Apparatus and methods for treating rhinitis

• US 10,307,200 B2
• Filed: 05/17/2018
• Issued: 06/04/2019
• Est. Priority Date: 09/30/2013
• Status: Active Grant

• Current Assignee: Arrinex, Inc. (Stryker Corporation)
• Original Assignee: Arrinex, Inc. (Stryker Corporation)
• Inventors: Saadat, Vahid
• Primary Examiner(s): Peffley, Michael F
• Assistant Examiner(s): Good, Samantha M
• Application Number:
  US15/982,537
• Publication Number:
  US 20180263678A1
• Time in Patent Office: 383 Days
• CPC Class Codes: A61B 17/24 for use in the oral cavity, larynx, bronchial passages or nose for medical inspection of cavities or tubes in the body A61B1/00; Tongue scrapers
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0268 with restriction of flow
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61N 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary
• CPC Class Codes: G01M 3/24 using infrasonic, sonic, or ultrasonic vibrations
• CPC Class Codes: G01N 2291/0258 : Structural degradation, e.g. fatigue of composites, ageing of oils
• CPC Class Codes: G01N 2291/0289 : Internal structure, e.g. defects, grain size, texture
• CPC Class Codes: G01N 29/043 : in the interior, e.g. by shear waves
• CPC Class Codes: G01N 29/0618 : synchronised with scanning, e.g. in real-time
• CPC Class Codes: G01N 29/07 : by measuring propagation velocity or propagation time of acoustic waves
• CPC Class Codes: G01N 29/225 : Supports, positioning or alignment in moving situation
• CPC Class Codes: G01N 29/262 : by electronic orientation or focusing, e.g. with phased arrays phased arrays per se G10K11/34
• CPC Class Codes: G01N 29/265 : by moving the sensor relative to a stationary material

Abstract

Apparatus and methods for treating conditions such as rhinitis are disclosed herein where a distal end of a probe shaft is introduced through the nasal cavity where the distal end has an end effector with a first configuration having a low-profile which is shaped to manipulate tissue within the nasal cavity. The distal end may be positioned into proximity of a tissue region having a post nasal nerve associated with a middle or inferior nasal turbinate. Once suitably positioned, the distal end may be reconfigured from the first configuration to a second configuration which is shaped to contact and follow the tissue region and the post nasal nerve may then be ablated via the distal end. Ablation may be performed using various mechanisms, such as cryotherapy, and optionally under direct visualization.

Claims

1. A method for treating nerve tissue within a nasal cavity of a patient, the method comprising:

advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient;

contacting a mucosal surface of the nasal cavity with the treatment delivery portion; and

delivering an energy-based treatment from the treatment delivery portion to treat the nerve tissue underlying the mucosal surface, wherein the delivering of the energy-based treatment comprises delivering energy in a form selected from the group consisting of ultrasound, radiofrequency, and electrical energy.

2. The method of claim 1, wherein the delivering of the energy-based treatment to treat the nerve tissue underlying the mucosal surface comprises ablating the nerve tissue.

3. The method of claim 1, wherein the delivering of the energy-based treatment comprises delivering radiofrequency energy from a first electrode on a tissue contact surface to a second electrode on the tissue contact surface.

4. The method of claim 3, wherein the first electrode and second electrode comprise dome shaped electrodes on the tissue contact surface, and wherein contacting the mucosal surface comprises contacting the dome shaped electrodes on the tissue contact surface with the mucosal surface.

5. The method of claim 1, further comprising measuring energy-based treatment delivery using a thermocouple disposed in a vicinity of the treatment delivery portion.

6. The method of claim 1, wherein the delivering of the energy-based treatment to treat the nerve tissue underlying the mucosal surface comprises ablating the nerve tissue such that at least one symptom of rhinitis is reduced.

7. The method of claim 1, wherein the nerve tissue comprises a posterior nasal nerve, a branch of a vidian nerve, a parasympathetic nerve, a greater palatine nerve, a maxillary nerve, a sphenopalatine ganglion nerve, or a posterolateral nerve.

8. The method of claim 1, wherein the delivering of the energy-based treatment comprises delivering bipolar radiofrequency energy.

