# US 2019/0167151 A1 · System and method for tracking patient movement during guided medical procedure > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167151 A1 - Document ID: US20190167151A1 - Status: Published application - Kind: A1 - Application number: 15/831,618 - Filed: 2017-12-05 - Published: 2019-06-06 - Earliest claimed: 2017-12-05 - Applicants: Acclarent, Inc. - Inventors: Jetmir Palushi; Don Q. Ngo-Chu; Itzhak Fang - Web page: https://patentgrep.com/patent/US20190167151A1 ## CPC - A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging} - A61B 1/233: for the nose, i.e. nasoscopes {, e.g. testing of patency of Eustachian tubes} - A61B 5/062: {using magnetic field} - A61B 5/11: Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb {(A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721)} - A61B 5/6803: {Head-worn items, e.g. helmets, masks, headphones or goggles} - A61B 5/6817: {Ear canal} - A61B 5/702: {Posture restraints} - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61M 25/10: Balloon catheters ({A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02;} inflatable balloons for placing stents or stent-grafts A61F2/958 {; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00}) - A61M 29/02: Dilators made of swellable material {(balloon catheters for angioplasty A61M25/104)} - A61B 17/24: for use in the oral cavity, larynx, bronchial passages or nose (for medical inspection of cavities or tubes in the body A61B1/00); Tongue scrapers - A61B 34/25: {User interfaces for surgical systems} - A61B 90/361: {Image-producing devices, e.g. surgical cameras} - A61B 2017/00216: {with eye tracking or head position tracking control} - A61B 2017/00946: {malleable} - A61B 2017/22051: {with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation (A61B2017/22048, A61B2017/3486 take precedence)} - A61B 2017/22062: {to be filled with liquid} - A61B 2034/2051: {Electromagnetic tracking systems} - A61B 2034/2072: {Reference field transducer attached to an instrument or patient} - A61B 2090/066: {for measuring torque} - A61B 2090/067: {for measuring angles} - A61B 2090/0818: {Redundant systems, e.g. using two independent measuring systems and comparing the signals} - A61B 2090/306: {using optical fibres} - A61B 2090/374: {NMR or MRI} - A61B 2090/3762: {using computed tomography systems [CT]} - A61B 2090/3937: {Visible markers} - A61B 2090/3975: {active} - A61B 2090/3983: {Reference marker arrangements for use with image guided surgery} - A61B 2217/007: with irrigation system - A61M 25/0041: {pre-formed, e.g. specially adapted to fit with the anatomy of body channels (urethral catheters A61F2/04)} - A61M 25/0113: {Mechanical advancing means, e.g. catheter dispensers} - A61M 2025/0166: {Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided} - A61M 2025/09116: {Design of handles or shafts or gripping surfaces thereof for manipulating guide wires} - A61M 2025/09175: {having specific characteristics at the distal tip} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract A medical instrument includes an instrument position sensor operable to generate an instrument position signal. A first head position sensor is configured to be secured in a first fixed location on or in a patient's head and generate a first head position signal. Field generating elements are configured to generate an electromagnetic field around the patient's head. A processor processes the instrument position signal to determine positioning of the patient's instrument within the electromagnetic field. The processor also processes the first head position signal to determine positioning of the patient's head within the electromagnetic field. The processor determines the position of the instrument within the patient's head based on the determined position of the patient's instrument within the electromagnetic field and based further on the determined position of the patient's head within the electromagnetic field. ## Claims ### Claim 1 A system comprising: (a) a medical instrument, wherein the medical instrument is configured to be inserted into a patient's head, wherein the medical instrument includes an instrument position sensor operable to generate an instrument position signal; (b) a first head position sensor, wherein the first head position sensor is configured to be secured in a first fixed location on or in a patient's head, wherein the first head position sensor is configured to generate a first head position signal; (c) a plurality of field generating elements, wherein the field generating elements are configured to be positioned around a patient's head such that the field generating elements are configured to generate an electromagnetic field around the patient's head; and (d) a processor, wherein the processor is in communication with the instrument position sensor, the first head position sensor, and the field generating elements, wherein the processor is operable to process the instrument position signal to determine positioning of the patient's instrument within the electromagnetic field, wherein the processor is operable to process the first head position signal to determine positioning of the patient's head within the electromagnetic field, wherein the processor is further configured to determine the position of the instrument within the patient's head based on the determined position of the patient's instrument within the electromagnetic field and based