Presented herein are implantable systems and methods for long-term delivery of treatment substance to a recipient.

Systems and methods can be employed for trans-tympanic membrane access to the middle ear for delivery of a therapeutic agent, for example, to the round window niche adjacent to the cochlea under direct visualization. The systems and methods can also be used to improve accessibility and visualization for various otological surgical procedures, such as, but not limited to, cholesteatoma removal, tympanic membrane repair and ossicular chain repair.

A system for delivering one or more therapeutics to a region of the ear, the region being internal to a tympanic membrane. The system includes a canal guide configured to be inserted within and fittingly engaged with walls of the ear canal and needle assembly having a flexible shaft sized to extend through the canal guide. The canal guide provides alignment of the needle assembly within the ear canal relative to the tympanic membrane. The canal guide includes a viewing lumen extending between a proximal end to a distal-most end of the canal guide and is sized to remain external to the tympanic membrane. The canal guide includes a guide lumen extending to a distal opening near the distal-most end of the canal guide. The guide lumen curves from a first axis to a second axis. Related devices, systems, and methods are provided.

Systems and methods for reducing pathogens near an implant are discussed. In some cases, the methods include reducing contaminants in a portion of a patient that has an implant and that is disposed interior to a closed surface of skin of the patient. The method can further include placing a conduit in the closed surface of skin and flowing an antimicrobial fluid into that portion of the patient to contact the antimicrobial fluid with a surface of the implant and tissue adjacent to the implant. In some cases, the antimicrobial fluid is then removed from the portion of the patient having the implant. As part of this method, biofilm near the implant can be mechanically, ultrasonically, electrically, chemically, enzymatically, or otherwise disrupted. Other implementations are described.

Presented herein are implantable systems and methods for long-term delivery of treatment substance to a recipient.

The invention provides liquid formulation compositions and medicament delivery devices, and methods for preparing and using the same. For example, the liquid formulation composition is an emulsion including a solvent and liquid particles, which includes surfactants and are dispersed in the solvent. The volume average particle size of the liquid particles is less than about 100 μm; the surface tension of the liquid formulation composition is less than about 60 mN/m; and the absolute value of zeta potential is greater than about 15 mV. The containment vessel may be a sprayer or a dropping device. The invention also provides methods for preparation of the liquid formulation compositions and medicament delivery devices as well as methods for using the same in treatment of various diseases and condition, for example, otitis media, otitis externa, rhinitis, sinusitis, lower respiratory tract inflammation, xerostomia (dry mouth), xerophthalmia (dry eyes) and xeromycteria (dry nose).

Devices, systems, and methods can be employed to facilitate indirect viewing into cavities such as, but not limited to, the middle ear space. Some embodiments have uses such as, but not limited to, facilitating visualization and procedures in the outer, middle, and/or inner ear in order to diagnose and/or treat disorders including, but not limited to, hearing loss and other ear disorders. In particular implementations, a surgical microscope is used in conjunction with an inverter lens and a distal lens. In some cases, the distal lens transverses a membrane or septum such as, but not limited to, the tympanic membrane. The distal lens can be an assembly combining two or more lenses, in some embodiments. For example, in some cases wide angle lenses, zoom lenses, lenses of other various shapes and/or prisms can be used in the distal lens.

Systems, apparatus, and methods are described for transporting and delivering a therapeutic substance to an ear of a subject, including a tubular element (216) configured for deployment in a tympanic membrane (TM) and a fluid transport element (230). The fluid transport element can be configured to transport the therapeutic substance from a proximal side to a distal side of the tubular element. Systems, apparatus, and methods further can include a fluid dispenser including a reservoir configured to contain a therapeutic substance, and a tubular element defining a lumen in fluid communication with an outlet in which the lumen and the outlet are configured to deliver the therapeutic substance from the reservoir to a region proximal to the tympanic membrane. Systems, apparatus, and methods further can include an electrode device.

A prosthesis including a device configured to deliver a therapeutic substance from outside a cochlea to inside the cochlea and configured to evoke a mechanically based hearing percept. In an exemplary embodiment, the device is configured to drive fluid into and out of the cochlea, thereby evoking a hearing percept.

Systems and methods can be employed for trans-tympanic membrane access to the middle ear for delivery of a therapeutic agent, for example, to the round window niche adjacent to the cochlea under direct visualization. The systems and methods can also be used to improve accessibility and visualization for various otological surgical procedures, such as, but not limited to, cholesteatoma removal, tympanic membrane repair and ossicular chain repair.