Dissolvable on-command implant
10758421 ยท 2020-09-01
Assignee
Inventors
- Brian K. Reilly (Chevy Case, MD, US)
- Carolyn T. Cochenour (Washington, DC, US)
- Peng (Patrick) Cheng (Fairfax, VA, US)
- Matthieu Dumont (Silver Spring, MD, US)
Cpc classification
A61L31/148
HUMAN NECESSITIES
A61L31/048
HUMAN NECESSITIES
A61F11/202
HUMAN NECESSITIES
A61L31/048
HUMAN NECESSITIES
A61L2430/14
HUMAN NECESSITIES
C08L33/12
CHEMISTRY; METALLURGY
C08L33/12
CHEMISTRY; METALLURGY
A61L31/14
HUMAN NECESSITIES
International classification
A61F11/00
HUMAN NECESSITIES
A61L31/14
HUMAN NECESSITIES
Abstract
The purpose of the Dissolvable on-command Implant is to act as a pressure equalizer tube in the eardrum, which has the unique characteristic that the tube can be dissolved with a specially formulated drop solution on-command. This tube can have various shapes and sizes, although the tube is usually a cylindrical tube with a hollow center, which maintains a ventilatory port for the middle ear space. With this design, the ear tube promotes drainage of middle ear fluid, lets air enter the middle ear, and allows for instillation of antibiotic drops.
Claims
1. A dissolvable on-command tympanostomy tube that is insertable into an eardrum of an ear of a patient, comprising: a tube having two flared ends, wherein the tube is comprised of a first material that is configured to be insoluble in bodily fluids of the patient but disintegrate upon intentional contact with a second material introduced from an extracorporeal environment into the ear of the patient, the disintegration being based on a chemical reaction between the first material and the second material, the two flared ends include an inner flange and an outer flange, the inner flange and the outer flange being connected by a connecting member having a through-hole that extends from the inner flange through the connecting member to the outer flange, and the inner flange is made of a third material that is biodegradable.
2. The dissolvable on-command tympanostomy tube of claim 1, wherein the inner flange has a larger diameter than the outer flange.
3. The dissolvable on-command tympanostomy tube of claim 1, wherein the inner flange is tailed.
4. The dissolvable on-command tympanostomy tube of claim 1, wherein an inner portion including the inner flange and a portion of the connecting member adjacent to the inner flange are made of the first material, and an outer portion including the outer flange and a remaining portion of the connecting member are made of a third material, the third material being biodegradable.
5. The dissolvable on-command tympanostomy tube of claim 1, wherein at least one of the inner flange and the outer flange are made of the first material and the connecting member is made of a fourth material, the fourth material being configured to disintegrate when in contact with the second material according to a chemical reaction between the fourth material and the second material, and the first material degrades faster than the fourth material when both the first material and the fourth material are in contact with the second material.
6. The dissolvable on-command tympanostomy tube of claim 1, wherein a portion of the connecting member that is adjacent to the outer flange has a greater thickness than a thickness of a portion of the connecting member that is adjacent to the inner flange.
7. The dissolvable on-command tympanostomy tube of claim 1, wherein an inner portion including the inner flange and a portion of the connecting member adjacent to the inner flange contains a plurality of micro-cavities.
8. The dissolvable on-command tympanostomy tube of claim 1, wherein a portion of the connecting member adjacent to the inner flange contains a plurality of micro-cavities.
9. The dissolvable on-command tympanostomy tube of claim 1, wherein the inner flange has a coating made of the first material.
10. The dissolvable on-command tympanostomy tube of claim 1, wherein an outer portion including the outer flange and a portion of the connecting member adjacent to the outer flange is coated with a nitrocellulose coating.
11. The dissolvable on-command tympanostomy tube of claim 1, wherein the first material is a mixture of methyl methacrylate, butyl methacrylate and 2-(Dimethylamino) ethyl methacrylate.
12. The dissolvable on-command tympanostomy tube of claim 1, wherein the second material is a liquid with a pH between 2.89 and 5.
13. The dissolvable on-command tympanostomy tube of claim 1, wherein an inner portion of the tube degrades more rapidly than an outer portion of the tube upon the contact with the second material.
14. The dissolvable on-command tympanostomy tube of claim 1, wherein the second material is ethanol.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) A more complete appreciation of the invention and many of the attendant advantages thereof will be readily obtained as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, wherein:
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DETAILED DESCRIPTION
(29) A more complete appreciation of the present advancements and many of the attendant advantages thereof will be readily obtained as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings. However, the accompanying drawings and their exemplary depictions do not in any way limit the scope of the advancements embraced by the specification. The scope of the advancements embraced by the specification and drawings are defined by the words of the accompanying claims.
(30) Selected embodiments are now described by referring now to the drawings, wherein like reference numerals designate identical or corresponding parts throughout the several views. It is noted that, as used in the specification and the appending claims, the singular forms a, an, and the can include plural references unless the context clearly dictates otherwise.
(31) The present embodiments disclose a bio-dissolvable ear tube and a method of creating the bio-dissolvable ear tube that maintains its mechanical integrity and clinical function until a special ear drop formulation is applied, which triggers the tube's softening, degradation or dissolution. The same on-command dissolvable property can be used in many other clinical areas.
(32) As illustrated in
(33) This new dissolvable on-command ear tubes will not require the surgeon to conduct a second surgery with anesthesia to remove the ear tubes. This approach is a significant improvement to the current procedure and results in substantially less trauma to the child. The dissolvable on-command ear tube provides the potential benefit of lower perforation rate and other complications from a tube that stays in too long while awaiting spontaneous extrusion.
(34) The dissolvable on-command ear tube could remain for the desired 6, 12, to 16 months that the clinician determines would be needed for child to outgrow the otitis media-prone time period. After resolution of the otitis media, the dissolvable on-command ear tube is easily removed with special ear drops formulation, allowing the drum to heal without any need for surgery.
