METHOD FOR TREATING CHRONIC RHINITIS

Abstract

A method for treating patients who suffer from chronic rhinitis that is efficient and causes fewer adverse effects than known methods. This is achieved by using a handheld surgical instrument, more particularly an electrosurgical applicator, for treatment of hypertrophic nasal conchae and/or for submucosal treatment of the posterior nasal nerve (PNN) in order to reduce at least one cardinal symptom of chronic rhinitis.

Claims

1. Method for treating chronic rhinitis with a handheld surgical instrument comprising at least one electrode which is supplied with HF or RF energy via an appropriate generator, wherein a hypertrophic nasal concha and a nasal congestion are treated with the same handheld surgical instrument in a single treatment step.

2. Method for treating chronic rhinitis according to claim 1, wherein the treatment is carried out submucously.

3. Method for treating chronic rhinitis according to claim 1, wherein a monopolar or bipolar HF or RF applicator is used for manipulation of the body tissue and/or nerve tissue, wherein thermal energy is generated within the tissue as a result of an electric voltage applied to two electrodes of the HF or RF applicator.

4. Method for treating chronic rhinitis according to claim 1, wherein the treatment of the hypertrophic nasal concha is carried out over the entire length of the inferior nasal concha.

5. Method for treating chronic rhinitis according to claim 4, wherein when the applicator is pulled out of the nasal concha, the treatment is continued over the entire length of the inferior nasal concha.

6. Method for treating chronic rhinitis according to claim 1, wherein the treatment is started at a posterior end of the inferior nasal concha, at which the posterior nasal nerve is also located.

7. Method for treating chronic rhinitis according to claim 1, wherein a posterior end of the nasal concha is supplied with HF or RF energy or with thermal energy to an increased extent in order to damage the posterior nasal nerve.

8. Method for treating chronic rhinitis according to claim 1, wherein the progress or course of the method is monitored via impedance feedback.

Description

[0014] It is therefore an object of the present invention to provide a method for treating patients who suffer from chronic rhinitis that is efficient and causes fewer adverse effects than the known methods described.

[0015] A method to achieve this object is described by the measures of claim 1. Accordingly, use is made of a handheld surgical instrument, more particularly an electrosurgical applicator, for treatment of hypertrophic nasal conchae and/or for submucosal treatment of the posterior nasal nerve (PNN) in order to reduce at least one cardinal symptom of chronic rhinitis.

[0016] Preferably, the method according to the invention is carried out submucously. Through this treatment, the mucosa, which is essential for performing various functions within the nasal cavity such as filtration of air, humidification and temperature adjustment, etc., can be kept intact and the adverse effects of the treatment can thus be reduced.

[0017] The use of an individual instrument for the treatment of the two main symptoms rhinorrhoea and nasal congestion can reduce treatment costs, increase comfort for the patient, and reduce the time taken off by workers. Furthermore, this method can treat both symptoms equally as a result of the improvement in air flow. Whereas size-reduction of the nasal concha has a direct influence on the improvement in air flow by solving the problem of nasal congestion, the treatment also reduces nasal discharge at least indirectly. The best possible result can therefore be achieved by this combination of the two methods. Besides this indirect effect, the nasal nerve is also directly restricted in its action submucously as a result of ablation.

[0018] This method can be carried out by using an electrosurgical HF or RF applicator. This applicator, which is monopolar or bipolar, comprises a long shaft with an “acicular” applicator tip at the distal end. One electrode or two electrodes is/are arranged at the tip of the applicator. In the case of the exemplary embodiment of a bipolar applicator, the two electrodes are separated from one another by an insulator. The two electrodes are supplied with an electric current provided by an HF or RF generator. The RF or HF field, which is formed between the two electrodes, leads to heating of the surrounding tissue. As a result of this thermal energy being supplied, the tissue can be coagulated in a specific manner. Both by varying the thermal energy and by appropriately positioning the probe or the applicator tip, it is possible to carry out the above-described treatment with great accuracy and reliability.

[0019] In the case of the size-reduction of hypertrophic nasal conchae, the entire length of the inferior nasal concha is treated in the manner just described. This involves starting at the posterior end of the inferior nasal concha, at which the posterior nasal nerve (PNN) is also located.

[0020] The method according to the invention is based, inter alia, on the fact that the posterior end of the inferior nasal concha is supplied with HF or RF energy or thermal energy to an increased extent in order to damage the PNN, which is responsible for the increased uncontrolled nasal discharge. Due to the fact that, when the applicator is pulled out of the nasal concha, the method is continued over the entire length, nasal congestion can be treated in the same procedure. It is therefore unnecessary to perform a further procedure for the nasal congestion.

[0021] The course or progress of the method can be monitored via impedance feedback. To this end, the impedance of the tissue to be treated is determined continuously or in cycles/periodically via the applicator. By means of the impedance value thus determined, a clear statement can be made about the course of the treatment.

[0022] The advantage resulting from this treatment, that two methods are combined together, is that two main symptoms of chronic rhinitis are treatable at the same time, i.e. with the same procedure. In addition, this treatment makes it possible to achieve a direct and indirect improvement in nasal discharge. Lastly, the nasal mucosa can be maintained owing to the completely submucosal approach.