Abstract:
An apparatus, system, and method are disclosed for facilitating intranasal administration of a medication to a patient&#39;s sphenopalatine/pterygopalatine recess. The apparatus includes a catheter having a lumen disposed therethrough, the catheter comprising an insertion end and a manipulation end, the insertion end having an intrinsic curvature with respect to a longitudinal axis of the catheter such that the insertion end of the catheter lies in a first plane and the manipulation end lies in a second plane, wherein the catheter smoothly transitions between the first plane and the second plane, the intrinsic curvature conforming to a patients nasal anatomy such that the catheter may be inserted into a sphenopalatine/pterygopalatine recess. The apparatus also includes a straightening member configured to removably engage the catheter. The straightening member straightens the intrinsic curvature such that the first plane and the second plane are aligned when the catheter is engaged by the straightening member.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a divisional of U.S. patent application Ser. No. 12/553,953 filed on Sep. 3, 2009, which claims the benefit of U.S. Provisional Application 61/094,323 filed on Sep. 4, 2008. The entire disclosures of application Ser. Nos. 12/553,953 and 61/094,323 are incorporated herein by reference, as if fully set forth herein. 
     FIELD OF ART 
     This invention relates to parasympathetic nerve blockade and more particularly relates to blockade of sphenopalatine/pterygopalatine ganglia. 
     BACKGROUND OF THE ART 
     Sympathetic pain is a type of nerve pain that arises due to abnormalities in the function of the sympathetic nervous system. With sympathetic pain an abnormality in a group of nerves called a ganglion cause pain to an organ or body region. To treat sympathetic pain physicians can block a ganglion with the injection of medication into a specific area of the body. To therapeutically treat acute pain a physician injects a local anesthetic into the affected neuronal ganglion. This type of treatment may be referred to as a nerve block. 
     The sphenopalatine/pterygopalatine ganglia is a neuronal structure located principally in the center of the head in the pterygopalatine fossa posterior to the middle turbinate. The sphenopalatine/pterygopalatine ganglia comprises the largest cluster of sympathetic neurons in the head outside of the brain. The sphenopalatine/pterygopalatine ganglia interfaces and directs nerve impulses to the majority of the head&#39;s autonomic or parasympathetic pathways. Therefore, any abnormality or injury to this structure may cause severe pain. A nerve block of the sphenopalatine/pterygopalatine ganglia is effective in relief in a variety of pain conditions ranging from headache to lower back pain. Additionally, other disease processes such as headache disorders and other neurological conditions can be arrested, or improved by local anesthetic blockade, and/or other pharmacological augmentation or mechanical alteration of the sphenopalatine/pterygopalatine ganglia and surrounding structures. 
     Unfortunately, because of the anatomical position of the sphenopalatine/pterygopalatine ganglia, the structure is very difficult to block with a local anesthetic solution. The anatomical location of the sphenopalatine/pterygopalatine ganglia is dangerously close to many vital and delicate mid brain structures. Although direct needle placement can be employed under fluoroscopic guidance to administer anesthetic to the sphenopalatine/pterygopalatine ganglia, most practitioners will not attempt the procedure due to the technical difficulty and extreme dangers of an aberrant needle placement. 
     SUMMARY 
     From the foregoing discussion, it should be apparent that a need exists for an apparatus, system, and method for treating parasympathetic nerve pain in the sphenopalatine/pterygopalatine ganglia. Beneficially, such an apparatus, system, and method would administer medication directly to the sphenopalatine/pterygopalatine ganglia. 
     The present invention has been developed in response to the present state of the art, and in particular, in response to the problems and needs in the art that have not yet been fully solved by currently available local anesthetic blockade methods, systems and apparatus for administering medication to a patient&#39;s sphenopalatine/pterygopalatine ganglia. Accordingly, the present invention has been developed to provide an apparatus, system, and method for performing a nerve block of the sphenopalatine/pterygopalatine ganglia that overcome many or all of the above-discussed shortcomings in the art. 
     The apparatus, in one embodiment, includes a catheter, a straightening member, a spray orifice and a medication delivery port. In certain embodiments the catheter has a lumen disposed therethrough. The catheter includes an insertion end and a manipulation end. The insertion end of the catheter has an intrinsic curvature with respect to a longitudinal axis of the catheter such that the insertion end of the catheter lies in a first plane and the manipulation end lies in a second plane. The catheter smoothly transitions between the first plane and the second plane such that the intrinsic curvature is rounded and conforms to a patient&#39;s nasal anatomy. In certain embodiments the intrinsic curvature allows the catheter to be inserted into a sphenopalatine/pterygopalatine recess with minimum discomfort to the patient. 