(35) The tube could be constructed in any suitable size and shape, for example a standard size and shape for ear tubes. Ear tubes are constructed in a variety of shapes, mostly varying the type and size of a flange. For example, accordingly to one exemplary embodiment illustrated in
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(37) In another exemplary embodiment, the design of the ear tube may be for near-permanent implantation, so that the tube would not fall out but would necessarily be removed by instillation of the dissolving ear drop formulations. However, there would still remain some possibility that the tube would naturally fall out.
(38) Moreover, beyond making the ear tube with one uniform material, different constructions are also utilized to achieve different mechanical properties and degradation profiles. For instance, a conventional biodegradable ear tube could be coated with a polymer layer. Once the outer layer reacts to a special ear drops formulation, the internal material is exposed and the degradation process is triggered. The ear tube can also be constructed with different polymers to achieve the ideal behavior. For instance, the tube can be formed such that the inner flange would dissolve more easily than the outer flanges. This is important because the outer flanges hold the tube in place such that the tube does not fall into the middle ear.
(39) For the dissolvable on-command ear tube, the portion inside the ear drum must dissolve/disintegrate first, so that the remaining structure will fall out of the ear, instead of falling into the middle ear.
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(44) Turning a polymer from powder form into solid block drastically reduces the surface area of the polymer, making the polymer dissolve much slower in solid form than in powder form. This characteristic is a desirable feature and provides benefits in the present context. A target polymer will dissolve/disintegrate within a reasonably short period of time once the triggering solution is applied. According in an exemplary embodiment, the surface area of the polymer could be increased by adding salt, sugar or other particles into the polymer mixture. The particles may be later dissolved away by using water or another solution, keeping the polymer structure in place while creating micro-cavities inside the polymer. This process is illustrated in
(45) Alternatively, in another exemplary embodiment, the dissolving solution can be applied multiple times over a period of several days so that each administration of the solution removes a layer until the entire tube is gone.
(46) In another exemplary embodiment, the inner portion of the ear tube could be fabricated out of a porous structure and could be used to achieve the same purpose. As shown in
(47) As illustrated in
(48) The shape and structure of the ear tube could be specially fabricated from a polymer so when the ear drops formulations are applied, the triggered reaction dissolves the ear tube in a specific way. In this way, the ear tube dissolves more evenly. The polymer of the ear tube can be engineered to possess the desired mechanical properties, including rigidity, stability, and solubility in the acidic solution. For example, the fabrication process may vary the amount of each monomer during the synthesis of the polymer. The polymer makeup of the ear tube design can be engineered to dissolve over the desired period of time, for example, from a few hours to few days.
(49) Materials used for dissolvable on-command implant may include but are not limited to: Dextran, chitosan, carbohydrates, gelatin, collagen, polyvinyl pyrrolidone (PVP), polyvinyl alcohol, polyethylene glycol diacrylate, acrylate polymers and combinations of the above. Dextran is a complex, branched polysaccharide composed of chains of varying lengths from about 3 to about 2000 kDa. Chitosan is a linear polysaccharide composed of randomly distributed -(1-4)-linked D-glucosamine (deacetylated unit) and N-acetyl-D-glucosamine (acetylated unit). The carbohydrates include monosaccharides, disaccharides, oligosaccharides, and polysaccharides. The gelatin is a substance derived from hydrolyzed collagen. The polyvinyl pyrrolidone (PVP) is a polymer made from repeating monomer N-vinylpyrrolidone units. Other names for PVP are polyvidone and povidone. The polyvinyl alcohol includes PVOH, PVA, and PVAI. The polyethylene glycol diacrylate is polyethylene glycol terminated with acrylate groups.
(50) Polymers for dissolvable on-command implant may include but are not limited to: acrylic polymers and copolymers architecture, chain length and monomer arrangements. The polymers architecture may include: block copolymer, star polymer, comb polymer, brush polymer, AB.sub.2 star, palm-tree AB.sub.n, H-shaped B.sub.2AB.sub.2, Dumbell, Pom-pom, ring block, star block AB.sub.n coil-cycle-coil, star A.sub.nB.sub.n, The monomer arrangement may include: Alternating copolymers, periodic copolymers, statistical copolymers, random copolymers, Bock copolymers, graft or grafted copolymers. The monomer may include: Acrylamide and Methacrylamide, Acrylates, Acrylic Acids and Salts, Acrylonitriles, Bisphenol Acrylics, Fluorinated Acrylics, Maleimides, Methacrylates, and Polyfunctional Acrylics as listed in Table 1 to Table 9.
