Apparatus and methods for treating rhinitis

• US 10,448,985 B2
• Filed: 08/19/2016
• Issued: 10/22/2019
• 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:
  US15/242,398
• Publication Number:
  US 20160354136A1
• Time in Patent Office: 1,159 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: 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 29/07 : 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

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 at least one symptom of rhinitis in a patient, the method comprising:

introducing a distal end of a probe shaft through a nasal cavity of a patient, wherein the distal end has an end effector with a first configuration having a low-profile which is shaped to contact tissue within the nasal cavity;

positioning the distal end into proximity of a tissue region having at least one posterior nasal nerve associated with a middle or inferior nasal turbinate;

reconfiguring the distal end from the first configuration to a second configuration which is shaped to facilitate treatment; and

ablating the at least one posterior nasal nerve within the tissue region via the distal end such that the at least one symptom of rhinitis is reduced.

2. The method of claim 1, wherein the positioning of the distal end comprises positioning the distal end at least 2 cm beyond an anterior entrance to a middle meatus.

3. The method of claim 1, wherein the positioning of the distal end comprises:

advancing the distal end along an upper surface of the inferior nasal turbinate to a mid-portion of a middle nasal turbinate;

advancing the distal end into a middle meatus; and

further advancing the distal end posteriorly up into a cul-de-sac defined by the middle nasal turbinate and lateral nasal wall.

4. The method of claim 1, wherein the positioning of the distal end comprises positioning the distal end between the middle and inferior nasal turbinate.

5. The method of claim 1, wherein the positioning of the distal end comprises positioning the distal end into proximity of a Pterygomaxillary fossa, a sphenopalatine ganglion, a sphenopalatine foramen, or a vidian nerve of the patient.

6. The method of claim 1, wherein the ablating comprises cryogenically ablating the at least one posterior nasal nerve by introducing a cryogenic fluid into or through the distal end.

7. The method of claim 1, wherein the ablating comprises delivering radio frequency energy to ablate the at least one posterior nasal nerve.

8. The method of claim 7, wherein the end effector comprises at least a plurality of electrodes for bipolar electrode ablation.

9. The method of claim 8, wherein the plurality of electrodes comprise two lateral arrays of electrodes.

10. The method of claim 9, wherein each of the lateral arrays comprises four electrodes.

11. The method of claim 8, wherein the plurality of electrodes comprise two to eight electrodes.

12. The method of claim 7, further comprising a temperature sensor disposed in a vicinity of the distal end.

13. The method of claim 1, wherein the ablating comprises delivering ultrasonic energy to ablate the at least one posterior nasal nerve.

14. The method of claim 1, wherein the reconfiguring of the distal end comprises shaping a distal malleable region of the probe shaft.

15. The method of claim 1, wherein the reconfiguring of the distal end comprises deploying the end effector from the first configuration to the second configuration having a T-shape.

16. A method for treating at least one symptom of rhinitis in a patient, the method comprising:

introducing a distal end of a probe shaft through a nasal cavity of a patient, wherein the distal end has a plurality of electrodes shaped to contact tissue within the nasal cavity;

positioning the distal end into proximity of a tissue region having at least one nasal nerve associated with a middle or inferior nasal turbinate; and

delivering radiofrequency energy to the at least one nasal nerve within the tissue region via the distal end such that the at least one symptom of rhinitis is reduced.

17. The method of claim 16, further comprising reconfiguring the distal end from a collapsed configuration to a deployed configuration having a T-shape.

18. The method of claim 16, further comprising reconfiguring the distal end by shaping a distal malleable region of the probe shaft.

19. The method of claim 16, wherein the delivering of radiofrequency energy to the at least one nasal nerve comprises ablating at least one of a posterior nasal nerve, a vidian nerve or branches or portions thereof, a parasympathetic nerve, a greater palatine nerve or branches or portions thereof, a maxillary nerve or branches or portions thereof, a sphenopalatine ganglion or branches or portions thereof, or a posterolateral nerve or branches or portions thereof.

20. The method of claim 16, further comprising cooling a mucosal surface to minimize thermal injury to the mucosal surface.