Phototherapeutical apparatus and method for the treatment and prevention of diseases of body cavities

Abstract

A phototherapeutical apparatus and method are described. The apparatus includes an ultraviolet light source, an optical guidance system, and a patient interface. The patient interface is insertable at least partially into a body cavity and is operable to apply the guided ultraviolet light to a tissue surface of a body cavity. The method includes providing the phototherapeutical apparatus, preparing for the application of the phototherapeutical apparatus, inserting the patient interface at least partially into a body cavity, and applying the ultraviolet light by the patient interface to a tissue surface of a body cavity, wherein the tissue of the body cavity has an inflammatory or a hyperproliferative disease. The inflammatory diseases include rhinitis, sinusitis and rhinosinusitis. A photochemotherapeutical method is also described, using photosensitizing substances, such as psoralen before treatment with ultraviolet light. The phototherapeutical method is also effective for the prevention of inflammatory or hyperproliferative diseases.

1 . A guide system useable to facilitate advancement of a phototherapeutical device to a position within the nasal cavity of a human or animal subject, the system comprising: 
 a. a tubular guide having a proximal end, a distal end adapted to be positioned within the nasal cavity and a lumen that extends longitudinally therethrough;    b. an endoscopic device incorporated in or attached to the tubular guide; and    c. a light source adapted to deliver a therapeutic dose of light from the distal end of the tubular guide into the nasal cavity.    
   
   
       2 . A system according to  claim 1  wherein a portion of the tubular guide is flexible.  
   
   
       3 . A system according to  claim 1  wherein the endoscopic device is attached to the exterior of the tubular guide.  
   
   
       4 . A system according to  claim 1  wherein the proximal end of the device is configured to deliver a focused light to a target area.  
   
   
       5 . The system of  claim 1 , wherein the light source is one of a laser, a fluorescent lamp, a light emitting diode, a dye laser, an arc lamp, and an electric discharge lamp, the electric discharge lamp comprising at least one of xenon, argon, and mercury vapor.  
   
   
       6 . The system of  claim 1 , further comprising a patient interface at the distal end of the tubular guide.  
   
   
       7 . The system of  claim 1 , wherein the phototherapeutical apparatus comprises: a concave mirror, reflecting a portion of the generated light; a focusing lens, operable to focus a portion of the generated light and a portion of the reflected light; an optical filter, operable to receive and filter the focused light; and a beam shutter, operable to control the generated light.  
   
   
       8 . The system according to  claim 1  wherein a portion of the tubular guide is substantially transparent.  
   
   
       9 . A method for inserting a phototherapeutical device into a target nasal cavity of a human or animal subject, the method comprising the steps of: 
 a. providing an endoscopic guide system that comprises i) a tubular guide having a proximal end, a distal end, and a lumen that extends longitudinally therethrough and ii) an endoscopic device incorporated in or attached to the tubular guide;    b. inserting the endoscopic guide system into the nasal cavity;    c. using the endoscopic guide system to guide the placement of the distal end of the tubular guide within the nasal cavity; and    d. advancing the phototherapeutical device though the lumen of the tubular guide and into the nasal cavity.    
   
   
       10 . A method according to  claim 9  wherein the endoscopic device wherein Step C further comprises obtaining a visual image through the endoscope.  
   
   
       11 . The method of  claim 9  wherein the endoscopic guide system further comprises a patient interface.  
   
   
       12 . The method of  claim 9  further comprising the step of applying non-coherent light comprising wavelengths less than 400 nm from the phototherapeutical apparatus onto nasal mucosa.  
   
   
       13 . The method of  claim 9  further comprising the step of applying non-coherent light comprising wavelengths less than 400 nm into a sinus cavity.  
   
   
       14 . The method of  claim 9  further comprising the step of applying non-coherent light comprising wavelengths less than 400 nm to a nasal polyp.  
   
   
       15 . A method for treating an inflammatory surface inside a nasal cavity comprising: 
 a. advancing a tubular structure into the nasal cavity, the tubular structure constructed so as to transmit ultraviolet light into the nasal cavity. b. applying ultraviolet light from the tubular structure through a patient interface to a structure within the nasal cavity. c. stopping the application of the ultraviolet light to the structure within the nasal cavity after a dose of ultraviolet light has been applied sufficiently to decrease the inflammatory response in the cells of the structure within the nasal cavity.    
   
   
       16 . The method of  claim 15  wherein the dose of ultraviolet light on the structure is between 20mJ/cm 2  to 100 mJ/cm 2 .  
   
   
       17 . The method of  claim 15  further comprising visualizing the tubular structure as it is applying the therapeutic dose of ultraviolet light.  
   
   
       18 . A method of treating a structure of a nasal cavity of a patient comprising the steps: 
 a. advancing a flexible, tubular structure at least partially into the nasal cavity, the flexible tubular structure enabling guidance to the structure of the nasal cavity,    b. applying energy to the structure of the nasal cavity through the flexible tubular structure.    
   
   
       19 . A method of treating a structure of a nasal cavity of a patient comprising the steps: 
 a. advancing a tubular structure at least partially into the nasal cavity, the tubular structure enabling guidance to the structure of the nasal cavity.    b. Applying therapeutic light energy to the structure of the nasal cavity through the tubular structure.    
   
   
       20 . The method of  claim 19  wherein the tubular structure further comprises a tissue interface.  
   
   
       21 . The method of  claim 20  wherein the interface is adapted to apply a spot treatment to a surface of the nasal mucosa.  
   
   
       22 . The method of  claim 19  wherein the light energy is ultraviolet light energy.  
   
   
       23 . The method of  claim 19  wherein the structure of the nasal cavity is a polyp.  
   
   
       24 . The method of  claim 19  wherein the structure of the nasal cavity is sinus cavity.  
   
   
       25 . The method of  claim 19  wherein the tubular structure is an endoscope.  
   
   
       26 . The method of  claim 19  further comprising the step of applying a photodynamic treatment to the nasal cavity prior to or during the step of advancing the tubular structure at least partially into the nasal cavity.