(51) TABLE-US-00001 TABLE 1 List of Acrylamides and Methacrylamides monomers. Acrylamide and Methacrylamide formula 2-Acrylamido-2-methyl-1-propanesulfonic acid C.sub.7H.sub.13NO.sub.4S 2-Acrylamido-2-methyl-1-propanesulfonic acid C.sub.7H.sub.12NNaO.sub.4S 3-(Acrylamido)phenylboronic acid C.sub.9H.sub.10BNO.sub.3 (3-Acrylamidopropyl)trimethylammonium chloride C.sub.9H.sub.19ClN.sub.2O N-Acryloylamido-ethoxyethanol C.sub.7H.sub.13NO.sub.3 Alkylacrylamide N-(3-Aminopropyl)methacrylamide hydrochloride C.sub.7H.sub.14N.sub.2OHCl N-tert-Butylacrylamide C.sub.7H.sub.13NO Diacetone acrylamide C.sub.9H.sub.15NO.sub.2 N,N-Diethylacrylamide C.sub.7H.sub.13NO N,N-Diethylmethacrylamide C.sub.8H.sub.15NO N,N-Dimethylacrylamide C.sub.5H.sub.9NO N-[3-(Dimethylamino)propyl]methacrylamide C.sub.9H.sub.18N.sub.2O N-Diphenylmethylacrylamide C.sub.16H.sub.15NO N-Ethylacrylamide C.sub.5H.sub.9NO N,N-Hexamethylenebis(methacrylamide) C.sub.14H.sub.24N.sub.2O.sub.2 N-Hydroxyethyl acrylamide C.sub.5H.sub.9NO.sub.2 N-(Hydroxymethyl)acrylamide C.sub.4H.sub.7NO.sub.2 N-(Isobutoxymethyl)acrylamide C.sub.8H.sub.15NO.sub.2 N-Isopropylacrylamide C.sub.6H.sub.11NO N-Isopropylacrylamide C.sub.6H.sub.11NO N-Isopropylmethacrylamide C.sub.7H.sub.13NO Methacrylamide C.sub.4H.sub.7NO N-(3-Methoxypropyl)acrylamide C.sub.7H.sub.13NO.sub.2 N-Phenylacrylamide C.sub.9H.sub.9NO N-(Triphenylmethyl)methacrylamide C.sub.23H.sub.21NO N-[Tris(hydroxymethyl)methyl]acrylamide C.sub.7H.sub.13NO.sub.4
(52) TABLE-US-00002 TABLE 2 List of Acrylates monomers. Acrylates formula 4-Acetoxyphenethyl acrylate C.sub.13H.sub.14O.sub.4 Acryloyl chloride C.sub.3H.sub.3ClO Acryloyl chloride C.sub.3H.sub.3ClO 4-Acryloylmorpholine C.sub.7H.sub.11NO.sub.2 [2-(Acryloyloxy)ethyl]trimethylammonium chloride C.sub.8H.sub.16ClNO.sub.2 2-(4-Benzoyl-3-hydroxyphenoxy)ethyl acrylate C.sub.18H.sub.16O.sub.5 Benzyl 2-propylacrylate C.sub.13H.sub.16O.sub.2 Butyl acrylate C.sub.7H.sub.12O.sub.2 tert-Butyl acrylate C.sub.7H.sub.12O.sub.2 2-[[(Butylamino)carbonyl]oxy]ethyl acrylate C.sub.10H.sub.17NO.sub.4 tert-Butyl 2-bromoacrylate C.sub.7H.sub.11BrO.sub.2 4-tert-Butylcyclohexyl acrylate C.sub.13H.sub.22O.sub.2 2-Carboxyethyl acrylate C.sub.6H.sub.8O.sub.4 2-Carboxyethyl acrylate oligomers 2-Chloroethyl acrylate contains >100 ppm MEHQ as C.sub.5H.sub.7ClO.sub.2 inhibitor, 97% 2-(Diethylamino)ethyl acrylate C.sub.9H.sub.17NO.sub.2 Di(ethylene glycol) ethyl ether acrylate C.sub.9H.sub.16O.sub.4 Di(ethylene glycol) 2-ethylhexyl ether acrylate C.sub.15H.sub.28O.sub.4 2-(Dimethylamino)ethyl acrylate C.sub.7H.sub.13NO.sub.2 3-(Dimethylamino)propyl acrylate C.sub.8H.sub.15NO.sub.2 Dipentaerythritol penta-/hexa-acrylate C.sub.25H.sub.32O.sub.12 Ethyl acrylate C.sub.5H.sub.8O.sub.2 2-Ethylacryloyl chloride C.sub.5H.sub.7ClO Ethyl 2-(bromomethyl)acrylate C.sub.6H.sub.9BrO.sub.2 Ethyl cis-(-cyano)acrylate C.sub.6H.sub.7NO.sub.2 Ethylene glycol dicyclopentenyl ether acrylate C.sub.15H.sub.20O.sub.3 Ethylene glycol methyl ether acrylate C.sub.6H.sub.10O.sub.3 Ethylene glycol phenyl ether acrylate C.sub.11H.sub.12O.sub.3 Ethyl 2-ethylacrylate C.sub.7H.sub.12O.sub.2 2-Ethylhexyl acrylate C.sub.11H.sub.20O.sub.2 Ethyl 2-propylacrylate C.sub.8H.sub.14O.sub.2 Ethyl 2-(trimethylsilylmethyl)acrylate C.sub.9H.sub.18O.sub.2Si Hexyl acrylate C.sub.9H.sub.16O.sub.2 4-Hydroxybutyl acrylate C.sub.7H.sub.12O.sub.3 2-Hydroxyethyl acrylate C.sub.5H.sub.8O.sub.3 2-Hydroxy-3-phenoxypropyl acrylate C.sub.12H.sub.14O.sub.4 Hydroxypropyl acrylate C.sub.6H.sub.10O.sub.3 Isobornyl acrylate C.sub.13H.sub.20O.sub.2 Isobutyl acrylate C.sub.7H.sub.12O.sub.2 Isodecyl acrylate C.sub.13H.sub.24O.sub.2 Isooctyl acrylate C.sub.11H.sub.20O.sub.2 Lauryl acrylate C.sub.15H.sub.28O.sub.2 Methyl 2-acetamidoacrylate C.sub.6H.sub.9NO.sub.3 Methyl acrylate C.sub.4H.sub.6O.sub.2 Methyl -bromoacrylate C.sub.4H.sub.5BrO.sub.2 Methyl 2-(bromomethyl)acrylate C.sub.5H.sub.7BrO.sub.2 