Method for ablating turbinates

• US 5,746,224 A
• Filed: 11/19/1996
• Issued: 05/05/1998
• Est. Priority Date: 06/24/1994
• Status: Expired due to Term

• Current Assignee: Gyrus ACMI, Inc. (Olympus Corporation)
• Original Assignee: Somnus Medical Technologies, Inc. (Olympus Corporation)
• Inventors: Edwards, Stuart D.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/754,588
• Time in Patent Office: 532 Days
• Field of Search: 606/41, 606/42, 606/45-50, 606/191-194, 607/100-105, 604/21, 604/22, 604/96-103, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00261 arranged in a line
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00708 : switching the power on or off
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00869 : Phase
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00886 : Duration
• CPC Class Codes: A61B 2018/00892 : Voltage
• CPC Class Codes: A61B 2018/00898 : Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/0091 : Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00916 : with means for switching or controlling the main function of the instrument or device
• 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 2018/046 : in liquid form
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61M 16/0481 : through the cuff wall
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2025/1086 : having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 5/04 : Radiators for near-field treatment

Abstract

A method is provided for ablating at least a portion of a nasal concha. By ablating at least a portion of a nasal concha, the size of the nasal concha is reduced. The three nasal concha in the body (inferior, middle and superior nasal concha) form at least a portion of the three nasal meatus (inferior, middle and superior nasal meatus) in the body. By reducing the size of a nasal concha, obstruction of a nasal meatus is reduced or eliminated. As a result, air flow through the nasal meatus is improved. In one embodiment, the method includes taking a catheter having a distal portion with an expandable member and an energy delivery device coupled to an energy source for delivering ablative energy and positioning the catheter distal portion through a nostril of a patient into a nasal meatus adjacent a surface of a nasal concha; expanding the expandable member within the nasal meatus so that the expandable member is brought into contact with the surface of the nasal concha; and delivering sufficient ablative energy from the energy delivery device to the nasal concha to ablate at least a portion of the nasal concha.

Claims

1. A method for reducing the size of a nasal concha comprising

delivering ablative energy through a surface of the nasal concha into an interior of the nasal concha without introducing an element into the interior of the nasal concha to ablate a portion of the interior of the nasal concha;

and

removing the ablated interior portion of the nasal concha by natural absorption of ablated tissue by the patient'"'"'s body.

2. The method according to claim 1, wherein delivering ablative energy includes taking a catheter having a distal portion with an expandable member and an energy delivery device coupled to an energy source for delivering ablative energy and positioning the catheter distal portion through a nostril of a patient into a nasal meatus adjacent a surface of a nasal concha;

expanding the expandable member within the nasal meatus so that the expandable member is brought into contact with the surface of the nasal concha; and

delivering sufficient ablative energy from the energy delivery device to the nasal concha to ablate at least a portion of the nasal concha.

3. The method according to claim 1, wherein the step of delivering ablative energy is performed substantially bloodlessly.

4. The method according to claim 1, wherein the step of removing the ablated nasal concha tissue is performed substantially bloodlessly.

5. The method according to claim 1, wherein the step of removing the ablated nasal concha tissue is performed without introducing an element into the nasal concha.

6. The method according to claim 1, wherein the nasal concha is reduced in size a sufficient amount to increase the rate of airflow through the nasal meatus at a given pressure by at least 25%.

7. A method for ablating at least a portion of a nasal concha comprising:

taking a catheter having a distal portion with an expandable member and an energy delivery device coupled to an energy source for delivering ablative energy and positioning the catheter distal portion through a nostril of a patient into a nasal meatus adjacent a surface of a nasal concha;

expanding the expandable member within the nasal meatus so that the expandable member is brought into contact with the surface of the nasal concha; and

delivering sufficient ablative energy from the energy delivery device to the nasal concha to ablate at least a portion of the nasal concha.

8. The method according to claim 7 wherein the nasal concha is an inferior nasal concha and the nasal meatus is the inferior nasal meatus.

9. The method according to claim 7 wherein the portion of the nasal concha ablated is an anterior section of the inferior nasal concha.

10. The method according to claim 9 wherein the portion of the nasal concha ablated is no more than one-third of the inferior nasal concha in the anterior portion of the inferior nasal concha.

11. The method according to claim 7 wherein ablating a portion of the nasal concha includes ablating an internal section of the nasal concha without ablating the surface of the nasal concha.

12. The method according to claim 11 wherein ablating an internal section of the nasal concha without ablating the surface of the nasal concha is performed by cooling the surface of the nasal concha during the delivery of energy.

13. The method according to claim 12 wherein cooling the surface of the nasal concha during the delivery of energy is performed by introducing a cool medium into the expandable member during ablation.

14. The method according to claim 7 wherein ablating a portion of the nasal concha includes ablating an internal section of the nasal concha without penetrating the surface of the nasal concha with an element of the catheter.

15. The method according to claim 7 wherein sufficient ablative energy is delivered to heat at least a portion of the nasal concha to a temperature above about 40°

C.

16. The method according to claim 7 wherein the ablative energy used is electromagnetic energy.

17. The method according to claim 16 wherein the electromagnetic energy used for ablation is energy selected from the group consisting of RF, microwave, ultrasonic, pulsed laser, and diffuse laser energy.

18. The method according to claim 16 wherein the electromagnetic energy used is RF radiation with a frequency between about 300 megahertz and about 700 megahertz.

19. The method according to claim 16 wherein the electromagnetic energy is RF radiation sufficient to deliver between about 5 and about 30 watts of energy to the portion of the nasal concha being treated.

20. The method according to claim 7 wherein the expandable member includes a microporous membrane.

21. The method according to claim 7 wherein the expandable member is expanded by delivering a medium into the expandable member.

22. The method according to claim 21 wherein the delivery of the medium is through a lumen within the catheter into the expandable member.

23. The method according to claim 21 wherein the medium is an electrolytic medium.

24. The method according to claim 23 wherein the electrolytic medium is saline.

25. The method according to claim 24 wherein the saline has a NaCl content of less than about 10% by weight.

26. The method according to claim 23 wherein the electrolytic medium further includes an agent having a bioactive, chemoactive, or radioactive effect.

27. The method according to claim 7, further including the step of insulating at least a portion of the nasal meatus from ablative energy during ablation.

28. The method according to claim 27 wherein the step of insulating includes having an insulative covering positioned over a portion of the expandable member to prevent the delivery of energy therethrough.

29. The method according to claim 7, further including the step of insulating at least a portion of the nasal concha from ablative energy during ablation.

30. A method for reducing the size of a nasal concha without the formation of a external wound comprising:

delivering ablative energy through a surface of the nasal concha into an interior of the nasal concha without introducing an element into the nasal concha to ablate a portion of the interior portion of the nasal concha;

cooling the surface of the nasal concha while delivering ablative energy such that a layer of tissue adjacent the nasal concha surface is not ablated; and

removing the ablated interior portion of nasal concha by natural absorption of ablated tissue by the patient'"'"'s body.

31. The method according to claim 30, wherein the step of delivering ablative energy is performed substantially bloodlessly.

32. The method according to claim 30, wherein the step of removing the ablated nasal concha tissue is performed substantially bloodlessly.

33. The method according to claim 30, wherein the step of removing the ablated nasal concha tissue is performed without introducing an element into the nasal concha.

34. The method according to claim 30, further including the step of insulating at least a portion of a nasal meatus adjacent the nasal concha from ablative energy during ablation.

35. The method according to claim 30, further including the step of insulating at least a portion of the nasal concha from ablative energy during ablation.