Hyaline cartilage shaping

Abstract

Disclosed embodiments include devices and methods for shaping, bending, and/or volumetrically reducing rigid cartilaginous structures, such as hyaline cartilage in the septum. In the case of septal cartilage, shaping, bending, or reducing the cartilage would be useful for reducing nasal obstruction or to improve the cosmetic appearance of the nose.

1 . A method for modifying a nasal septum of a subject's nose without forming an incision or removing tissue, the method comprising:
 injecting a substance under nasal mucosa and into contact with cartilage of the nasal septum, wherein the substance is configured to modify a property of the cartilage, and wherein the substance is selected from the group consisting of collagenase, hyaluronidase, tosyl lysyl chloromethane, trypsin, and trypsin/EDTA;   inserting an elongate treatment element of a bipolar radiofrequency energy delivery device into the subject's nose, wherein the elongate treatment element comprises two rows of bipolar electrodes;   applying force to the nasal septum with the elongate treatment element, to change a shape of the cartilage of the nasal septum;   applying radiofrequency energy to the cartilage of the nasal septum at a selected tissue depth by transmitting the radiofrequency energy from a first row of the two rows of bipolar electrodes to a second row of the two rows, while continuing to apply force to the nasal septum with the elongate treatment element; and   removing the elongate treatment element from the subject's nose, wherein the shape of the cartilage of the nasal septum remains changed after the elongate treatment element is removed.   
     
     
         2 . (canceled) 
     
     
         3 . The method of  claim 1 , wherein the substance is configured to soften the cartilage of the nasal septum. 
     
     
         4 . The method of  claim 1 , wherein the substance is configured to dissolve proteoglycan structures of the cartilage. 
     
     
         5 . The method of  claim 1 , wherein the substance comprises about 0.5 ml to about 2.5 ml of collagenase at a concentration of about 1 mg/ml to about 10 mg/ml. 
     
     
         6 . The method of  claim 1 , wherein the substance comprises between about 0.5 ml to about 2.5 ml of trypsin at a concentration of about 10 μg/ml to about 100 μg/ml. 
     
     
         7 . The method of  claim 1 , further comprising allowing the substance to reside on the nasal septum for a period of time before applying the radiofrequency energy to the cartilage of the nasal septum. 
     
     
         8 . The method of  claim 7 , wherein the period of time is between 15 minutes and 90 minutes. 
     
     
         9 . The method of  claim 7 , wherein the period of time is selected to be sufficient for the substance to create a band of degraded cartilage ranging from 100 μm to 1 mm from a surface of the cartilage. 
     
     
         10 . (canceled) 
     
     
         11 . The method of  claim 1 , wherein injecting the substance comprises injecting into a space between the nasal mucosa and the cartilage. 
     
     
         12 . The method of  claim 1 , further comprising defining an area of application of the substance by providing a physical barrier to contain the substance. 
     
     
         13 . The method of  claim 1 , wherein applying the radiofrequency energy to the cartilage of the nasal septum comprises heating the cartilage. 
     
     
         14 . The method of  claim 13 , wherein heating the cartilage of the nasal septum comprises heating the cartilage to a temperature selected to denature or deactivate the substance. 
     
     
         15 . (canceled) 
     
     
         16 . The method of  claim 1 , wherein changing the shape of the cartilage comprises correcting a deviation of the nasal septum. 
     
     
         17 .- 19 . (canceled) 
     
     
         20 . The method of claim  17 , further comprising:
 inserting a reshaping device into the patient's nose, such that a first treatment element of the reshaping device is positioned on one side of the nasal septum and a second treatment element of the reshaping device is positioned on an opposite side of the nasal septum; and   reshaping the nasal septum using the first treatment element and the second treatment element at least one of before, during or after applying the radiofrequency energy.