Sinus ablation devices, methods, and systems
An embodiment of the invention concerns systems, devices, and methods for minimally invasive sinus mucosal restorative techniques. Such an embodiment may remove persistent mucosal disease while protecting bony structures of sinus cavities from damage. For example, guard members may keep ablation electrodes a set distance away from sinus bone. This may preserve healthy tissue over the bone to thereby facilitate healing while ablating the disease tissue.
1. A method comprising:
inserting a wand into a patient's sinus that has a diseased mucosal lining covering bone;
expanding the wand inside the sinus by deploying first and second guard members, each of the first and second guard members being coupled to the wand;
connecting outer portions of the first and second guard members respectively with first and second portions of the mucosal lining to directly compress the first and second portions of the mucosal lining against the bone so a third portion of the mucosal lining, which is not directly compressed by any guard member, lays between the compressed first and second portions of the mucosal lining; and
while compressing the first and second portions of the mucosal lining, simultaneously (a) ablating the third portion of the mucosal lining with an ablation electrode, coupled to the wand, and (b) maintaining the outer portions of the first and second guard members between an outer portion of the ablation electrode and the bone to preserve the bone.
2. The method of claim 1 including inserting the wand through the patient's sinus ostium, past the ucinate process area, into the maxillary sinus, and then ablating the third portion of the mucosal lining.
3. The method of claim 1 , wherein the first guard member is included in a first spline coupled to the wand and the second guard member is included in a second spline coupled to the wand, and the method further includes expanding the first and second splines within the sinus.
4. The method of claim 1 , wherein the first and second guard members are included in a mesh and the method further includes deploying and expanding the mesh only after inserting the mesh inside the sinus.
5. The method of claim 1 , wherein the wand couples to a sinuplasty balloon and the method further includes expanding the sinuplasty balloon in the patient's sinus ostium to expand the sinus ostium.
6. The method of claim 1 , wherein the first and second guard members are included in a window and the third portion of the mucosal lining projects, at least partially, through the window and toward the ablation electrode while ablating the third portion of the mucosal lining.
7. The method of claim 1 , wherein the third portion of the mucosal lining includes one of a polyp and chronically diseased sinus lining.
8. The method of claim 3 , wherein the ablation electrode is included on a surface of a balloon, and the method further comprises:
fully expanding the balloon entirely within the expanded first and second splines; and
preventing the balloon from expanding outside the outer portions of the first and second guard members.
9. The method of claim 1 , wherein the deployed first and second guard members are separated from each other by a maximum first breadth and the ablation electrode includes a maximum second breadth greater than the maximum first breadth to ensure the ablation electrode cannot pass between the deployed first and second guard members and ablate too closely to the bone.
10. The method of claim 1 including pressing the ablation electrode against inner portions of the first and second guard members while ablating the third portion of the mucosal lining.
11. The method of claim 1 comprising:
contacting the ablation electrode to one of the first and second guard members; and
automatically discontinuing ablating the third portion of the mucosal lining upon contacting the ablation electrode to the one of the first and second guard members.
12. The method of claim 1 comprising:
expanding the wand inside the sinus by deploying a third guard member that is coupled to the wand;
connecting an outer portion of the third guard member with a fourth portion of the mucosal lining to directly compress the fourth portion of the mucosal lining against the bone so a fifth portion of the mucosal lining, which is not directly compressed by any guard member, lays between the compressed fourth and second portions of the mucosal lining;
while compressing the fourth and second portions of the mucosal lining, simultaneously ablating the third and fifth portions of the mucosal lining with one or more of the ablation electrode and an additional ablation electrode, the additional ablation electrode coupled to the wand.
13. The method of claim 12 comprising ablating the third portion of the mucosal lining, located away from the superior sinus wall, at a first energy level and ablating the fifth portion of the mucosal lining, located along the superior sinus wall, at a second energy level lower than the first energy level.
14. The method of claim 12 , wherein the third and fifth portions of the mucosal lining are collectively included in a diffuse diseased mucosal lining.
15. The method of claim 1 comprising guiding the ablation electrode along a track, included in the wand, until the ablation electrode contacts one of the first and second guard members.
16. The method of claim 10 , wherein the first guard member is longer than 0.5 mm and the first and second guard members are low energy conducting insulators, and the method further includes ablating the third portion of the mucosal lining without aid of simultaneous endoscopic visualization.
17. The method of claim 1 including sensing the ablation electrode is in contact with the third portion of the mucosal lining before ablating the third portion of the mucosal lining.
18. An apparatus comprising:
a wand;
first and second guard members coupled to the wand; and
an ablation electrode coupled to the wand;
wherein the wand is configured so (a) in a first position the wand is compressed to slide within a patient's nasal passage; and (b) in a second position the wand is located in the patient's sinus and the first and second guard members are expanded to connect outer portions of the first and second guard members respectively with first and second portions of the mucosal lining to directly compress the first and second portions of the mucosal lining against the bone so a third portion of the mucosal lining, which is not directly compressed by any guard member, lays between the compressed first and second portions of the mucosal lining while a user simultaneously (i) ablates the third portion of the mucosal lining with an ablation electrode, coupled to the wand, and (ii) maintains the outer portions of the first and second guard members between an outer portion of the ablation electrode and the bone to preserve the bone.
19. The apparatus of claim 18 , wherein the first guard member is included in a first spline coupled to the wand and the second guard member is included in a second spline coupled to the wand.
20. The apparatus of claim 19 , wherein the ablation electrode is included on a surface of a balloon so when the balloon is fully expanded the expanded balloon fits entirely within the expanded first and second splines and is prevented from deploying outside the outer portions of the first and second guard members.
21. The method of claim 3 , wherein the ablation electrode is included in an array of electrodes on a surface of a balloon, and the method further comprises simultaneously expanding the balloon and deploying the first and second guard members, the first and second guard members being fixedly coupled to the balloon.
22. The method of claim 3 including:
abrading the sinus with a brush coupled to the wand; and
applying a fluid to the sinus via a lumen coupled to the wand.