Methods and devices to treat nasal airways
Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.
1 . A method for treating a nasal cavity of a patient, the method comprising:
advancing a treatment element of a treatment device into a nostril of the patient;
contacting multiple electrodes on the treatment element with mucosa lining the nasal cavity;
measuring tissue impedance in the mucosa and the submucosal tissue between a first electrode of the multiple electrodes and a second electrode of the multiple electrodes, using an impedance sensor in a control system coupled with the treatment device;
determining, with the control system, at least one of an amount of time to deliver radiofrequency energy or an amount of the radiofrequency energy to deliver, based on the tissue impedance; and
delivering radiofrequency energy from the first electrode of the multiple electrodes, through the mucosa, into a submucosal tissue, and then to the second electrode of the multiple electrodes, while leaving at least a third electrode of the multiple electrodes in an inactive state,
wherein delivering the radiofrequency energy from the first electrode to the second electrode changes a property of the submucosal tissue.
2 . The method of claim 1 , further comprising delivering radiofrequency energy from the third electrode, through the mucosa, into the submucosal tissue, and then to a fourth electrode of the multiple electrodes.
3 . The method of claim 2 , further comprising delivering radiofrequency energy from a fifth electrode of the multiple electrodes, through the mucosa, into the submucosal tissue, and then to a sixth electrode of the multiple electrodes while leaving at least one of the first electrode or the third electrode in the inactive state.
4 . The method of claim 1 , wherein contacting the multiple electrodes with the mucosa comprises expanding multiple pre-shaped segments of the treatment element, and wherein each of the multiple pre-shaped segments has at least two of the multiple electrodes attached to it.
5 . The method of claim 4 , wherein the first electrode and the second electrode are located on a first segment of the multiple pre-shaped segments.
6 . The method of claim 5 , wherein the first electrode, the second electrode, the third electrode, and a fourth electrode of the multiple electrodes are located on the first segment.
7 . The method of claim 1 , further comprising:
delivering radiofrequency energy from the third electrode to a fourth electrode of the multiple electrodes;
measuring a first impedance in the mucosa and the submucosal tissue between the first electrode and the second electrode, using an impedance sensor in a control system coupled with the treatment device;
measuring a second impedance between the third electrode and the fourth electrode, using the impedance sensor; and
determining, with the control system, that at least one of the third electrode or the fourth electrode is not in contact with the mucosa, based on the tissue impedance.
8 . The method of claim 1 , wherein the submucosal tissue is selected from the group consisting of nerve, cartilage, and muscle.
9 . The method of claim 8 , wherein delivering the radiofrequency energy ablates nerve tissue.
10 . The method of claim 9 , further comprising determining that the patient has a nasal mucus hypersecretion condition, wherein deactivating the nerve tissue ameliorates at least one symptom of the nasal mucus hypersecretion condition.
11 . The method of claim 1 , further comprising displaying on a display of a control system an image illustrating radiofrequency energy being delivered by the treatment element.
12 . A method for treating a nasal cavity of a patient, the method comprising:
advancing a treatment element of a treatment device into a nostril of the patient;
contacting multiple electrodes on the treatment element with mucosa lining the nasal cavity;
delivering radiofrequency energy from a first electrode of the multiple electrodes, through the mucosa, into a submucosal tissue, and then to a second electrode of the multiple electrodes, while leaving at least a third electrode of the multiple electrodes in an inactive state,
delivering radiofrequency energy from the third electrode to a fourth electrode of the multiple electrodes;
measuring a first impedance in the mucosa and the submucosal tissue between the first electrode and the second electrode, using an impedance sensor in a control system coupled with the treatment device;
measuring a second impedance between the third electrode and the fourth electrode, using the impedance sensor; and
determining, with the control system, that at least one of the third electrode or the fourth electrode is not in contact with the mucosa, based on the second impedance,
wherein delivering the radiofrequency energy from the first electrode to the second electrode changes a property of the submucosal tissue.
13 . A method for treating a nasal cavity of a patient, the method comprising:
advancing a treatment element of a treatment device into a nostril of the patient;
contacting multiple electrodes on the treatment element with mucosa lining the nasal cavity; and
delivering radiofrequency energy from a first electrode of the multiple electrodes, through the mucosa, into a submucosal tissue, and then to a second electrode of the multiple electrodes, while leaving at least a third electrode of the multiple electrodes in an inactive state,
wherein the submucosal tissue comprises nerve tissue,
wherein delivering the radiofrequency energy from the first electrode to the second electrode ablates the nerve tissue.