Methyl 2-(chloromethyl)acrylate C.sub.5H.sub.7ClO.sub.2 Methyl 3-hydroxy-2-methylenebutyrate C.sub.6H.sub.10O.sub.3 Methyl 2-(trifluoromethyl)acrylate C.sub.5H.sub.5F.sub.3O.sub.2 Octadecyl acrylate C.sub.21H.sub.40O.sub.2 Pentabromobenzyl acrylate C.sub.10H.sub.5Br.sub.5O.sub.2 Pentabromophenyl acrylate C.sub.9H.sub.3Br.sub.5O.sub.2 Pentafluorophenyl acrylate C.sub.9H.sub.3F.sub.5O.sub.2 Poly(ethylene glycol) diacrylate Poly(ethylene glycol) methyl ether acrylate Poly(propylene glycol) acrylate Soybean oil, epoxidized acrylate 3-Sulfopropyl acrylate C.sub.6H.sub.9KO.sub.5S Tetrahydrofurfuryl acrylate C.sub.8H.sub.12O.sub.3 3-(Trimethoxysilyl)propyl acrylate C.sub.9H.sub.18O.sub.5Si 3,5,5-Trimethylhexyl acrylate 10-Undecenyl acrylate C.sub.14H.sub.24O.sub.2
(53) TABLE-US-00003 TABLE 3 List of Acrylic Acids and Salts monomers. Acrylic Acids and Salts formula Acrylic acid anhydrous C.sub.3H.sub.4O.sub.2 2-Bromoacrylic acid C.sub.3H.sub.3BrO.sub.2 2-(Bromomethyl)acrylic acid C.sub.4H.sub.5BrO.sub.2 2-Ethylacrylic acid C.sub.5H.sub.8O.sub.2 Hafnium carboxyethyl acrylate C.sub.24H.sub.28HfO.sub.16 Methacrylic acid C.sub.4H.sub.6O.sub.2 2-Propylacrylic acid C.sub.6H.sub.10O.sub.2 Sodium acrylate C.sub.3H.sub.3NaO.sub.2 Sodium methacrylate C.sub.4H.sub.5NaO.sub.2 2-(Trifluoromethyl)acrylic acid C.sub.4H.sub.3F.sub.3O.sub.2 Zinc acrylate C.sub.6H.sub.6O.sub.4Zn Zirconium acrylate C.sub.12H.sub.12O.sub.8Zr Zirconium bromonorbornanelactone carboxylate triacrylate Zirconium carboxyethyl acrylate C.sub.24H.sub.28O.sub.16Zr
(54) TABLE-US-00004 TABLE 4 List of Acrylonitriles monomers. Acrylonitriles formula Acrylonitrile C.sub.3H.sub.3N 1-Cyanovinyl acetate C.sub.5H.sub.5NO.sub.2 Ethyl 2- C.sub.6H.sub.7NO.sub.2 cyanoacrylate
(55) TABLE-US-00005 TABLE 5 List of Bisphenol Acrylic monomers. Bisphenol Acrylics formula Bisphenol A ethoxylate diacrylate average M.sub.n ~468 Bisphenol A ethoxylate diacrylate average M.sub.n ~512 Bisphenol A ethoxylate diacrylate average M.sub.n ~688 Bisphenol A ethoxylate dimethacrylate average M.sub.n ~1,700 Bisphenol A glycerolate dimethacrylate glycerol/phenol 1 C.sub.29H.sub.36O.sub.8 Bisphenol A glycerolate (1 glycerol/phenol) diacrylate C.sub.27H.sub.32O.sub.8 Bisphenol A dimethacrylate C.sub.23H.sub.24O.sub.4 Bisphenol F ethoxylate (2 EO/phenol) diacrylate average M.sub.n ~484
(56) TABLE-US-00006 TABLE 6 List of Fluorinated Acrylics monomers. Fluorinated Acrylics formula 2,2,3,3,4,4,5,5,6,6,7,7-Dodecafluoroheptyl acrylate C.sub.10H.sub.6F.sub.12O.sub.2 3,3,4,4,5,5,6,6,7,7,8,8,9,9,10,10,11,11,12,12,12- C.sub.15H.sub.7F.sub.21O.sub.2 Heneicosafluorododecyl acrylate 3,3,4,4,5,5,6,6,7,7,8,8,9,9,10,10,11,11,12,12,12- C.sub.16H.sub.9F.sub.21O.sub.2 Heneicosafluorododecyl methacrylate 3,3,4,4,5,5,6,6,7,7,8,8,9,9,10,10,10-Heptadecafluorodecyl C.sub.14H.sub.9F.sub.17O.sub.2 methacrylate 2,2,3,3,4,4,4-Heptafluorobutyl acrylate C.sub.7H.sub.5F.sub.7O.sub.2 2,2,3,3,4,4,4-Heptafluorobutyl methacrylate C.sub.8H.sub.7F.sub.7O.sub.2 2,2,3,4,4,4-Hexafluorobutyl acrylate C.sub.7H.sub.6F.sub.6O.sub.2 2,2,3,4,4,4-Hexafluorobutyl methacrylate C.sub.8H.sub.8F.sub.6O.sub.2 1,1,1,3,3,3-Hexafluoroisopropyl acrylate C.sub.6H.sub.4F.sub.6O.sub.2 1,1,1,3,3,3-Hexafluoroisopropyl methacrylate C.sub.7H.sub.6F.sub.6O.sub.2 2,2,3,3,4,4,5,5-Octafluoropentyl acrylate C.sub.8H.sub.6F.sub.8O.sub.2 2,2,3,3,4,4,5,5-Octafluoropentyl methacrylate C.sub.9H.sub.8F.sub.8O.sub.2 2,2,3,3,3-Pentafluoropropyl acrylate C.sub.6H.sub.5F.sub.5O.sub.2 2,2,3,3,3-Pentafluoropropyl methacrylate C.sub.7H.sub.7F.sub.5O.sub.2 1H,1H,2H,2H-Perfluorodecyl acrylate C.sub.13H.sub.7F.sub.17O.sub.2 2,2,3,3-Tetrafluoropropyl methacrylate C.sub.7H.sub.8F.sub.4O.sub.2 3,3,4,4,5,5,6,6,7,7,8,8,8-Tridecafluorooctyl acrylate C.sub.11H.sub.7F.sub.13O.sub.2 3,3,4,4,5,5,6,6,7,7,8,8,8-Tridecafluorooctyl methacrylate C.sub.12H.sub.9F.sub.13O.sub.2 2,2,2-Trifluoroethyl methacrylate C.sub.6H.sub.7F.sub.3O.sub.2 1,1,1-Trifluoro-2-(trifluoromethyl)-2-hydroxy-4-methyl-5- C.sub.11H.sub.14F.sub.6O.sub.3 pentylmethacrylate 2-[(1,1,1-Trifluoro-2-(trifluoromethyl)-2- C.sub.15H.sub.18F.sub.6O.sub.3 hydroxy)propyl]-3-norbornyl methacrylate