9. The method of claim 1, wherein the treatment delivery portion comprises a plurality of electrodes and the delivering of the energy-based treatment comprises delivering radiofrequency energy.

10. The method of claim 9, wherein the plurality of electrodes comprise eight electrodes arranged in two lateral arrays.

11. The method of claim 1, further comprising adjusting a shape of the treatment delivery portion of the energy-based treatment device to increase contact with the mucosal surface or pressure against the mucosal surface.

12. The method of claim 11, wherein the treatment delivery portion comprises an expandable structure having bipolar electrode elements and adjusting the shape of the treatment delivery portion comprises expanding the bipolar electrode elements away from a longitudinal axis of the energy-based treatment device.

13. A method for treating nerve tissue within a nasal cavity of a patient, the method comprising:

advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient;

contacting a mucosal surface of the nasal cavity with the treatment delivery portion;

delivering an energy-based treatment from the treatment delivery portion to treat the nerve tissue underlying the mucosal surface wherein the delivering of the energy-based treatment to treat the nerve tissue underlying the mucosal surface comprises ablating the nerve tissue such that rhinorrhea is reduced; and

wherein the delivering of the energy-based treatment comprises delivering bipolar radiofrequency energy.

14. The method of claim 13, further comprising adjusting a shape of the treatment delivery portion of the energy-based treatment device.

15. The method of claim 14, wherein the treatment delivery portion comprises an expandable structure and adjusting the shape of the treatment delivery portion comprises inflating the expandable structure from a deflated configuration into an expanded configuration against the mucosal surface.

16. A method for treating nerve tissue within a nasal cavity of a patient, the method comprising:

advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient, wherein the advancing the treatment delivery portion of the energy-based treatment device into the nostril of the patient comprises positioning the treatment delivery portion relative to a tissue region surrounded by a middle nasal turbinate, an inferior nasal turbinate, and a lateral nasal wall;

contacting a mucosal surface of the nasal cavity with the treatment delivery portion;

adjusting a shape of the treatment delivery portion of the energy-based treatment device; and

delivering an energy-based treatment from the treatment delivery portion to treat the nerve tissue underlying the mucosal surface.

17. The method of claim 16, wherein the delivering of the energy-based treatment to treat the nerve tissue underlying the mucosal surface comprises ablating the nerve tissue.

18. The method of claim 16, wherein the delivering of the energy-based treatment comprises delivering energy in a form selected from the group consisting of ultrasound, radiofrequency, electrical, and thermal energy.

19. The method of claim 16, wherein the delivering of the energy-based treatment comprises applying cryotherapy.

20. The method of claim 19, wherein the applying the cryotherapy comprises ablating the nerve tissue.

21. The method of claim 16, wherein the delivering of the energy-based treatment to treat the nerve tissue underlying the mucosal surface comprises ablating the nerve tissue such that at least one symptom of rhinitis is reduced.

22. The method of claim 16, further comprising measuring energy-based treatment delivery using a thermocouple disposed in a vicinity of the treatment delivery portion.

23. The method of claim 16, wherein the delivering of the energy-based treatment comprises delivering bipolar radiofrequency energy.

24. The method of claim 16, wherein the treatment delivery portion comprises an expandable structure and adjusting the shape of the treatment delivery portion comprises inflating the expandable structure from a deflated configuration into an expanded configuration against the mucosal surface.

25. A method for treating nerve tissue within a nasal cavity of a patient, the method comprising:

advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient;

contacting a mucosal surface of the nasal cavity with the treatment delivery portion;

adjusting a shape of the treatment delivery portion of the energy-based treatment device, wherein the treatment delivery portion comprises an expandable structure and adjusting the shape of the treatment delivery portion comprises inflating the expandable structure from a deflated configuration into an expanded configuration against the mucosal surface; and

delivering an energy-based treatment from the treatment delivery portion to treat the nerve tissue underlying the mucosal surface.

26. The method of claim 25, wherein the inflating comprises introducing a cryogenic fluid into the expandable structure, wherein evaporation of the cryogenic fluid inflates the expandable structure into the expanded configuration.

27. The method of claim 25, wherein the contacting the mucosal surface comprises positioning a member extending within the expandable structure into contact against the mucosal surface through the expandable structure.