Transnasal method and catheter for lacrimal system

A balloon catheter for dilating a prepared small, tight nasal opening in a wall separating a patient's lacrimal sac and the patient's nasal cavity, comprising a tubular catheter body having a proximal end, a proximal segment, a distal end, and a distal segment;

• an inflatable member disposed about said distal segment, said distal segment having a slot;
• said catheter body being closed at a point that is closer to said distal end that is said slot;
• means for applying fluid under pressure to said proximal end of said catheter body, said fluid under pressure flowing through said slot to inflate said inflatable member for dilating said prepared opening;
• and said catheter body being formed of a hypotube of sufficient stiffness and column strength to enable said catheter, when said inflatable member is deflated, to be pushed from said nasal cavity through said prepared opening in said lateral nasal wall into said lacrimal sac;
• and,
• wherein said catheter body is closed at a point spaced from said distal end and between said slot and said distal end, whereby an open-ended distal portion of said distal segment is provided, said open-ended distal portion being engagable by an end of a probe to help guide said catheter body.

A balloon catheter for dilating a prepared opening in a lateral nasal wall separating a patient's lacrimal sac and the patient's nasal cavity, consisting essentially of:

• a tubular catheter body having a proximal end, a proximal segment, a distal end, and a distal segment;
• an inflatable member disposed about said distal segment, said distal segment having a slot;
• said catheter body being closed at a point that is closer to said distal end than is said slot;
• means for applying fluid under pressure to said proximal end of said catheter body, said fluid under pressure flowing through said slot to inflate said inflatable member for dilating said prepared opening;
• and said distal segment having a rigid, rounded bend placing said distal segment at an angle of 70° to 115° to said proximal segment;
• wherein said inflatable member comprises a distal neck, a center region, and a proximal neck and said proximal neck is adhesively bonded to the proximal end of said distal segment and said bend, said distal neck is adhesively bonded to the portion of said distal segment between said slot and said distal end, thereby allowing a greater length of said center region to be on said distal segment.

A balloon catheter for dilating a prepared opening in a lateral nasal wall separating a patient's lacrimal sac and the patient's nasal cavity, consisting essentially of:

• a tubular catheter body having a proximal end, a proximal segment, a distal end, and a distal segment;
• an inflatable member disposed about said distal segment, said distal segment having a slot;
• said catheter body being closed at a point that is closer to said distal end than is said slot;
• means for applying fluid under pressure to said proximal end of said catheter body, said fluid under pressure flowing through said slot to inflate said inflatable member for dilating said prepared opening;
• and said distal segment having a rigid, rounded bend placing said distal segment at an angle of 70° to 115° to said proximal segment;
• wherein said inflatable member comprises a distal neck, a center region, and a proximal neck and said proximal neck is adhesively bonded to the proximal end of said distal segment, the distal end of said proximal segment, and said bend, said distal neck is adhesively bonded to the portion of said distal segment between said slot and said distal end, thereby allowing a greater length of said center region to be on said distal segment.

A method forming a relatively large opening in a lateral nasal wall separating a patient's lacrimal sac and nasal cavity, comprising:

• providing a balloon catheter having a rigid tubular catheter body formed with a proximal segment, a bend, and a distal segment at an angle of 70° to 115° with said proximal segment, an inflatable member mounted around said distal segment, a slot through a wall of said distal segment within said inflatable member, said tubular catheter body being closed at a point distally of said slot, and means for providing fluid under pressure at the proximal end of said tubular catheter body to inflate said inflatable member;
• forming a small, tight prepared opening through the patient's medial sac wall and lacrimal fossa, and said lateral nasal wall with one or more surgical tools, said opening being of such size that it will snugly receive said distal segment with said inflatable member deflated;
• pushing said distal segment of said catheter body into said prepared opening with said inflatable member deflated without using a guide wire or curve retention element;
• and introducing said fluid under pressure through said proximal end of said catheter body and said slot to inflate said inflatable body and dilate said prepared opening.

