Post nasal drip treatment

• US 9,415,194 B2
• Filed: 03/31/2015
• Issued: 08/16/2016
• Est. Priority Date: 06/14/2011
• Status: Active Grant

• Current Assignee: Aerin Medical Inc.
• Original Assignee: Aerin Medical Inc.
• Inventors: Wolf, Scott J., Frazier, Andrew
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US14/675,689
• Publication Number:
  US 20150202003A1
• Time in Patent Office: 504 Days
• US Class Current: 1/1
• 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 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/00922 by switching or controlling the treatment energy directly within the hand-piece
• CPC Class Codes: A61B 2018/00994 combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/0225 using an instrument for clamping tissue, e.g. forceps
• CPC Class Codes: A61B 2018/0293 using an instrument interstitially inserted into the body, e.g. needle
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/143 : multiple needles
• CPC Class Codes: A61B 2018/1869 : with an instrument interstitially inserted into the body, e.g. needles
• CPC Class Codes: A61F 5/08 : Devices for correcting deformities of the nose ; Devices for enlarging the nostril, e.g. for breathing improvement
• CPC Class Codes: A61M 2025/0091 : the single injection needle being fixed
• CPC Class Codes: A61M 2025/105 : having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Systems and methods for treating a patient'"'"'s mucus hypersecretion condition are disclosed herein. Certain implementations may involve a method for reducing mucus secretion in an upper airway of a patient to treat at least one of post nasal drip or chronic cough. The method may include advancing a treatment delivery portion of an energy-based treatment device into a nostril of the patient. The treatment delivery portion may contact mucosal tissue of the upper airway without piercing the mucosal tissue. The treatment delivery portion may deliver treatment to at least one tissue selected from the group of the mucosal tissue and another tissue underlying the mucosal tissue to modify a property of the at least one tissue and thus treat at least one of post nasal drip or chronic cough in the patient.

Claims

1. A method for reducing mucus secretion in an upper airway of a patient to treat at least one of post nasal drip or chronic cough, the method comprising:

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

contacting mucosal tissue of the upper airway with the treatment delivery portion, without piercing the mucosal tissue; and

delivering a treatment from the treatment delivery portion to at least one tissue selected from the group of the mucosal tissue and another tissue underlying the mucosal tissue to modify a property of the at least one tissue and thus treat at least one of post nasal drip or chronic cough in the patient.

2. The method of claim 1, wherein the treatment is delivered without forming an incision in the mucosal tissue and without delivering an implant.

3. The method of claim 1, wherein delivering the treatment comprises delivering energy from the delivery treatment portion in a form selected from the group consisting of ultrasound, microwave, heat, radiofrequency, electrical, light and laser energy.

4. The method of claim 3, wherein delivering the treatment comprises delivering radiofrequency energy from a first electrode on a tissue contact surface of the treatment portion across a convex portion of the tissue contact surface to a second electrode on the tissue contact surface.

5. The method of claim 4, wherein contacting the mucosal tissue comprises contacting multiple non-piercing bumps on the tissue contact surface with the mucosal tissue.

6. The method of claim 3, wherein the at least one tissue comprises nerve tissue underlying the mucosal tissue, and wherein delivering the energy comprises ablating the nerve tissue.

7. The method of claim 3, further comprising measuring an amount of delivered energy using a thermocouple on the treatment portion.

8. The method of claim 7, further comprising adjusting the amount of delivered energy by adjusting a setting of the treatment delivery portion.

9. The method of claim 1, wherein delivering the treatment comprises removing energy, and wherein the treatment delivery portion comprises a cryotherapy device.

10. The method of claim 9, wherein the at least one tissue comprises nerve tissue underlying the mucosal tissue, and wherein removing energy comprises ablating the nerve tissue using the cryotherapy device.

11. The method of claim 1, wherein applying a treatment comprises injecting a polymerizing liquid.

12. The method of claim 1, wherein delivering the treatment comprises injuring the at least one tissue.

13. The method of claim 12, wherein delivering the treatment comprises injuring goblet cells that are part of the mucosal tissue.