(57) TABLE-US-00007 TABLE 7 List of Maleimides monomers. Maleimides formula 2-[8-(3-Hexyl-2,6-dioctylcyclohexyl)octyl]pyromellitic diimide N,N-(o-Phenylene)dimaleimide 99% C.sub.14H.sub.8N.sub.2O.sub.4 N,N-(1,4-Phenylene)dimaleimide 97% C.sub.14H.sub.8N.sub.2O.sub.4
(58) TABLE-US-00008 TABLE 8 List of Methacrylates monomers. Methacrylates formula Allyl methacrylate C.sub.7H.sub.10O.sub.2 2-Aminoethyl methacrylate hydrochloride C.sub.6H.sub.11NO.sub.2HCl 2-[3-(2H-Benzotriazol-2-yl)-4-hydroxyphenyl]ethyl C.sub.18H.sub.17N.sub.3O.sub.3 methacrylate Benzyl methacrylate C.sub.11H.sub.12O.sub.2 Bis(2-methacryloyl)oxyethyl disulfide C.sub.12H.sub.18O.sub.4S.sub.2 2-(2-Bromoisobutyryloxy)ethyl methacrylate C.sub.10H.sub.15BrO.sub.4 2-(tert-Butylamino)ethyl methacrylate C.sub.10H.sub.19NO.sub.2 Butyl methacrylate C.sub.8H.sub.14O.sub.2 tert-Butyl methacrylate C.sub.8H.sub.14O.sub.2 9H-Carbazole-9-ethylmethacrylate C.sub.18H.sub.17NO.sub.2 3-Chloro-2-hydroxypropyl methacrylate C.sub.7H.sub.11ClO.sub.3 Cyclohexyl methacrylate C.sub.10H.sub.16O.sub.2 2-(Diethylamino)ethyl methacrylate C.sub.10H.sub.19NO.sub.2 Diethylene glycol butyl ether methacrylate C.sub.12H.sub.22O.sub.4 Di(ethylene glycol) methyl ether methacrylate C.sub.9H.sub.16O.sub.4 2-(Diisopropylamino)ethyl methacrylate C.sub.12H.sub.23NO.sub.2 2-(Dimethylamino)ethyl methacrylate C.sub.8H.sub.15NO.sub.2 2-Ethoxyethyl methacrylate C.sub.8H.sub.14O.sub.3 Ethylene glycol dicyclopentenyl ether methacrylate C.sub.16H.sub.22O.sub.3 Ethylene glycol methyl ether methacrylate C.sub.7H.sub.12O.sub.3 Ethylene glycol phenyl ether methacrylate C.sub.12H.sub.14O.sub.3 2-Ethylhexyl methacrylate C.sub.12H.sub.22O.sub.2 Ethyl methacrylate C.sub.6H.sub.10O.sub.2 Ferrocenylmethyl methacrylate C.sub.15H.sub.16FeO.sub.2 Furfuryl methacrylate C.sub.9H.sub.10O.sub.3 Glycidyl methacrylate C.sub.7H.sub.10O.sub.3 Glycosyloxyethyl methacrylate C.sub.12H.sub.20O.sub.8 Hexyl methacrylate C.sub.10H.sub.18O.sub.2 Hydroxybutyl methacrylate C.sub.8H.sub.14O.sub.3 2-Hydroxyethyl methacrylate C.sub.6H.sub.10O.sub.3 2-Hydroxyethyl methacrylate C.sub.6H.sub.10O.sub.3 Hydroxypropyl methacrylate 2-Hydroxypropyl 2-(methacryloyloxy)ethyl phthalate C.sub.17H.sub.20O.sub.7 2-Hydroxy-3-{3-[2,4,6,8-tetramethyl-4,6,8-tris(propyl C.sub.32H.sub.62O.sub.14Si.sub.4 glycidyl ether)-2-cyclotetrasiloxanyl]propoxy}propyl methacrylate Isobornyl methacrylate C.sub.14H.sub.22O.sub.2 Isobutyl methacrylate C.sub.8H.sub.14O.sub.2 2-Isocyanatoethyl methacrylate C.sub.7H.sub.9NO.sub.3 Isodecyl methacrylate C.sub.14H.sub.26O.sub.2 Lauryl methacrylate C.sub.16H.sub.30O.sub.2 Methacrylic acid N-hydroxysuccinimide ester C.sub.8H.sub.9NO.sub.4 [3-(Methacryloylamino)propyl]dimethyl(3- C.sub.12H.sub.24N.sub.2O.sub.4S sulfopropyl)ammonium hydroxide [3-(Methacryloylamino)propyl]trimethylammonium C.sub.10H.sub.21ClN.sub.2O chloride Methacryloyl chloride C.sub.4H.sub.5ClO Methacryloyl chloride C.sub.4H.sub.5ClO [2-(Methacryloyloxy)ethyl]dimethyl-(3- C.sub.11H.sub.21NO.sub.5S sulfopropyl)ammonium hydroxide 2-Methacryloyloxyethyl phosphorylcholine C.sub.11H.sub.22NO.sub.6P [2-(Methacryloyloxy)ethyl]trimethylammonium C.sub.9H.sub.18ClNO.sub.2 chloride Methyl methacrylate C.sub.5H.sub.8O.sub.2 2-(Methylthio)ethyl methacrylate C.sub.7H.sub.12O.sub.2S mono-2-(Methacryloyloxy)ethyl maleate C.sub.10H.sub.12O.sub.6 mono-2-(Methacryloyloxy)ethyl succinate C.sub.10H.sub.14O.sub.6 2-N-Morpholinoethyl methacrylate C.sub.10H.sub.17NO.sub.3 1-Naphthyl methacrylate C.sub.14H.sub.12O.sub.2 2-(2-Oxo-1-imidazolidinyl)ethyl methacrylate C.sub.9H.sub.14N.sub.2O.sub.3 Pentabromophenyl methacrylate C.sub.10H.sub.5Br.sub.5O.sub.2 Pentafluorophenyl methacrylate