Cryogenic Blunt Dissection Methods and Devices

Abstract

A point of incision is created within tissue, the tissue having a temporoparietal fascia-deep temporoparietal fascia layer (TPF-sDTF) beneath skin and a temporal branch of a target nerve extending along a portion of the TPF-sDTF, the point of incision being laterally displaced from the target nerve. A cryogenic probe having a distal tip extending from an elongated body is inserted into the point of incision. The TPF-sDTF is bluntly dissected using the cryogenic probe such that a treating portion of the cryogenic probe is directly adjacent to a first treatment portion of the target nerve. The cryogenic probe is activated to create a first treatment zone at the first treatment portion of the target nerve to cause a therapeutic effect.

What is claimed is: 
     
         1 . A method comprising:
 creating a point of incision within tissue, the tissue comprising a temporoparietal fascia-deep temporoparietal fascia layer (TPF-sDTF) beneath skin and a temporal branch of a target nerve extending along a portion of the TPF-sDTF, the point of incision being laterally displaced from the TB-FN;   inserting a cryogenic probe having a distal tip extending from an elongated body into the point of incision;   bluntly dissecting the TPF while moving the cryogenic probe over the sDTF to place a treating portion of the cryogenic probe adjacent to a first treatment portion of the target nerve; and   activating the cryogenic probe to create a first treatment zone at the first treatment portion of the target nerve to cause a therapeutic effect.   
     
     
         2 . The method of  claim 1 , wherein the elongated body is placed such that it traverses across the first treatment portion of the target nerve. 
     
     
         3 . The method of  claim 2 , wherein the first treatment zone emanates from a distinct portion of the elongated body. 
     
     
         4 . The method of  claim 1 , wherein the distal tip is placed such that it is located at the first treatment portion of the target nerve. 
     
     
         5 . The method of  claim 4 , wherein the cooling treatment zone emanates from the distal tip. 
     
     
         6 . The method of  claim 1 , further comprising relocating the treating portion of the cryogenic probe to a second treatment portion of the target nerve, and activating the cryogenic probe to create a second cooling treatment zone at the second treatment portion of the target nerve to further the therapeutic effect. 
     
     
         7 . The method of  claim 6 , wherein the second treatment zone is adjacent to the first treatment zone. 
     
     
         8 . The method of  claim 6 , wherein the second treatment zone overlaps with the first treatment zone. 
     
     
         9 . The method of  claim 1 , wherein the first treatment portion is directly beneath a visible area of the skin, and wherein the incision is directly beneath a portion of scalp covered by hair. 
     
     
         10 . The method of  claim 1 , wherein the target nerve is the temporal branch of a facial nerve. 
     
     
         11 . The method of  claim 1 , wherein the target nerve is a sensory nerve. 
     
     
         12 . A method comprising:
 creating a point of incision within tissue, the tissue comprising a temporoparietal fascia-deep temporoparietal fascia layer (TPF-sDTF) beneath skin and a temporal branch of a facial nerve (TB-FN) extending along a portion of the TPF-sDTF, the point of incision being laterally displaced from the TB-FN;   inserting a cryogenic probe having a distal tip extending from an elongated body into the point of incision;   bluntly dissecting the TPF-sDTF using the cryogenic probe such that a treating portion of the cryogenic probe is directly adjacent to the TB-FN; and   repeatedly moving and activating the treating portion of the cryogenic probe such that a plurality of treatment zones is created across the TB-FN.   
     
     
         13 . The method of  claim 12 , wherein the elongated body is placed such that it traverses across the TB-FN. 
     
     
         14 . The method of  claim 12 , wherein the cooling treatment zone emanates from a distinct portion of the elongated body. 
     
     
         15 . The method of  claim 12 , wherein the distal tip is placed such that it is located at the first treatment portion of the TB-FN. 
     
     
         16 . The method of  claim 15 , wherein the cooling treatment zone emanates from the distal tip. 
     
     
         17 . The method of  claim 12 , wherein the plurality of treatment zones comprises a treatment fence across the TB-FN. 
     
     
         18 . The method of  claim 12 , wherein the plurality of treatment zones comprises a treatment plane across the TB-FN. 
     
     
         19 . The method of  claim 12 , wherein the plurality of treatment zones comprises at least two treatment zones. 
     
     
         20 . The method of  claim 12 , wherein each treatment zone of the plurality of treatment zones is spatially separated from each other. 
     
     
         21 . The method of  claim 12 , wherein each treatment zone of the plurality of treatment zones overlaps with one another. 
     
     
         22 . The method of  claim 12 , wherein the first treatment portion is directly beneath a visible area of the skin, and wherein the incision is directly beneath a portion of scalp covered by hair. 
     
     
         23 . A system comprising:
 a probe body;   an elongated probe having a blunt distal tip; and   a cryogen supply tube extending within the elongated probe, wherein the elongated probe and supply tube are configured to resiliently bend.   
     
     
         24 . The system of  claim 23 , wherein the elongated probe is 15 gauge or smaller in diameter. 
     
     
         25 . The system of  claim 23 , wherein the elongated probe is 20-30 mm in diameter. 
     
     
         26 . The system of  claim 23 , wherein the elongated probe is over 30 mm in length. 
     
     
         27 . The system of  claim 23 , wherein the elongated probe is 30-150 mm in length. 
     
     
         28 . The system of  claim 23 , wherein the elongated probe and cryogen supply tube are configured to resiliently bend at a first portion of the elongated probe an angle up to 120°. 
     
     
         29 . The system of  claim 28 , wherein a second portion of the elongated probe is configured to resiliently bend to a lesser degree than the first portion. 
     
     
         30 . The system of  claim 23 , further comprising a coolant supply source coupled to the supply tube. 
     
     
         31 . The system of  claim 23 , wherein the supply tube comprises a fused silica tube having a reinforcement portion. 
     
     
         32 . The system of  claim 23 , further comprising a cannula curved to assist in directing the elongated probe into a desired tissue layer coincident with predetermined pathway. 
     
     
         33 . A method comprising:
 creating a point of incision within tissue, the tissue comprising skin, a layer of soft tissue and a layer of resilient tissue,   inserting a cryogenic probe having a distal tip extending from an elongated body into the point of incision;   bluntly dissecting the soft tissue using the cryogenic probe such that a treating portion of the cryogenic probe is directly adjacent to the resilient layer;   advancing the cryogenic probe along the resilient layer; and   repeatedly moving and activating the treating portion of the cryogenic probe such that a plurality of treatment zones is created across a nerve adjacent to the resilient layer.   
     
     
         34 . The method of  claim 33 , wherein the soft tissue layer is comprised of adipose tissue, muscle, and/or subcutaneous tissue. 
     
     
         35 . The method of  claim 33 , wherein the layer of resilient tissue is a fascia layer. 
     
     
         36 . The method of  claim 33 , wherein the layer of resilient tissue is cartilage, periosteum, or bone.