Apparatus and methods for treating rhinitis

Abstract

Apparatus and methods for treating conditions such as rhinitis are disclosed herein where a distal end of a probe shaft is introduced through the nasal cavity where the distal end has an end effector with a first configuration having a low-profile which is shaped to manipulate tissue within the nasal cavity. The distal end may be positioned into proximity of a tissue region having a post nasal nerve associated with a middle or inferior nasal turbinate. Once suitably positioned, the distal end may be reconfigured from the first configuration to a second configuration which is shaped to contact and follow the tissue region and the post nasal nerve may then be ablated via the distal end. Ablation may be performed using various mechanisms, such as cryotherapy, and optionally under direct visualization.

What is claimed is: 
     
         1 . A system for applying RF energy in a nasal region of a human patient, the system comprising:
 a shaft having a proximal portion and a distal portion, wherein the shaft is configured to locate the distal portion at a target site in a nasal cavity, wherein the target site is at least one of proximate to a sphenopalatine foramen of a human patient, or inferior to the sphenopalatine foramen;   a therapeutic assembly at the distal portion of the shaft and transformable between a low-profile delivery state and an expanded state, wherein the therapeutic assembly comprises:   a plurality of struts arranged in at least two branches radially spaced apart from each other when the therapeutic assembly is in the expanded state;   a plurality of electrodes disposed on the struts;   wherein the therapeutic assembly is configured to conform to anatomical structures adjacent to the target site and to place at least two of the electrodes in contact with tissue at the target site when the therapeutic assembly is in the expanded state, and   wherein the electrodes are configured to apply radiofrequency (RF) energy to the target site to therapeutically treat at least one nasal nerve.   
     
     
         2 . The system of  claim 1 , wherein the electrodes are configured to operate in a monopolar, bipolar, or multipolar fashion. 
     
     
         3 . The system of  claim 1 , wherein the electrodes are configured to be individually connectable to different poles of an RF generator. 
     
     
         4 . The system of  claim 1 , wherein the plurality of struts comprise two struts arranged in two opposing branches. 
     
     
         5 . The system of  claim 4 , wherein in the expanded state the two struts form a T-shape with the shaft. 
     
     
         6 . The system of  claim 5 , wherein in the low-profile delivery state the struts are parallel with the shaft. 
     
     
         7 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy for decreasing or interrupting parasympathetic nerve signals. 
     
     
         8 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy for treatment of at least one symptom of rhinitis. 
     
     
         9 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy for electrical neuro-stimulation of the at least one nasal nerve. 
     
     
         10 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy for electrical neuro-blockade of the at least one nasal nerve. 
     
     
         11 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy for electrical neuro-stimulation or electrical neuro-stimulation of the nasal nerve in order to determine locations of the at least one nasal nerves at the target site. 
     
     
         12 . The system of  claim 11 , wherein the locations of the at least one nasal nerves at the target site are detected based on a physiological response. 
     
     
         13 . The system of  claim 1 , further comprising a Doppler flow sensor at the distal end, wherein the Doppler flow sensor is configured to locate a blood vessel associated with the at least one nasal nerve. 
     
     
         14 . The system of  claim 1 , wherein the at least one nasal nerve comprises a posterior nasal nerve, a vidian nerve or branches or portions thereof, a parasympathetic nerve, a greater palatine nerve or branches or portions thereof, a maxillary nerve or branches or portions thereof, a nerve branch or portion of a sphenopalatine ganglion, or a posterolateral nerve or branches or portions thereof. 
     
     
         15 . The system of  claim 1 , wherein the electrodes are configured to apply the RF energy to ablate the at least one nasal nerve. 
     
     
         16 . The system of  claim 1 , wherein the target site is located intraluminally in an upper airway of a human patient 
     
     
         17 . The system of  claim 1 , wherein the target site is at microforamina of a palatine bone of the human patient. 
     
     
         18 . A method for applying RF energy in a nasal region of a human patient, the method comprising:
 inserting a distal end of a surgical probe into a nasal cavity of a patient through a nostril of the patient in a low-profile delivery state, wherein the surgical probe comprises a shaft, and an therapeutic assembly coupled to the distal end, and wherein the therapeutic assembly comprises a plurality of struts arranged in at least two branches radially spaced apart from each other when the therapeutic assembly is in an expanded state, and a plurality of electrodes disposed on the struts;   advancing the distal end of the surgical probe into the nasal cavity with the therapeutic assembly in the low-profile delivery state;   transitioning the therapeutic assembly from the low-profile delivery state to the expanded state;   positioning the therapeutic assembly in the expanded state at a target site proximate or inferior to a sphenopalatine foramen of a human patient; and   applying radiofrequency (RF) energy with the electrodes to the target site to therapeutically treat at least one nasal nerve.   
     
     
         19 . The method of  claim 18 , wherein applying RF energy comprises operating the electrodes in a monopolar, bipolar, or multipolar fashion. 
     
     
         20 . The method of  claim 18 , further comprising individually connecting the electrodes to different poles of an RF generator. 
     
     
         21 . The method of  claim 18 , wherein the plurality of struts comprise two struts arranged in two opposing branches. 
     
     
         22 . The method of  claim 21 , wherein in the expanded state the two struts form a T-shape with the shaft. 
     
     
         23 . The method of  claim 22 , wherein in the low-profile delivery state the struts are parallel with the shaft. 
     
     
         24 . The method of  claim 18 , wherein applying RF energy comprises decreasing or interrupting parasympathetic nerve signals. 
     
     
         25 . The method of  claim 18 , wherein applying RF energy comprises treating at least one symptom of rhinitis. 
     
     
         26 . The method of  claim 18 , wherein applying RF energy comprises electrical neuro-stimulation of the at least one nasal nerve. 
     
     
         27 . The method of  claim 18 , wherein applying RF energy comprises electrical neuro-blockade of the at least one nasal nerve. 
     
     
         28 . The method of  claim 18 , wherein applying RF energy comprises electrical neuro-stimulation or electrical neuro-stimulation of the nasal nerve in order to determine locations of the at least one nasal nerves at the target site. 
     
     
         29 . The method of  claim 28 , further comprising detecting the locations of the at least one nasal nerves at the target site based on a physiological response. 
     
     
         30 . The method of  claim 18 , further comprising detecting a Doppler flow signal with a Doppler flow sensor at the distal end to locate a blood vessel associated with the at least one nasal nerve. 
     
     
         31 . The method of  claim 18 , wherein the at least one nasal nerve comprises a posterior nasal nerve, a vidian nerve or branches or portions thereof, a parasympathetic nerve, a greater palatine nerve or branches or portions thereof, a maxillary nerve or branches or portions thereof, a nerve branch or portion of a sphenopalatine ganglion, or a posterolateral nerve or branches or portions thereof. 
     
     
         32 . The method of  claim 18 , wherein applying RF energy comprises ablating the at least one nasal nerve. 
     
     
         33 . The method of  claim 18 , wherein the target site is at microforamina of a palatine bone of the human patient.