further on the determined position of the patient's head within the electromagnetic field. ### Claim 2 (depends on 1) The system of claim 1, further comprising an earbud configured to fit in a patient's ear, wherein the first head position sensor is located in the earbud. ### Claim 3 (depends on 1) The system of claim 1, further comprising a transmitter, wherein the transmitter in communication with the first head position sensor and the processor, wherein the transmitter is configured to transmit the first head position signal to the processor. ### Claim 4 (depends on 3) The system of claim 3, wherein the transmitter is in communication with the first head position sensor via one or more wires. ### Claim 5 (depends on 3) The system of claim 3, wherein the transmitter is in communication with the head position sensor wirelessly. ### Claim 6 (depends on 3) The system of claim 3, wherein the transmitter is in communication with the processor via one or more wires. ### Claim 7 (depends on 3) The system of claim 3, wherein the transmitter is in communication with the processor wirelessly. ### Claim 8 (depends on 1) The system of claim 1, further comprising a second head position sensor, wherein the second head position sensor is configured to be secured in a second fixed location on or in a patient's head, wherein the second head position sensor is configured to generate a second head position signal, wherein the processor is in communication with the second head position sensor, wherein the processor is operable to process the second head position signal to further determine positioning of the patient's head within the electromagnetic field. ### Claim 9 (depends on 8) The system of claim 8, further comprising a first earbud and a second earbud, wherein the first head position sensor is located in the first earbud, wherein the second head position sensor is located in the second earbud. ### Claim 10 (depends on 8) The system of claim 8, wherein the processor is further configured to determine whether patient head movement is intentional, based on whether movement of the first head position sensor differs from movement of the second head position sensor. ### Claim 11 (depends on 10) The system of claim 10, wherein the processor is configured to effectively disregard the head position signals in response to determining that patient head movement is unintentional, wherein the processor is further configured to determine the position of the instrument within the patient's head based on the determined position of the patient's instrument within the electromagnetic field, based on the first head position signal, and based on the second head position signal. ### Claim 12 (depends on 1) The system of claim 1, wherein the medical instrument comprises a guidewire. ### Claim 13 (depends on 12) The system of claim 12, wherein the instrument position sensor is located at a distal end of the guidewire. ### Claim 14 (depends on 1) The system of claim 1, wherein the medical instrument comprises a dilation catheter. ### Claim 15 (depends on 1) The system of claim 1, wherein the instrument position sensor comprises a coil configured to generate a signal based on movement of the coil within the electromagnetic field. ### Claim 16 (depends on 1) The system of claim 1, wherein the first head position sensor comprises a coil configured to generate a signal based on movement of the coil within the electromagnetic field. ### Claim 17 (depends on 1) The system of claim 1, further comprising a chair configured to support a patient, wherein the field generating elements are fixedly secured to the chair. ### Claim 18 (depends on 1) The system of claim 1, further comprising a curved frame supporting the field generating elements, wherein the curved frame is configured to form an arcuate shape near a patient's head. ### Claim 19 A method comprising: (a) securing a head position sensor to a patient's head; (b) inserting a medical instrument in the patient's head, wherein the medical instrument includes a medical instrument sensor; (c) activating a navigation system, wherein the activated navigation system: (i) generates an electromagnetic field around the patient's head, (ii) determines the position of the medical instrument within the electromagnetic field based on a signal from the medical instrument sensor, (iii) determines the position of the patient's head within the electromagnetic field based on a signal from the medical instrument sensor, and (iv) determines the position of the medical instrument within the patient's head based on at least: (A) the determined position of the medical instrument within the electromagnetic field, and (B) the determined position of the patient's head within the electromagnetic field. ### Claim 20 A method, comprising: (a) generating an electromagnetic field around a patient's head; (b) receiving a medical instrument position signal from a medical instrument position sensor indicating a position of the medical instrument in the electromagnetic field; (c) receiving a head position signal from a head position sensor indicating a position of the patient's head in the electromagnetic field, wherein the head position sensor is fixedly secured to the patient's head; and (d) determining the position of the medical instrument in the patient's head based on at least: (i) the received medical instrument position signal, and (ii) the received head position signal.