A method forming a relatively large opening in a lateral nasal wall separating a patient's lacrimal sac and nasal cavity, comprising:

• providing a balloon catheter having a tubular catheter body formed with a proximal segment, a bend, and a distal segment at an angle of 70° to 115° with said proximal segment, an inflatable member mounted around said distal segment, a slot through a wall of said distal segment within said inflatable member, said tubular catheter body being closed at a point distally of said slot, and means for providing fluid under pressure at the proximal end of said tubular catheter body to inflate said inflatable member;
• forming a small, tight prepared opening through the patient's medial sac wall and lacrimal fossa, and said lateral nasal wall with one or more surgical tools, said opening being of such size that it will snugly receive said distal segment with said inflatable member deflated;
• pushing said distal segment of said catheter body into said prepared opening with said inflatable member deflated;
• and introducing said fluid under pressure through said proximal end of said catheter body and said slot to inflate said inflatable body and dilate said prepared opening;
• wherein said step of forming said prepared opening comprises bringing a Bowman probe through the patient's superior punctum, superior canaliculus, common canaliculus, and lacrimal sac and pushing said probe through the patient's medial sac wall, lacrimal fossa bone, and lateral nasal wall into the patient's nasal cavity to form a small opening;
• and
• further comprising repeating said pushing of said probe to form several small openings through said medial sac wall, lacrimal fossa bone, and lateral nasal wall into said nasal cavity.

A method forming a relatively large opening in a lateral nasal wall separating a patient's lacrimal sac and nasal cavity, comprising:

• providing a balloon catheter having a tubular catheter body formed with a proximal segment, a bend, and a distal segment at an angle of 70° to 115° with said proximal segment, an inflatable member mounted around said distal segment, a slot through a wall of said distal segment within said inflatable member, said tubular catheter body being closed at a point distally of said slot, and means for providing fluid under pressure at the proximal end of said tubular catheter body to inflate said inflatable member;
• forming a small, tight prepared opening through the patient's medial sac wall and lacrimal fossa, and said lateral nasal wall with one or more surgical tools, said opening being of such size that it will snugly receive said distal segment with said inflatable member deflated;
• pushing said distal segment of said catheter body into said prepared opening with said inflatable member deflated;
• and introducing said fluid under pressure through said proximal end of said catheter body and said slot to inflate said inflatable body and dilate said prepared opening;
• and
• wherein said proximal segment is introduced into a patient's nasal cavity until said distal segment is moved to a point adjacent said prepared opening, and said proximal segment, is rotated to align said distal segment with said prepared opening to facilitate entry of said distal segment into said prepared opening.

A method forming a relatively large opening in a lateral nasal wall separating a patient's lacrimal sac and nasal cavity, comprising:

• providing a balloon catheter having a tubular catheter body formed with a proximal segment and a distal segment having a rigid, rounded bend, an inflatable member mounted around said distal segment, a slot through a wall of said distal segment within said inflatable member, said tubular catheter body being closed at a point distally of said slot, and means for providing fluid under pressure at the proximal end of said tubular catheter body to inflate said inflatable member, said catheter body being formed to have sufficient stiffness and column strength to enable said catheter, when said inflatable member is deflated, to be pushed from said nasal cavity through a small, tight prepared opening into said lacrimal sac without necessitating a guide wire or curve retention element;
• forming a prepared opening through said lateral nasal wall with one or more surgical tools, said opening being of such size that it will snugly receive said distal segment with said inflatable member deflated;
• pushing said distal segment of said catheter body into said prepared opening with said inflatable member deflated;
• and introducing said fluid under pressure through said proximal end of said catheter body and said slot to inflate said inflatable body and dilate said prepared opening.

A balloon catheter for dilating an opening between a patient's lacrimal sac and nasal cavity, said catheter consisting essentially of:

• a rigid tubular catheter body having a proximal end, a proximal segment, a distal end, and a distal segment having a rigid, rounded bend;
• an inflatable member disposed about said distal segment;
• and,
• means for successively inflating said member;
• wherein said distal segment is at an angle of 70° to 115° to said proximal segment;
• and,
• wherein said catheter body is closed at a point spaced from said distal end, whereby an open-ended distal portion of said distal segment is provided, said open-ended distal portion being engagable by an end of a probe to help guide said catheter body.