Surgical guide and method for guiding a therapy delivery device into the pterygopalatine fossa

Abstract

A surgical guide to facilitate delivery of a therapy delivery device into the pterygopalatine fossa of a subject includes a curvilinear body having a distal end portion, a proximal end portion, and an intermediate portion extending between the distal and proximal end portions. The proximal end portion is defined by oppositely disposed first and second surfaces. The proximal end portion and the intermediate portion define a longitudinal plane that extends between the proximal and distal end portions. The distal end portion has an arcuate configuration relative to the longitudinal plane and is defined by oppositely disposed third and fourth surfaces.

1 - 29 . (canceled) 
     
     
         30 . A surgical guide configured to deliver a neurostimulator into a subject comprising:
 a curvilinear body comprising a proximal end portion and a contoured distal end portion, the contoured distal end portion shaped and configured to be advanced under a zygomatic bone along a maxillary tuberosity towards a pterygopalatine fossa.   
     
     
         31 . (canceled) 
     
     
         32 . The surgical guide of  claim 30 , further comprising an intermediate portion extending between the distal and proximal end portions, the proximal end portion being defined by oppositely disposed first and second surfaces, the proximal end portion and the intermediate portion defining a longitudinal plane that extends between the proximal and the distal end portions, the distal end portion having an arcuate configuration relative to the longitudinal plane and being defined by oppositely disposed third and fourth surfaces. 
     
     
         33 . The surgical guide of  claim 32 , wherein the third surface has a flattened cross-sectional shape and the fourth surface has an elliptical cross-sectional shape. 
     
     
         34 . (canceled) 
     
     
         35 . (canceled) 
     
     
         36 . (canceled) 
     
     
         37 . The surgical guide of  claim 32 , wherein the third surface has a concave shape relative to the longitudinal plane, and the fourth surface has a convex shape relative to the longitudinal plane. 
     
     
         38 . (canceled) 
     
     
         39 . A method of treating a medical condition in a subject comprising:
 receiving a neurostimulator through a tunnel created by a surgical guide, the tunnel extending between a gingival-buccal insertion site and a craniofacial location of the subject, the neurostimulator comprising:
 a controller; and 
 an electrical lead extending from the controller and including an electrode; and 
   delivering an electrical current to a target site in the craniofacial location to treat the medical condition.   
     
     
         40 . The method of  claim 39 , wherein the craniofacial location is a pterygopalatine fossa (PPF) of the subject. 
     
     
         41 . The method of  claim 39 , wherein the target site is a sphenopalatine ganglion (SPG) of the subject. 
     
     
         42 . The method of claim  1 , wherein the medical condition is pain, a movement disorder, epilepsy, a cerebrovascular disease, an autoimmune disease, a sleep disorder, an autonomic disorder, a urinary bladder disorder, an abnormal metabolic state, a disorder of the muscular system, a neuropsychiatric disorder, an infectious or parasitic disease, a neoplasm, an endocrine disease, a nutritional or metabolic disease, an immunological disease, a disease of the blood or blood-forming organs, a mental disorder, a disease of the nervous system, a disease of the sense organs, a disease of the circulatory system, a disease of the respiratory system, a disease of the digestive system, a disease of the genitourinary system, a disease of the skin or subcutaneous tissue, a disease of the musculoskeletal system or connective tissue, a congenital anomaly, or a condition originating in the perinatal period. 
     
     
         43 . The method of  claim 42 , wherein the movement disorder is caused by Parkinson's disease, cerebral palsy, dystonia, essential tremor, or a hemifacial spasm. 
     
     
         44 . The method of  claim 42 , wherein the epilepsy is generalized or partial. 
     
     
         45 . The method of  claim 42 , wherein the cerebrovascular disease is caused by an aneurysm, a stroke, or a cerebral hemorrhage. 
     
     
         46 . The method of  claim 42 , wherein the autoimmune disease is multiple sclerosis. 
     
     
         47 . The method of  claim 42 , wherein the sleep disorder is caused by sleep apnea or a parasomnia. 
     
     
         48 . The method of  claim 42 , wherein the autonomic disorder is caused by a gastrointestinal disorder. 
     
     
         49 . The method of  claim 42 , wherein the autonomic disorder is caused by autonomic insufficiency. 
     
     
         50 . The method of  claim 42 , wherein the autonomic disorder is caused by a cardiovascular disorder. 
     
     
         51 . The method of  claim 42 , wherein the urinary bladder disorder is caused by a spastic or a flaccid bladder. 
     
     
         52 . The method of  claim 42 , wherein the abnormal metabolic state is caused by hyperthyroidism or hypothyroidism. 
     
     
         53 . The method of  claim 42 , wherein the disorder of the muscular system is caused by muscular dystrophy, a spasm of the upper respiratory tract, or a spasm of the face. 
     
     
         54 . The method of  claim 42 , wherein the neuropsychiatric or mental disorder is caused by depression, schizophrenia, bipolar disorder, or obsessive-compulsive disorder. 
     
     
         55 . The method of  claim 39 , further comprising delivering power to the controller via an external power source.