1. Team Members Kieran Sweeney (Leader) Sara Worzella (Leader) Leah Brandon (Communications) Adam Budde (BSAC) Tom Knight (BWIG) Client Ashley G. Anderson Jr., M.D. UW Dept. of Otolaryngology Advisor Willis Tompkins, Ph.D. UW Dept. of Biomedical Engineering Endoscopic Device

2. Problem Statement Background Operating Room Setup Patent Review Designs Decision Matrix Future Work Questions Overview

3. Problem Statement Currently endoscopic sinus surgery telescopes present a fire danger in the operating room. Inserting and extracting the scope from the nose frequently results in blood on the lens. This project will attempt to address both those problems with a scope caddy containing antifog, and an alar (nose) opening retractor which will reduce contamination of the scope during insertion.

4. Background information Endoscopic sinus surgery Removes obstructions that block natural drainage and create an increased risk of infection and removes inflamed tissue and bone 2.36 million Nose, Mouth, and Pharynx Surgeries in 2003

5. Background information Several related patents Endosheath Rigid, non-movable protector Meant for ease of sanitation Used off label by client

6. Background information Several related patents (continued) Irrigation Suction-Straw System Cleans lens through flowing water Operated by button

7. Operating Room Setup Hand-held Equipment –Endoscope –Debrider with suction Video Monitors –Endoscope lens –3D mapping system Scrub Tech Tray Anesthesia Equipment

8. Operating Room Setup

9. Operating Room Traffic Jam Concerns Endoscope set on drapes can start a fire Cleaning pad ergonomically inefficient Cords become tangled, obstructive Seconds count

10. Nasal Anatomy Components: Bone, cartilage, fatty tissue Problem Area: Between the nostrils and nasal bone –Vessels lie close to nasal membrane surface –Variations in nostril diameter

11. Nose Anatomy Nasal Septum stops growing ~ 18 years old Nasal Septum*: 2.6 ± 0.3 cm x 3.1 ± 0.4 cm Nasal walls mainly hyaline cartilage –Elastic deformation up to 5 MPa** –Young’s Modulus of to 39.2 +/- 11.9 N/mm** * Mowlavi, A. et.al. ** Spahn G. et.al.

12. Surgery Clean Endoscope during surgery Deduced visibility due to blood contact during surgery

13. Design 1a- Horizontal Tray Scope and Debrider sit on tray Natural to use Clamps to existing table Cleaning, defogging done in one step

14. Design 1b- Holster Style Modeled much like a gun holster Scope tip stored in defogging solution Funneled entry for easy access Cleaning cloth held stationary near entrance Device ratchet clipped off patient’s shoulder

15. Design 2a- Shape Memory Polymer Moldable Will recover ‘memory’ shape when unrestrained Custom thermal activation (-30°C to 260 °C ) Safety ‘lip’ for removal

16. Design 2b- Conic Plastic Expands nasal passage for increased maneuverability using elastic nature of plastics Provides uniform force for patient comfort Prevent fluids from contacting endoscope tip (Optional) Ratcheting lock mechanism maintains expanded dimensions until released

17. Design 2c- Retractable Sheath Movable shield Protects endoscope during entry Slides back to allow for viewing

18. Design Matrix for Endoscope Holder

19. Design Matrix for Nasal Expanders

20. Future Work Measure heat sink capacity of holster with fluid Critique design flaws for next generation Modify design to accommodate methods for mass production Research patentability of sheath design Research necessary approval for clinical use

21. References Anderson A. Personal Interview. 2006, Sept. 15. Gray, H. Gray's Anatomy of the Human Body, 30th edition. 1985 Lippincott Williams & Wilkins;. Hudson P. MD PA, Rhinoplasty: Anatomy of the Nose. http://www.phudson.com/RHINO/anatomy.html. 2006, Oct. 10. Mowlavi A, et.al. Septal Cartilage Defined: Implications for Nasal Dynamics and Rhinoplasty, American Society of Plastic Surgeons. 2006; 117(7): 2171-2174 Shape Memory Polymers - A Short Tutorial. http://www.crgrp.net/tutorials/smp1.htm. 2006, Oct. 04. Spahn G, et.al. [Biomechanical properties (compressive strength and compressive pressure at break) of hyaline cartilage under axial load], Zentralbl Chir. 2003; 128(1):78-82 Surgery Statistics, Yale Medical Group, http://ymghealthinfo.org/content.asp?pageid=P01412. 2006, Oct. 10.

22. Questions?