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US-12622812-B2 - Otological surgery under perfluorocarbon liquids

US12622812B2US 12622812 B2US12622812 B2US 12622812B2US-12622812-B2

Abstract

Certain embodiments described herein provide a method of performing an otological surgical procedure including surgically accessing a middle ear, injecting a perfluorocarbon liquid into the middle ear, and suctioning the isolated blood from the middle ear without removing the perfluorocarbon liquid. The perfluorocarbon liquid is immiscible with blood for isolating blood in the middle ear from the perfluorocarbon liquid. In certain embodiments, the perfluorocarbon liquid has a specific gravity greater than blood to apply positive pressure to surrounding tissues. In certain embodiments, the method includes suctioning the perfluorocarbon liquid from the middle ear after the isolated blood is removed.

Inventors

  • Paul R. Hallen

Assignees

  • ALCON INC.

Dates

Publication Date
20260512
Application Date
20220901

Claims (17)

  1. 1 . A method of performing a medial tympanoplasty surgical procedure, comprising: surgically accessing a middle ear by making an incision in a wall of an ear canal; raising a skin flap along the incision to enter the middle ear; injecting a perfluorocarbon liquid into the middle ear, the perfluorocarbon liquid is immiscible with blood for isolating blood, in the middle ear from the incision, from the perfluorocarbon liquid; and suctioning the isolated blood from the middle ear without removing the perfluorocarbon liquid.
  2. 2 . The method of claim 1 , wherein the perfluorocarbon liquid has a specific gravity greater than blood to apply positive pressure to surrounding tissues.
  3. 3 . The method of claim 1 , further comprising suctioning the perfluorocarbon liquid from the middle ear after the isolated blood is removed.
  4. 4 . The method of claim 3 , further comprising inserting bioabsorbable packing into the middle ear before suctioning the perfluorocarbon liquid from the middle ear.
  5. 5 . The method of claim 1 , wherein the perfluorocarbon liquid comprises at least one of perfluoro-n-octane, perfluoroperhydrophenanthrene, perfluorodecalin, perfluorotributylamide, or perfluorooctylbromide.
  6. 6 . The method of claim 5 , wherein the perfluorocarbon liquid comprises perfluoro-n-octane.
  7. 7 . The method of claim 1 , wherein the perfluorocarbon liquid has a viscosity less than blood to enable the perfluorocarbon liquid to conform to a shape of the middle ear.
  8. 8 . The method of claim 7 , wherein the viscosity is less than about 0.8 centistokes at 25° C.
  9. 9 . The method of claim 1 , wherein a volume of the perfluorocarbon liquid injected into the middle ear is about equal to a total volume of the middle ear.
  10. 10 . The method of claim 9 , wherein the volume of the perfluorocarbon liquid injected into the middle ear is about 0.5 cc to about 1 cc.
  11. 11 . The method of claim 1 , wherein a ratio of a volume of the perfluorocarbon liquid injected into the middle ear to a total volume of the middle ear is about 0.5 to about 1.
  12. 12 . The method of claim 1 , wherein the perfluorocarbon liquid remains in the middle ear throughout the procedure.
  13. 13 . The method of claim 12 , wherein the perfluorocarbon liquid is removed from the middle ear in a follow-up procedure.
  14. 14 . The method of claim 12 , wherein the perfluorocarbon liquid is absorbed naturally by a human body.
  15. 15 . The method of claim 1 , further comprising inserting bioabsorbable packing into the middle ear.
  16. 16 . The method of claim 15 , further comprising inserting a tissue graft under a tympanic membrane and over the bioabsorbable packing.
  17. 17 . The method of claim 16 , further comprising filling the ear canal with packing material.

Description

PRIORITY CLAIM This application claims the benefit of priority of U.S. Provisional Patent Application Ser. No. 63/249,123 titled “OTOLOGICAL SURGERY UNDER PERFLUOROCARBON LIQUIDS,” filed on Sep. 28, 2021, whose inventor is Paul R. Hallen, which is hereby incorporated by reference in its entirety as though fully and completely set forth herein. BACKGROUND There are many conditions that affect the middle ear and require surgical intervention (referred to as “otological surgery”). For example, tympanoplasty is an otological surgical procedure performed to repair a perforated tympanic membrane. Stapendectomy is another example otological surgical procedure performed to remove all or part of the stapes bone and replace it with an artificial device. Adequate visualization is needed to perform many types of otological surgical procedures in addition to the above examples. Current otological surgery techniques access the middle ear in one of two ways. One option is to remove the mastoid bone and visualize the middle ear using a microscope. A drawback of the first option is that removal of the mastoid bone is a very invasive procedure. A second option is to use an endoscope inserted into the ear canal to visualize the middle ear, however the endoscope can interfere with insertion and manipulation of other instruments. With either option, blood that is present in the middle ear during surgery further interferes with visualization. Current otological surgery techniques are performed under air and are unable to adequately prevent bleeding, hold back tissues, and isolate the blood to improve visualization. Use of diathermy to induce clotting is challenging because the source of bleeding is often unknown. Thus, there is a need in the art for improved fluids and/or surgical methods that address at least some of the issues described above. BRIEF SUMMARY The present disclosure relates generally to fluids used in otological surgery and surgical procedures associated with the use of such fluids. Certain embodiments described herein provide a method of performing an otological surgical procedure including surgically accessing a middle ear, injecting a perfluorocarbon liquid into the middle ear, and suctioning the isolated blood from the middle ear without removing the perfluorocarbon liquid. The perfluorocarbon liquid is immiscible with blood for isolating blood in the middle ear from the perfluorocarbon liquid. In certain embodiments, the perfluorocarbon liquid has a specific gravity greater than blood to apply positive pressure to surrounding tissues. In certain embodiments, the method includes suctioning the perfluorocarbon liquid from the middle ear after the isolated blood is removed. The following description and the related drawings set forth in detail certain illustrative features of one or more embodiments. BRIEF DESCRIPTION OF THE DRAWINGS The appended figures depict certain aspects of the one or more embodiments and are therefore not to be considered limiting of the scope of this disclosure. FIG. 1 illustrates an example otological surgical procedure using fluids described herein, according to certain embodiments. FIGS. 2A-2K schematically illustrate the ear at each stage of the procedure of FIG. 1, according to certain embodiments. FIGS. 3A-3E illustrate chemical structures of example perfluorocarbon liquids, according to certain embodiments To facilitate understanding, identical reference numerals have been used, where possible, to designate identical elements that are common to the drawings. It is contemplated that elements and features of one embodiment may be beneficially incorporated in other embodiments without further recitation. DETAILED DESCRIPTION Aspects of the present disclosure provide fluids for use in otological surgery and surgical procedures associated with the use of such fluids. As described above, current otological surgery techniques are performed under air and are unable to adequately prevent bleeding, hold back tissues, and isolate the blood to improve visualization. Particular embodiments described in the present disclosure overcome these deficiencies by providing improved fluids and/or surgical methods for improving visualization. Certain embodiments disclosed herein provide fluids that are heavy (e.g., higher molecular weight or specific gravity) compared to water and blood for applying pressure to stop bleeding and holding back or flattening tissues in the ear to improve visualization of and/or access to a surgical target. Certain embodiments disclosed herein provide fluids that are less viscous compared to water and blood to enable the fluid to conform to the shape of the middle ear. Certain embodiments disclosed herein provide fluids that are translucent and/or transparent to enable visualization of a surgical target through the fluid. Certain embodiments disclosed herein provide fluids that are immiscible with blood for isolating or separating blood from the fluid and enabling the surg