System and methods for electrosurgical treatment of turbinates

• US 6,659,106 B1
• Filed: 01/10/2000
• Issued: 12/09/2003
• Est. Priority Date: 06/07/1995
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Hovda, David C., Ellsberry, Maria B., Thapliyal, Hira V.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/480,880
• Time in Patent Office: 1,429 Days
• Field of Search: 606/41, 606/32, 606/34, 607/99, 607/105, 607/113, 604/114, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• 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 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00583 : Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00601 : Cutting
• 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 2018/0072 : Current
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00779 : Power or energy
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• 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 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 2018/165 : Multiple indifferent electrodes
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient'"'"'s body, particularly including tissue in the ear, nose and throat. In one aspect, a method is provided for reducing the volume of enlarge swollen tissue in the patient'"'"'s nose, such as swollen nasal tissue, mucus membranes, turbinates, polyps, neoplasms, cartilage (e.g., the nasal septum) or the like. In particular, the turbinates are treated by positioning one or more electrode terminal(s) adjacent to the turbinates, and delivering electrically conductive fluid, such as isotonic saline, to the nasal cavity to substantially surround the electrode terminal(s) with the fluid. High frequency voltage is applied between the electrode terminal(s) and one or more return electrode(s) to remove a small tissue segment, channel or hole from the region near or in the turbinates to shrink the turbinates and prevent swelling, due to the formation of scar tissue as the wound heals. The high frequency voltage may be selected to effect a small amount of thermal damage to the walls of the channel or hole to facilitate the formation of scar tissue without extending this thermal damage beyond the immediate region of the target site.

Claims

1. A method for treating turbinates comprising:

positioning an electrode terminal in contact with or in close proximity to the turbinate; and

applying a sufficient high frequency voltage difference between the electrode terminal and a return electrode to form a void within the turbinate by imminently removing tissue.

2. The method of claim 1 wherein the void is a hole having a maximum lateral dimension of about 2.0 mm.

3. The method of claim 1 wherein the void is a channel extending along an outer surface of the turbinate.

4. The method of claim 1 further comprising applying a sufficient high frequency voltage difference between the electrode terminal and the return electrode to form a plurality of voids within the turbinate.

5. The method of claim 1 further comprising, during the applying step, translating at least a portion of the electrode terminal relative to the turbinate.

6. A method for treating turbinates comprising:

positioning an electrode terminal in contact with or in close proximity to the turbinate; and

applying a sufficient high frequency voltage difference between the electrode terminal and a return electrode to imminently form a void within the turbinate.

7. The method of claim 6 wherein the void is a hole having a maximum lateral dimension of about 2.0 mm.

8. The method of claim 6 wherein the void is a channel extending along an outer surface of the turbinate.

9. The method of claim 6 further comprising applying a sufficient high frequency voltage difference between the electrode terminal and the return electrode to form a plurality of voids within the turbinate.

10. The method of claim 6 further comprising, during the applying step, translating at least a portion of the electrode terminal relative to the turbinate.

11. A method for treating turbinates comprising:

positioning an electrode terminal in contact with or in close proximity to the turbinate; and

forming a void within the turbinate by applying a sufficient high frequency voltage difference between the electrode terminal and a return electrode to disintegrate tissue.

12. The method of claim 11 wherein the void is a hole having a maximum lateral dimension of about 2.0 mm.

13. The method of claim 11 wherein the void is a channel extending along an outer surface of the turbinate.

14. The method of claim 11 further comprising forming a plurality of voids within the turbinate by applying sufficient high frequency voltage difference between the electrode terminal and the return electrode to disintegrate tissue.

15. The method of claim 11 further comprising, during the applying step, translating at least a portion of the electrode terminal relative to the turbinate.

16. The method of claim 11 wherein disintegration of tissue is accomplished by molecular dissociation of tissue.

17. A method for treating turbinates comprising:

positioning an electrode terminal in contact with or in close proximity to the turbinate; and

applying a high frequency voltage difference between the electrode terminal and a return electrode sufficient to form a void within the turbinate by quickly removing tissue.