C.sub.10H.sub.5F.sub.5O.sub.2 1,4-Phenylene dimethacrylate C.sub.14H.sub.14O.sub.4 Phenyl methacrylate C.sub.10H.sub.10O.sub.2 Phosphoric acid 2-hydroxyethyl methacrylate ester Poly(ethylene glycol) behenyl ether methacrylate Poly(ethylene glycol) 2,4,6-tris(1-phenylethyl)phenyl ether methacrylate Poly(propylene glycol) methacrylate Propyl methacrylate C.sub.7H.sub.12O.sub.2 1-Pyrenemethyl methacrylate C.sub.21H.sub.16O.sub.2 Solketal methacrylate C.sub.10H.sub.16O.sub.4 Stearyl methacrylate C.sub.22H.sub.42O.sub.2 3-Sulfopropyl methacrylate C.sub.7H.sub.11KO.sub.5S TEMPO methacrylate C.sub.13H.sub.22NO.sub.3 Tetrahydrofurfuryl methacrylate C.sub.9H.sub.14O.sub.3 3-(Trichlorosilyl)propyl methacrylate C.sub.7H.sub.11Cl.sub.3O.sub.2Si Triethylene glycol methyl ether methacrylate C.sub.11H.sub.20O.sub.5 1,1,1-Trifluoro-2-(trifluoromethyl)-2-hydroxy-4- C.sub.11H.sub.14F.sub.6O.sub.3 methyl-5-pentyl methacrylate 2-[(1,1,1-Trifluoro-2-(trifluoromethyl)-2- C.sub.15H.sub.18F.sub.6O.sub.3 hydroxy)propyl]-3-norbornyl methacrylate 3-(Trimethoxysilyl)propyl methacrylate C.sub.10H.sub.20O.sub.5Si 3,3,5-Trimethylcyclohexyl methacrylate C.sub.13H.sub.22O.sub.2 (Trimethylsilyl)methacrylate C.sub.7H.sub.14O.sub.2Si 2-(Trimethylsilyloxy)ethyl methacrylate C.sub.9H.sub.18O.sub.3Si 3-[Tris(trimethylsiloxy)silyl]propyl methacrylate C.sub.16H.sub.38O.sub.5Si.sub.4 Vinyl methacrylate C.sub.6H.sub.8O.sub.2
(59) TABLE-US-00009 TABLE 9 List of Polyfunctional Acrylics monomers. Polyfunctional Acrylics formula Acrylamide:N,N-Methylenebisacrylamide 3-(Acryloyloxy)-2-hydroxypropyl methacrylate C.sub.10H.sub.14O.sub.5 Bis[2-(methacryloyloxy)ethyl] phosphate C.sub.12H.sub.19O.sub.8P Bisphenol A propoxylate diacrylate 1,3-Butanediol diacrylate C.sub.10H.sub.14O.sub.4 1,4-Butanediol diacrylate C.sub.10H.sub.14O.sub.4 1,3-Butanediol dimethacrylate C.sub.12H.sub.18O.sub.4 1,4-Butanediol dimethacrylate C.sub.12H.sub.18O.sub.4 N,N-(1,2-Dihydroxyethylene)bisacrylamide C.sub.8H.sub.12N.sub.2O.sub.4 Di(trimethylolpropane) tetraacrylate average M.sub.w 466 C.sub.24H.sub.34O.sub.9 Diurethane dimethacrylate C.sub.23H.sub.38N.sub.2O.sub.8 N,N-Ethylenebis(acrylamide) C.sub.8H.sub.12N.sub.2O.sub.2 Glycerol 1,3-diglycerolate diacrylate C.sub.15H.sub.24O.sub.9 Glycerol dimethacrylate C.sub.11H.sub.16O.sub.5 Glycerol propoxylate (1PO/OH) triacrylate 1,6-Hexanediol diacrylate C.sub.12H.sub.18O.sub.4 1,6-Hexanediol dimethacrylate C.sub.14H.sub.22O.sub.4 1,6-Hexanediol ethoxylate diacrylate Hydroxypivalyl hydroxypivalate bis[6- C.sub.28H.sub.44O.sub.10 (acryloyloxy)hexanoate] Neopentyl glycol diacrylate C.sub.11H.sub.16O.sub.4 Neopentyl glycol propoxylate (1 PO/OH) diacrylate C.sub.11H.sub.24O.sub.6 Pentaerythritol diacrylate monostearate C.sub.29H.sub.50O.sub.7 Pentaerythritol tetraacrylate C.sub.17H.sub.20O.sub.8 Pentaerythritol triacrylate C.sub.14H.sub.18O.sub.7 Poly(propylene glycol) diacrylate Poly(propylene glycol) dimethacrylate 1,3,5-Triacryloylhexahydro-1,3,5-triazine C.sub.12H.sub.15N.sub.3O.sub.3 Tricyclo[5.2.1.0.sup.2,6]decanedimethanol C.sub.18H.sub.24O.sub.4 Trimethylolpropane ethoxylate (1 EO/OH) methyl ether C.sub.19H.sub.32O.sub.8 Trimethylolpropane ethoxylate triacrylate average M.sub.n ~428 Trimethylolpropane ethoxylate triacrylate average M.sub.n ~692 Trimethylolpropane ethoxylate triacrylate average M.sub.n ~912 Trimethylolpropane propoxylate triacrylate C.sub.33H.sub.56O.sub.12 average M.sub.n ~644 Trimethylolpropane triacrylate C.sub.15H.sub.20O.sub.6 Trimethylolpropane trimethacrylate C.sub.18H.sub.26O.sub.6 Tri(propylene glycol) diacrylate C.sub.15H.sub.24O.sub.6 Tris[2-(acryloyloxy)ethyl] isocyanurate C.sub.18H.sub.21N.sub.3O.sub.9
(60) The polymer can be constructed into a variety of shapes and structures using techniques such as but not limited to extrusion, imprinting, spray coating, injection molding, braiding, weaving, knitting, molding, 3D printing, and machining.
