Tympanostomy tube delivery device with rotatable flexible shaft

1. A method, comprising:

advancing a tip of an elongate tube of a shaft assembly through an ear canal of a patient to engage the tip with a tympanic membrane of the patient, the shaft assembly extending distally from a handpiece body, the elongate tube having a proximal section defining a longitudinal axis and a bent section disposed between the proximal section and the tip, the bent section maintaining the tip at a non-zero angle relative to the longitudinal axis;

rotating the elongate tube relative to the tympanic membrane prior to engaging the tip of the elongate tube with the tympanic membrane; and

actuating a drive assembly disposed within the handpiece body to longitudinally translate a plurality of shafts of the shaft assembly relative to the elongate tube of the shaft assembly and through the bent section in a predetermined sequence to at least one of pierce the tympanic membrane or deploy a tympanostomy tube in the tympanic membrane.

2. The method of claim 1 , wherein the rotating includes rotating the elongate tube relative to the handpiece body.

3. The method of claim 1 , wherein the rotating includes rotating the elongate tube relative to the handpiece body by rotating a thumbwheel coupled to the elongate tube.

4. The method of claim 1 , wherein the non-zero angle is less than 45 degrees.

5. The method of claim 1 , further comprising:

bending the bent section from a first configuration to a second configuration, the bent section being malleable such that the non-zero angle of the tip relative to the longitudinal axis is adjustable and the bent section is configured to remain in the second configuration without a continuously applied force.

6. The method of claim 1 , wherein at least a portion of each shaft of the plurality of shafts is flexible.

7. The method of claim 1 , wherein a first shaft of the plurality of shafts is nested within a second shaft of the plurality of shafts.

8. An apparatus, comprising:

a handpiece body:

a shaft assembly extending distally from the handpiece body, the shaft assembly including an elongate tube with a plurality of shafts coaxially and slidably disposed therein, the elongate tube having (1) a proximal section defining a first longitudinal axis, (2) a tip configured to engage a tympanic membrane of a patient and defining a second longitudinal axis, and (3) a bent section configured to maintain a position of the tip relative to the proximal section such that the second longitudinal axis is disposed at a non-zero angle relative to the first longitudinal axis;

the elongate tube is rotatable relative to the handpiece body; and

a drive assembly disposed within the handpiece body that can longitudinally translate the plurality of shafts relative to the elongate tube of the shaft assembly and through the bent section in a predetermined sequence to at least one of pierce the tympanic membrane or deploy a tympanostomy tube into the tympanic membrane.

9. The apparatus of claim 8 , wherein the non-zero angle is less than 45 degrees.

10. The apparatus of claim 8 , further comprising a thumbwheel configured to rotate the elongate tube such that the tip moves in a path around the first longitudinal axis.

11. The apparatus of claim 10 , wherein the thumbwheel is coupled to the elongate tube at a distal end of the handpiece body.

12. The apparatus of claim 8 , further comprising:

a pushbutton disposed on the handpiece body and operable to actuate the drive assembly.

13. The apparatus of claim 8 , wherein at least a portion of each shaft of the plurality of shafts is flexible.

14. The apparatus of claim 8 , wherein a first shaft of the plurality of shafts is nested within a second shaft of the plurality of shafts.

15. A method, comprising:

advancing a tip of an elongate tube of a shaft assembly through an ear canal of a patient to engage the tip with a tympanic membrane of the patient, the shaft assembly extending distally from a handpiece body, the elongate tube having a proximal section defining a longitudinal axis and a bendable section disposed distal of the proximal section and proximal of the tip;

rotating the elongate tube about the longitudinal axis of the proximal section to change an angle of the tip; and

actuating a drive assembly disposed within the handpiece body to longitudinally translate a plurality of shafts of the shaft assembly relative to the elongate tube of the shaft assembly and through the bendable section in a predetermined sequence to at least one of pierce the tympanic membrane or deploy a tympanostomy tube in the tympanic membrane.

16. The method of claim 15 , wherein the rotating includes rotating the elongate tube relative to the handpiece body.

17. The method of claim 15 , wherein the rotating includes rotating the elongate tube relative to the handpiece body by rotating a thumbwheel coupled to the elongate tube.

18. The method of claim 15 , wherein the bendable section defines a plurality of cutouts extending around a portion of the bendable section with a solid longitudinally extending member extending along a length of the bendable section.

19. The method of claim 15 , wherein the bendable section of the elongate tube is malleable such that the bendable section remains in a bent state without a continuously applied force.

20. The method of claim 15 , wherein the plurality of shafts of the shaft assembly includes at least one of a piercer configured to pierce the tympanic membrane or a pusher configured to deploy the tympanostomy tube in the tympanic membrane.

21. The method of claim 15 , wherein lubricant is disposed on at least one surface of at least one shaft of the plurality of shafts.

22. The method of claim 15 , wherein the tip of the elongate tube is obliquely angled relative to a central axis of the tip.

23. The method of claim 15 , wherein at least a portion of each shaft of the plurality of shafts is flexible.

24. The method of claim 15 , wherein a first shaft of the plurality of shafts is nested within a second shaft of the plurality of shafts.