14 . The method of claim 13 , wherein the multiple electrodes further comprise a fourth electrode, a fifth electrode, and a sixth electrode, wherein the first electrode, the second electrode, and a first output channel form a first individual subsystem, the third electrode, a fourth electrode, and a second output channel form a second individual subsystem, and a fifth electrode, a sixth electrode, and a third output channel form a third individual subsystem,
wherein the first individual subsystem, the second individual subsystem, and the third individual subsystem are configured such that a first level of radiofrequency energy provided to the first individual subsystem, a second level of radiofrequency energy provided to the second individual subsystem, and a third level of radiofrequency energy provided to the third individual subsystem are adjustable independent of one another when the first level of radiofrequency energy, the second level of radiofrequency energy, and the third level of radiofrequency energy are provided at the same time.
15 . The method of claim 13 , wherein the multiple electrodes further comprise a fourth electrode, a fifth electrode, and a sixth electrode, wherein the first electrode, the second electrode, and a first output channel form a first individual subsystem, the third electrode, a fourth electrode, and a second output channel form a second individual subsystem, and a fifth electrode, a sixth electrode, and a third output channel form a third individual subsystem,
wherein the first output channel, the second output channel, and the third output channel are configured to be electrically isolated from one another, such that a first level of radiofrequency energy provided to the first individual subsystem, a second level of radiofrequency energy provided to the second individual subsystem, and a third level of radiofrequency energy provided to the third individual subsystem are adjustable independent of one another when the first level of radiofrequency energy, the second level of radiofrequency energy, and the third level of radiofrequency energy are provided at the same time due to the electrical isolation of the first output channel, the second output channel, and the third output channel from one another.
16 . The method of claim 15 , further comprising activating the first individual subsystem to achieve a first level of radiofrequency energy; and subsequently activating the third individual subsystem to the third level of radiofrequency energy without changing the first level of radiofrequency energy.
17 . The method of claim 15 , further comprising:
measuring a first tissue impedance in the mucosa and the submucosal tissue between the first electrode and the second electrode;
measuring a third tissue impedance in the mucosa and the submucosal tissue between the fifth electrode and the sixth electrode; and
determining, with a control system, that at least one of the first electrode and second electrode and the fifth electrode and sixth electrode are in contact with the mucosa, based on the measured first tissue impedance and the measured third tissue impedance.
18 . The method of claim 17 , wherein the step of delivering the radiofrequency energy further comprises:
causing a radiofrequency generator to deliver a first level of radiofrequency energy to the first individual subsystem when the first electrode and the second electrode are in contact with the mucosa and a third level of radiofrequency energy to the third individual subsystem when the fifth electrode and the sixth electrode are in contact with the mucosa; and
adjusting the first level of radiofrequency energy delivered to the first individual subsystem independently of the third level of radiofrequency energy delivered to the third individual subsystem, wherein the first level of radiofrequency energy and the third level of radiofrequency energy are delivered concurrently.
19 . The method of claim 18 , wherein the radiofrequency generator comprises a first electrical channel, a second electrical channel, and a third electrical channel, the first electrical channel being connected to the first electrode and the second electrode by the first output channel, the second electrical channel being connected to the third electrode and the fourth electrode by the second output channel, and the third electrical channel being connected to the fifth electrode and the sixth electrode by the third output channel, wherein the first electrical channel, the second electrical channel, and the third electrical channel are configured to be electrically isolated from one another to allow for adjustment of the first level of radiofrequency energy, the second level of radiofrequency energy, and the third level of radiofrequency energy independent of one another.
20 . The method of claim 17 , further comprising:
activating the first individual subsystem to a first level of radiofrequency energy to deliver radiofrequency energy from the first electrode, through the mucosa, into a submucosal tissue, and then to the second electrode; and
activating the third individual subsystem to a third level of radiofrequency energy to deliver radiofrequency energy from the fifth electrode, through the mucosa, into a submucosal tissue, and then to the sixth electrode while maintaining the first individual subsystem in an activated state and without changing the first level of radiofrequency energy.
21 . The method of claim 17 , further comprising:
adjusting the radiofrequency energy delivered from the first electrode to the second electrode based on the measured first tissue impedance; and
independently adjusting the radiofrequency energy delivered from the fifth electrode to the sixth electrode based on the measured third tissue impedance, wherein the first electrode and the fifth electrode are activated concurrently.
22 . The method of claim 17 , further comprising:
measuring a second tissue impedance in the mucosa and the submucosal tissue between the third electrode and the fourth electrode of the multiple electrodes;
determining, with the control system, that the third electrode and fourth electrode are not in contact with the mucosa, based on the measured second tissue impedance; and
maintaining the third electrode in the inactive state.