(61) In addition to using pH as a trigger for degradation, embodiments of this invention include responses to a variety of trigger mechanisms. For example, Chitosan dissolves in the presence of salt water and could be constructed to make an ear tube as well as many of the other embodiments mentioned in this document. Other potential triggers include, but are not limited to: Enzymes, Mechanical (i.e. ultrasound, vibration, force, etc.), Electrical, Temperature, Chemical reaction (i.e. alcohol, acid & base, solvent, etc.), and Physical (i.e. light, laser, magnetic field).
(62) The use of the dissolvable on-command material is not limited to ear tubes. For example, in an exemplary embodiment, the material could be used in many ear, nose, and throat procedures where a temporary implant is needed. Such as a stent for treating sinusitis, as taught by U.S. Pat. No. 8,337,454 B2, (herein incorporated by reference in its entirety) in which a bio-absorbable, drug eluting, and shape memory polymer is used to construct a stent. With this on-command technology, as illustrated in
(63) In another exemplary embodiment, this technology could also be applied for esophageal and gastrointestinal implant and prosthesis, which are frequently used to treat malformation and strictures. There are frequent clinical situations in which esophageal and gastrointestinal stents should be removed, which often require surgical intervention. Nonsurgical stent removal has been difficult due to the embedding of the uncovered stent ends.
(64) The on-command dissolvable materials can be used to manufacture these stents, and with an ingestion of a particular solution, inhalation of certain gas or mist, or introduction of a particular liquid through an enema procedure, the stent could be triggered to dissolve and obviate the need for other invasive removal methods.
(65) Beyond stents, the present technology could be used to create implants for treating gastroesophageal reflux disease, gastro-intestinal by-pass devices for treating obesity and diabetes, and any device where it would be advantageous for the removal or disappearance of the foreign body after a period of time.
(66) In another exemplary embodiment, the present disclosure could be applied to ophthalmology. For instance, surgical solutions have been developed for treating glaucoma, which involves implanting a small shunt device. Referring to
(67) The present materials could be used to make sutures and stiches. When it is time to remove the sutures and stiches, a patch that contains the triggering solution could be applied to the wound, and trigger the suture/stiches to dissolve.
(68) The present disclosure could be applied to gynecological implants and prosthesis. The popularity of contraceptive implants has risen in recent years. However, some of these implants require removal when a woman wishes to conceive again. This can be an uncomfortable process and might require a visit to the doctor's office for removal. Providing a solution that the female could administer herself to dissolve the contraceptive provides significant advantages. Referring to
(69) The present dissolvable on-command materials could also be used in urological applications. There are clinical needs for stents in the urinary tract as well as implants to restore continuity to the urinary tract. Permanent implants can lead to infection after tissue remolding has occurred. A dissolvable on-command option would allow the physician to monitor the tissue remolding and then noninvasively remove the implant through a catalyst, such as pH as mentioned above or another mechanism.
(70) There are also clinical indications for indwelling catheters, which require a follow up visit to remove. Referring to
(71) The present materials could also be used in oral implants to alleviate the need for sedation or pain management during the removal of oral prosthesis such as braces or other orthodontics.
(72) These materials could also be used as dermal patches to either protect an area of interest or reduce discomfort when removing a device attached to the skin. Since the mechanical properties can be altered of this material, the material could be made to be quite hard and durable lending usefulness to applications such as a water proof cast that does not need a saw for removal.
(73) In an exemplary embodiment, an ear tube may have a nitrocellulose coating. As illustrated in
(74) According to another exemplary embodiment, the ear tube could be made out of a solid block of EUDRAGIT E-PO Polymer. The solid block of EUDRAGIT E-PO polymer is formed by melting EUDRAGIT E-PO polymer in its powder form in an aluminum mold at 150 degrees Celsius. The block is then cut into smaller elongated pieces. These pieces of solid polymer are machined by turning the polymer block on a micro turn machine to make flanges specific to the ear tube shape.
(75) In another exemplary embodiment, the ear tube may be fabricated using EUDRAGIT E-PO polymer. The shape of the ear tube is printed in polymer using a 3D printer. From this positive duplicate of the ear tube, a negative mold in shape of the ear tube is fabricated using silicone. A small amount of EUDRAGIT E-PO polymer in its powder form is introduced in the negative mold and kept in the oven at 150 degrees Celsius for 10 minutes. This process is repeated until the mold is full of molten polymer. The mold is then cooled off and the ear tube extracted from the silicone.
