Methods and Devices for Alleviating Disorders Associated with Sinus Cavities

Abstract

Generally, abnormal pressures in the sinus cavity can have physiological effects due to stimulation or injury of various nerves that are in proximity to the sinus, including increased or decreased pressure on the nerves as well as extrusion of the nerves into the sinus cavities due to bony dehiscence. Methods and devices for alleviating disorders associated with the sinus cavities are described. Embodiments herein include diagnosing these disorders by occluding or restricting the sinus ostium and assessing the physiological effects caused by the occlusion/restriction and treating these disorders by navigating/directing a dilating device to the sinus ostium and dilating the sinus ostium. Other embodiments are directed to devices for maintaining the ostial opening.

1 - 22 . (canceled) 
     
     
         23 . A method for diagnosing chronic neurogenic sinusitis comprising:
 obtaining a medical image of an individual, wherein the medical image comprises an image of a sinus cavity;   identifying an anatomical feature within the sinus cavity, wherein the anatomical structure is selected from one or more of: pneumatization, ostium size, dehiscence, injury, remodeling, inflammation, and irritation; and   identifying neurogenic sinusitis in the individual, wherein neurogenic sinusitis is characterized by anatomical features that allow for stimulation of at least one nerve due to an abnormal barometric pressure within the sinus cavity.   
     
     
         24 . The method of  claim 23 , wherein identifying an anatomical feature within the sinus cavity utilizes at least one of artificial intelligence and machine learning to identify the anatomical feature. 
     
     
         25 . The method of  claim 23 , wherein identifying an anatomical feature within the sinus cavity utilizes at least one of artificial intelligence and machine learning to access the effect and degree of pressure change within the sinus cavity. 
     
     
         26 . The method of  claim 23 , wherein the medical image is obtained by at least one of the following: a camera, an endoscope, a telescope, MRI, CT, PET, X-ray and an image guided surgery system. 
     
     
         27 . The method of  claim 23 , wherein at least one of the anatomical features identified is the ostium size and wherein the effect of the ostium size and location on pressure and ventilation within the sinus cavity is calculated by a computer assisted algorithm. 
     
     
         28 . The method of  claim 23 , wherein at least one of the anatomical features identified is the ostium size and wherein an ideal ostium size needed to normalize pressure and ventilation within the sinus cavity is determined by computer assisted algorithm. 
     
     
         29 . The method of  claim 23 , wherein identifying neurogenic sinusitis comprises determining the size of at least one anatomical feature. 
     
     
         30 . The method of  claim 29 , wherein determining the size of at least one anatomical feature comprises determining a pneumatization of the sinus cavity. 
     
     
         31 . The method of  claim 30 , wherein determining the size of at least one anatomical feature further comprises determining an ostium size of the sinus cavity. 
     
     
         32 . The method of  claim 31 , wherein identifying neurogenic sinusitis further comprises identifying a smaller than average ostium and sinus cavity hyperpneumatization, wherein the smaller than average ostium increases a risk of abnormal pressure within the sinus cavity, and wherein hyperpneumatization of the sinus cavity increases a risk of an exposed nerve susceptible to stimulation due to the abnormal pressure caused by the smaller than average ostium. 
     
     
         33 . The method of  claim 32 , wherein the sinus cavity is selected from the sinus group consisting of the sphenoid, frontal, maxillary, and ethmoid. 
     
     
         34 . The method of  claim 32 , wherein the exposed nerve is selected from: a trigeminal nerve, a vidian nerve; an optical nerve; a cranial nerve II, a cranial nerve III, a cranial nerve IV, a cranial nerve V, a cranial nerve VI; a direct fibers from cranial nerve II, a direct fibers from cranial nerve III, a direct fibers from cranial nerve IV, a direct fibers from cranial nerve V, a direct fibers from cranial nerve VI, a direct fibers from cranial nerve VII, a direct fibers from cranial nerve IX, a direct fibers from cranial nerve X, and combinations thereof. 
     
