Hyaline cartilage shaping
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 treating a deviated nasal septum of a subject's nose, the method comprising:
injecting a substance under nasal mucosa and into contact with cartilage of the deviated nasal septum, wherein the substance is configured to modify a property of the cartilage;
inserting a channel stylus device into the subject's nose, the channel stylus device comprising;
a handle;
an elongate shaft extending from the handle;
an elongate treatment element configured to create at least one channel in the deviated nasal septum; and
multiple bipolar radiofrequency electrode pairs disposed in one line along the elongate treatment element;
applying force to the deviated nasal septum with the elongate treatment element of the channel stylus device, to create the at least one channel in the deviated nasal septum; and
delivering radiofrequency energy from the multiple bipolar radiofrequency electrode pairs of the channel stylus device to a selected tissue depth in the deviated nasal septum, to cure, deactivate, or denature the injected substance and modify the property of the cartilage of the deviated nasal septum and thus treat the deviated nasal septum.
2. The method of claim 1 , wherein the substance is selected from the group consisting of collagenase, hyaluronidase, tosyl lysyl chloromethane, trypsin, and trypsin/EDTA.
3. The method of claim 1 , wherein the substance is configured to soften the cartilage of the deviated 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 0.5 ml to 2.5 ml of collagenase at a concentration of 1 mg/ml to 10 mg/ml.
6. The method of claim 1 , wherein the substance comprises between 0.5 ml to 2.5 ml of trypsin at a concentration of 10 μg/ml to 100 μg/ml.
7. The method of claim 1 , further comprising allowing the substance to reside in contact with the cartilage for a period of time before delivering the radiofrequency energy to the deviated 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 micrometers to 1 millimeter from a surface of the cartilage.
10. The method of claim 1 , wherein injecting the substance comprises injecting the substance into the cartilage.
11. The method of claim 1 , wherein injecting the substance comprises injecting the substance into a space between the nasal mucosa and the cartilage.
12. The method of claim 1 , wherein delivering the radiofrequency energy heats the cartilage.
13. The method of claim 12 , wherein delivering the radiofrequency energy heats the cartilage to a temperature selected to denature or deactivate the substance.
14. The method of claim 12 , wherein the multiple bipolar radiofrequency electrode pairs are arranged with a center of each electrode of the electrode pairs residing along a longitudinal axis of the treatment element.
15. The method of claim 1 , wherein modifying the property of the cartilage comprises reshaping the cartilage from a deviated shape to a shape that is straighter than the deviated shape.
16. The method of claim 1 , wherein the substance is injected via an injection member on the channel stylus device.
17. The method of claim 1 , further comprising applying additional force to the deviated nasal septum with the elongate treatment element to change a shape of the cartilage during delivery of the radiofrequency energy.
18. The method of claim 1 , wherein the deviated nasal septum comprises a posterior-running deviation.
19. The method of claim 1 , further comprising removing at least a portion of the cartilage.
20. The method of claim 19 , wherein the cartilage is removed without making an incision.
21. The method of claim 1 , wherein the substance is injected via an injection member on the channel stylus device.
22. The method of claim 1 , wherein the substance is injected via an injection device that is separate from the channel stylus device.