the distal flexible portion. The partial sleeve also defines a longitudinally extending gap.

Abstract: A method of dilating a target anatomical structure of an ear, a nose, or a throat of a patient includes inserting a distal end of a balloon catheter into the ear, the nose, or the throat. The balloon catheter includes a balloon assembly coaxially disposed along a proximally extending shaft. The balloon assembly includes at least first and second dilation balloons that at least partially overlap one another. The method also includes distally advancing the distal end until the balloon assembly is disposed in the target anatomical structure. The method also includes selectively dilating the target anatomical structure based on a diameter of the target anatomical structure by inflating the first dilation balloon to a first diameter or inflating the second dilation balloon to a second diameter that is greater than the first diameter. The second inflation lumen is not in fluid communication with the first inflation lumen.

Abstract: An apparatus includes a body and a dilation catheter operatively coupled with the body and configured to translate between proximal and distal positions. The dilation catheter includes a dilation member configured to dilate an anatomical passageway when the dilation catheter is in the distal position. A guide catheter is coupled to the body and defines a longitudinal axis. The guide catheter is selectively positionable in a plurality of rotational orientations about the longitudinal axis relative to the body, and is configured to guide the dilation catheter therethrough between the proximal and distal positions. The apparatus further includes at least one illuminating indicator feature configured to emit light to facilitate positioning of the guide catheter in one or more of the rotational orientations.

Abstract: An apparatus includes a body, an upright member, a frame, and a plurality of field generating elements. The body is configured to be positioned between a patient's back and a backrest of a chair. The upright member extends upwardly from the body. The frame has a curved configuration configured to partially surround a patient's head. The field generating elements are configured to generate an electromagnetic field around a patient's head partially surrounded by the frame.

Abstract: A surgical instrument and method of tracking the surgical instrument includes a shaft, a cutting member, and navigation system. The shaft has a shaft lumen, a shaft window, and a shaft edge. The cutting member is disposed within the shaft lumen and is configured to cyclically move from a first position to a second position relative to the shaft. The cutting member includes a cutting window opening, a cutting edge, and a suction lumen to cut the tissue portion with the cutting member in the first position. The navigation system includes a navigation sensor positioned on at least one of the shaft or the cutting member that is configured to be tracked within a patient for identifying a positional movement of the shaft or the cutting member within the patient.

Abstract: An implant that may maintain position with a Eustachian tube of a patient, the implant includes an engagement body, an anchoring assembly, and a pressure balance assembly. The engagement body includes an exterior surface dimensioned to bear radially outward against the Eustachian tube. The anchoring assembly may lock the implant in the Eustachian tube. The pressure balance assembly includes a vented pathway that may transition between an occluded state and a vented state. The vented pathway may provide fluid communication between the proximal end and the distal end of the implant in the ventilated state while inhibiting fluid communication between the proximal end and the distal end of the implant in the occluded state.

Abstract: An endoscopic camera has two or more cameras positioned at a distal end, positioned to provide partially overlapping fields of view. The cameras communicate captured digital images the length of the flexible endoscope, where they may be saved and processed to provide additional imaging features. With partially overlapping images from two or more cameras, image processing can provide panoramic images, super resolution images, and three-dimensional images. One or more of these image modes may also be enhanced to provide a virtualization window that displays a portion of a larger or higher resolution image. The virtualization window displays the selected area of the image, and may be moved or zoomed around the image to provide a virtual endoscope repositioning experience, where the endoscope remains statically positioned but the virtualization window presents a sense of movement and navigation around the surgical area.