Systems and methods for tissue suspension and compression

Abstract

Suture passer systems for tissue suspension and tissue compression are described. The system can include a shaft and a needle, wherein the needle is freely rotatable with respect to the shaft. The suture may include an overmolded segment. Methods of placing one or more implants, sutures, fastener, bone anchors and other devices are also described. The methods include moving tissue, including the superior pharyngeal constrictor muscle, palatopharyngeal arch, and palatoglossal arch. The methods include hyoid bone suspension.

1 . A suture passer comprising:
 a proximal handle;   an elongate shaft having a proximal end, a distal end, and a longitudinal axis;   a suture passing element coupled to the distal end of the shaft, wherein the a suture passing element is movable with respect to the shaft, and configured to swivel with respect to the shaft in an arc of at least about 90 degrees.   
     
     
         2 - 20 . (canceled) 
     
     
         21 . A suspension line for tensioning tissue, comprising:
 a suture having a first thickness dimension;   an elastomer surrounding a portion of the suture having a second thickness dimension greater than the first thickness dimension; and   at least one bearing element configured to allow the suture to move with respect to the elastomer while maintaining the flexibility of the suture.   
     
     
         22 . The suspension line of  claim 21 , wherein the at least one bearing element is at least partially covered by the elastomer. 
     
     
         23 . The suspension line of  claim 21 , wherein the at least one bearing element comprises a knot. 
     
     
         24 . The suspension line of  claim 21 , wherein the at least one bearing element comprises a bead. 
     
     
         25 . The suspension line of  claim 21 , wherein the at least one bearing element comprises a coil. 
     
     
         26 . The suspension line of  claim 25 , wherein the coil comprises polypropylene. 
     
     
         27 . The suspension line of  claim 21 , wherein the elastomer comprises silicone. 
     
     
         28 . The suspension line of  claim 21 , wherein the elastomer is at least partially radiopaque. 
     
     
         29 . The suspension line of  claim 28 , wherein the elastomer is compounded with a radiopacifier. 
     
     
         30 - 54 . (canceled) 
     
     
         55 . An method comprising:
 providing a suture having a first strand, a second strand, and an arc between the first strand and the second strand;   placing the arc on one side of the hyoid bone;   placing the first strand and the second strand on the other side of the hyoid bone;   forming a girth hitch around the hyoid bone; and   securing the first strand and the second strand to a bone anchor   
     
     
         56 . The method of  claim 55 , wherein the bone anchor is located on the mandible. 
     
     
         57 . The method of  claim 55 , further comprising a second suture comprising a third strand, a fourth strand, and a second arc between the third strand and the fourth strand. 
     
     
         58 . The method of  claim 57 , further comprising coupling the third strand to the first strand. 
     
     
         59 . The method of  claim 58 , further comprising pulling the third strand to form the girth hitch. 
     
     
         60 . The method of  claim 57 , further comprising placing the second arc under the first arc 
     
     
         61 . The method of  claim 57 , further comprising pulling the suture such that the second arc is on one side of the hyoid bone and both the third and fourth strands are on other side of the hyoid bone. 
     
     
         62 . The method of  claim 55 , further comprising an elastomer surrounding a portion of the suture. 
     
     
         63 . The method of  claim 55 , further comprising at least one bearing element on the suture. 
     
     
         64 . The method of  claim 63 , wherein the at least one bearing element is at least partially covered by the elastomer.