(76) In a further exemplary embodiment, a triggering solution of 70% ethanol is used. The 70% ethanol solution dissolves ear tube prototypes in approximately 30-90 minutes, depending on the size of the prototype. As illustrated in
(77) The same prototypes are not affected by prolonged stay in water or waste mixed with soap (mimicking bath water or shower).
(78) A similar experiment was performed in a simulated eardrum/ear canal environment using water and an 80% Isopropyl alcohol solution. The results are illustrated in
(79) According to an exemplary embodiment, the pH value needed to trigger the degradation in the proposed polymer is between 1.5 and 5, which will not pose any health concern. The pH values of 15 commonly used topical ear drop formulations listed below in Table 10 ranged from 2.89 to 7.83. A conventional ear drop formulation with low enough pH value or a combination of several could be used to trigger the on-command dissolve process. Other chemicals could be combined together to speed the process, such as saline, alcohol, isopropry alcohol or acetone that would provide dispersive, ionic, polar, or H-Bond interactions. Other local anesthetics, such as liquid lidocaine could also be added to the solution to improve the comfort of the procedure.
(80) TABLE-US-00010 TABLE 10 pH value of commonly used ear drops formulations pH Product Value Acetic acid 2% 2.89 Dexamethasone 0.1%, neomycin sulfate 3,250 units/ml, acetic 3.00 acid 2% Hydrogen peroxide 6% 3.00 Aluminum acetate 13% 3.18 Aluminum acetate 8% 3.40 Triamcinolone acetonide 0.1%, neomycin undecenoate 0.35% 4.38 Glycerin and ichthammol 10% 4.90 Ciprodex Otic 5.00 Hydrocortisone 1%, neomycin sulfate polymyxin B sulfate 5.50 10,000 units/ml Framycetin sulfate 0.5%, gramicidin 0.005%, dexamethasone 5.53 0.05% Gentamicin sulfate 0.3%, hydrocortisone acetate 1% 6.18 Floxin Otic 6.50 Flumetasone pivalate 0.02%, clioquinol 1% 7.14 Betamethasone sodium phosphate 0.1%, neomycin sulfate 0.5% 7.28 Prednisolone sodium phosphate 0.5% 7.74 Betamethasone sodium phosphate 0.1% 7.70 Prednisolone sodium phosphate 0.5%, neomycin sulfate 0.5% 7.83
(81) Source: Eng, Chee-Yean, and Amged S. El-Hawrani. The pH of commonly used topical ear drops formulations in the treatment of otitis externa. Ear Nose and Throat Journal 90.4 (2011): 160, hereby incorporated by reference in its entirety.
(82) At the desired time, ear drop formulations with an acidic solution such as citric or acetic acid (pH=2-3) are introduced to the ear tube. The acidic aqueous solution reacts with the amine groups. At pH<5, the tertiary amine on the 2-(Dimethylamino)ethyl methacrylate group is protonated and makes increase the hydophilicity of the polymeric chain. By incorporating more water molecules in between the chains, the co-polymer swells, losing its mechanical properties and to eventually dissolves the ear tube. The co-polymer of the ear tube can be engineered to possess the desired mechanical properties, including rigidity, stability and solubility in the acidic solution. For example, the fabrication process may vary the amount of each monomer during the synthesis of the polymer. The co-polymer makeup of the ear tube design can be engineered to dissolve over the desired period of time, anywhere from a few minutes to few days.
(83) In an exemplary embodiment, the ear tube may be fabricated from a mixture of different monomers. For example, the material composing the ear tube is a statistical co-polymer that includes of 3 different monomers, as illustrated in
(84) In particular, the E-PO polymer is manufactured through a bulk polymerization process to produce polymer granules and further milled into powder form. The E-PO polymer exhibits good solvability in acetone. As the solvent evaporates, the liquid mixture becomes a sticky pliable material which can be easily shaped and molded into the desired structure. When the solution in the mixture completely evaporates, the residue polymer becomes a solid and hard material, showing good mechanical and structural strength. Through this dissolve-and-dry process, the E-PO polymer transforms from powder form into solid bulk and still maintains its original chemical properties. For example, it can be dissolved by ethanol again, though at a much slower rate, given that it now has much less surface area compare to powder form.
(85) The chemical profile and physical property of the EUDRAGIT E-PO polymer presents itself as a good candidate for the intended applications for the following reasons: (1) the polymer class is FDA approved for medical applications and considered non-toxic; (2) it is only water soluble in low pH environment (pH 1.0-4.0), which means it is non-dissolvable or stable in most human implants environments, which is usually pH neutral; (3) it can be easily dissolved in ethanol or isopropyl alcohol (IPA), which is considered non-toxic/minimal risk for medical applications; (4) it can be easily shaped and milled into the desired structure with low-cost/low-tech equipment; and (5) it has good mechanical strength as a medical implant material
(86) As discussed, when the E-PO polymer is dissolved in acetone the result is in liquid form. Once in the correct shape, the acetone needs to be evaporated out of the construct yielding a solid form. Since the acetone solution is viscous, air bubbles are prone and can make the final product brittle. To remove the air from the mixture, it should be exposed to a vacuum prior to setting into a particular shape. Using the ear tube application as a specific example, the polymer can be made into the standard ear tube shape through the dissolve-and-dry process. It can be molded into the desired shape when the polymer is still soft and pliable, or milled when it's completely dry and hardens. Other polymers or materials can be added to adjust the desired mechanical property, such as but not limited to, degradation rate, hardness and elasticity. Other pharmaceutical ingredients or drugs could also be added for therapeutic purposes.
(87) Obviously, numerous modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described herein.