14. The method of claim 12, wherein the at least one tissues is selected from the group consisting of cilia, goblet cells, nerves, submucosal tissue, muscle, ligaments, cartilage, tendon, and skin.

15. The method of claim 1, wherein delivering the treatment comprises simultaneously mechanically altering the mucosal tissue and delivering energy to the at least one tissue.

16. The method of claim 1, wherein delivering the treatment comprises modifying the at least one tissue in a manner that decreases a volumetric rate of mucus production of the mucosal tissue without changing a shape of the mucosal tissue.

17. The method of claim 1, wherein delivering the treatment comprises delivering a cauterizing agent to tissue to be treated.

18. The method of claim 1, wherein delivering the treatment comprises delivering the treatment to at least one turbinate of the upper airway.

19. The method of claim 18, wherein the at least one turbinate comprises an inferior turbinate, and contacting the mucosal tissue comprises contacting a posterior aspect of the inferior turbinate.

20. A device for reducing mucus secretion in an upper airway of a patient to treat at least one of post nasal drip or chronic cough, the device comprising:

an elongate, malleable shaft having a proximal end and a distal end;

a handle at the proximal end of the elongate shaft; and

a treatment portion at the distal end of the elongate shaft, the treatment portion comprising a treatment surface, the treatment surface comprising;

at least two energy delivery members extending longitudinally along the treatment surface; and

a concave trough extending longitudinally along the treatment surface and separating the at least two energy delivery members.

21. The device of claim 20, wherein the at least two energy delivery members comprise at least one positive electrode on one side of the concave trough and at least one negative electrode on an opposite side of the concave trough.

22. The device of claim 21, wherein the at least one positive electrode comprises a row of positive electrodes, and wherein the at least on negative electrode comprises a row of negative electrodes.

23. The device of claim 22, wherein the electrodes protrude from the treatment surface.

24. The device of claim 23, wherein the electrodes are blunt-tipped electrodes.

25. The device of claim 20, further comprising a thermocouple disposed within the concave trough.

26. A method for reducing mucus secretion in an upper airway of a patient to treat at least one of post nasal drip or chronic cough, the method comprising:

bending a malleable shaft of a treatment device into a desired configuration;

advancing a treatment portion of the treatment device into a nostril of the patient to contact a treatment surface of the treatment portion with mucosal tissue of the upper airway, without piercing the mucosal tissue;

delivering radiofrequency energy from a first electrode on the treatment surface across a concave trough in the treatment surface to a second electrode on the treatment surface, to treat at least one tissue selected from the group of the mucosal tissue and another tissue underlying the mucosal tissue to modify a property of the at least one tissue and thus treat at least one of post nasal drip or chronic cough in the patient;

measuring an amount of the radiofrequency energy delivered, using a thermocouple disposed in the concave trough; and

removing the treatment portion from the upper airway without leaving an implant in the upper airway.

27. The method of claim 26, further comprising performing a test to determine whether a desired contact between the treatment surface and the mucosal tissue has been achieved.

28. The method of claim 26, wherein the delivering and measuring steps comprise:

delivering a first amount of the radiofrequency energy from the first electrode to the second electrode;

measuring a temperature of the mucosal tissue using the thermocouple; and

delivering a second amount of the radiofrequency energy from the first electrode to the second electrode, wherein the second amount of radiofrequency energy is based at least in part on the measured temperature.

29. The method of claim 26, wherein the mucosal tissue comprises tissue located on at least one nasal turbinate of the upper airway.

30. The method of claim 29, wherein the mucosal tissue comprises tissue located on a posterior aspect of an inferior turbinate.

31. The method of claim 26, wherein delivering the radiofrequency energy comprises delivering the radiofrequency energy in an amount that deactivates mucus producing cells by impairing at least one of mucus production ability or cell differentiation ability of the mucus producing cells.

32. The method of claim 26, wherein delivering the radiofrequency energy comprises delivering the radiofrequency energy in an amount that causes one or more mucus paths of the upper airway to divert.

33. The method of claim 26, further comprising repeating the bending, advancing, and delivery steps.