     
         35 . The method of  claim 31 , wherein identifying neurogenic sinusitis comprises identifying an occluded ostium and sinus cavity hyperpneumatization, wherein the smaller than average ostium increases a risk of abnormal pressure within the sinus cavity, and wherein hyperpneumatization of the sinus cavity increases a risk of an exposed nerve susceptible to stimulation due to the abnormal pressure caused by the occluded ostium. 
     
     
         36 . The method of  claim 35 , wherein the sinus cavity is selected from the sinus group consisting of the sphenoid, frontal, maxillary, and ethmoid. 
     
     
         37 . The method of  claim 36 , wherein the exposed nerve is selected from: a trigeminal nerve, a vidian nerve; an optical nerve; a cranial nerve II, a cranial nerve III, a cranial nerve IV, a cranial nerve V, a cranial nerve VI; a direct fibers from cranial nerve II, a direct fibers from cranial nerve III, a direct fibers from cranial nerve IV, a direct fibers from cranial nerve V, a direct fibers from cranial nerve VI, a direct fibers from cranial nerve VII, a direct fibers from cranial nerve IX, a direct fibers from cranial nerve X, and combinations thereof 
     
     
         38 . The method of  claim 31 , identifying neurogenic sinusitis comprises modeling sinus ventilation based on the size of the ostium and pneumatization of the sinus cavity, wherein subnormal ventilation prevents pressure normalization, and increases risk of abnormal pressure within the sinus cavity and increases a risk of an exposed nerve susceptible to stimulation due to the abnormal pressure. 
     
     
         39 . The method of  claim 23 , further comprising:
 manipulating a barometric pressure within the sinus cavity of an individual, wherein manipulating the barometric pressure comprises:
 occluding all ostia associated with the sinus cavity; and 
 changing the barometric pressure within the sinus cavity; and 
   assessing one or more of neuropathy and neuralgia of the individual, wherein a change of severity of at least one of the one or more of neuropathy and neuralgia due to the manipulated barometric pressure indicates the individual possesses neurogenic sinusitis.   
     
     
         40 . The method of  claim 23 , further comprising:
 manipulating a change in a barometric pressure within the sinus cavity comprising:
 occluding at least one ostia associated with the sinus cavity, and 
 changing the barometric pressure within the sinus cavity; and 
   assessing one or more of a neuropathy and a neuralgia of the individual, wherein a change of severity of at least one of the one or more of neuropathy and neuralgia due to the manipulated barometric pressure indicates neurogenic sinusitis in the individual.   
     
     
         41 . The method of  claim 40 , wherein occluding at least one ostia comprises placing a restricting device in all ostia associated with the sinus cavity. 
     
     
         42 . The method of  claim 41 , wherein the restricting device is selected from the group consisting of a plug, a balloon, and a dam. 
     
     
         43 . The method of  claim 40 , wherein changing the barometric pressure is accomplished using a syringe, a vacuum, or a bulb. 
     
     
         44 . A method of treating chronic neurogenic sinusitis comprising:
 obtaining a medical image of an individual, wherein the medical image comprises an image of a sinus cavity;   identifying an anatomical feature within the sinus cavity, wherein the anatomical structure is selected from one or more of: pneumatization, ostium size, dehiscence, injury, inflammation, bony remodeling and irritation;   identifying neurogenic sinusitis in the individual, wherein neurogenic sinusitis is characterized by anatomical features that allow for stimulation of at least one nerve due to an abnormal barometric pressure within the sinus cavity; and   dilating the sinus ostium of the individual to at least 3 mm, wherein dilating the sinus ostium relieves the abnormal barometric pressure within the sinus cavity, wherein relieving the abnormal barometric pressure within the sinus cavity alleviates at least one of the one or more of neuropathy and neuralgia.   
     
     
         45 . The method of  claim 44 , further comprising navigating a dilating device to the sinus ostium of an individual by:
 inserting a dilating device into a nostril; and   passing the dilating device through the nasal cavity.   
     
     
         46 . The method of  claim 44 , wherein the medical image is obtained by at least one of the following: a camera, an endoscope, a telescope, MRI, CT, PET, X-ray and an image guided surgery system.