     In one embodiment the straightening member is configured to removably engage the catheter. The straightening member straightens the intrinsic curvature of the insertion end such that the first plane and the second plane are aligned when the catheter is engaged by the straightening member. Thus, with the intrinsic curvature of the catheter straightened, the catheter can easily be inserted into a patients nasal cavity. 
     The spray orifice is located adjacent to the insertion end of the catheter. The spray orifice is in fluid communication with the lumen which is in communication with the medication delivery port. The medication delivery port is located adjacent to the manipulation end of the catheter and is configured to receive a medication and deliver the medication through the lumen to the spray orifice. 
     The apparatus, in one embodiment, also includes a second lumen. The straightening member in certain embodiments includes a stylus configured to be received within the second lumen. In one embodiment the stylus is keyed to fit within the second lumen in one predefined orientation. In such an embodiment the stylus may identity a direction of the intrinsic curvature when the stylus is disposed within the second lumen. The stylus may also include a finger tab for manipulating the catheter. 
     In another embodiment the straightening member may be a sleeve configured to receive the catheter. In such an embodiment the sleeve may be configured to straighten the intrinsic curvature of the catheter when the catheter is received within the sleeve. 
     In one embodiment the apparatus may also include a rotational direction indicator that identifies a direction of the intrinsic curvature when the catheter is placed within the patient&#39;s nasal cavity. Thus, a physician may be able to identify the rotational direction of the spray orifice without being able to see the spray orifice or intrinsic curvature. Similarly, in certain embodiments the apparatus may include a depth indicator located on the catheter to identifying a defined depth. In one embodiment the defined depth is a depth equaling a distance between an entrance to a patient&#39;s sphenopalatine/pterygopalatine recess and an external entrance to the patient&#39;s nostril. In certain embodiments the apparatus includes a second depth indicator located on the catheter. The second depth indicator may identify a second defined depth. The second defined depth may be a depth equaling a distance between a location at a posterior position within a patient&#39;s sphenopalatine/pterygopalatine recess and an external entrance to the patient&#39;s nostril. In one embodiment the depth indicators are moveable on the catheter so that a physician can adjust a position of the depth indicator according to a patient&#39;s nasal anatomy. In another embodiment the depth indicators may be preposition to identify the typical distance between a patient&#39;s external opening of a nostril and the patient&#39;s sphenopalatine/pterygopalatine recess. The typical distance between a patient&#39;s external opening of a nostril and the patient&#39;s sphenopalatine/pterygopalatine recess may vary according to a patient&#39;s gender or age. 
     A method of the present invention is also presented for treating migraines. The method in the disclosed embodiments substantially includes the steps necessary to carry out the functions presented above with respect to the operation of the described apparatus. In one embodiment, the method includes inserting a catheter and a straightening member into a nostril of a patient, advancing the catheter and the straightening member past a middle sinus turbinate in the nostril of the patient. The catheter includes an insertion end and a manipulation end. The insertion end has an intrinsic curvature with respect to a longitudinal axis of the catheter such that the insertion end of the catheter lies in a first plane and the manipulation end lies in a second plane. The catheter smoothly transitions between the first plane and the second plane with the intrinsic curvature conforming to a patient&#39;s nasal anatomy. This allows the catheter to easily be inserted into a sphenopalatine/pterygopalatine recess. The straightening member removably engages the catheter and straightens the intrinsic curvature of the insertion end such that the first plane and the second plane are aligned when the catheter is engaged by the straightening member. 
     The method also may include removing the straightening member from the catheter such that the catheter bends in a direction towards a sphenopalatine/pterygopalatine recess of the patient and advancing the catheter into the sphenopalatine/pterygopalatine recess. In certain embodiments the method also includes dispensing a medication to a sphenopalatine/pterygopalatine ganglia disposed within the sphenopalatine/pterygopalatine recess of the patient. 
     In a further embodiment, the method includes identifying a direction of the intrinsic curvature and aligning the intrinsic curvature of the catheter with the patient&#39;s sphenopalatine/ptervgopalatine recess. In another embodiment the method includes identifying a defined depth of the catheter. In one embodiment the defined depth is a depth equaling a distance between an entrance to a patient&#39;s sphenopalatine/pterygopalatine recess and an external entrance to the patient&#39;s nostril. 
     Reference throughout this specification to features, advantages, or similar language does not imply that all of the features and advantages that may be realized with the present invention should be or are in any single embodiment of the invention. Rather, language referring to the features and advantages is understood to mean that a specific feature, advantage, or characteristic described in connection with an embodiment is included in at least one embodiment of the present invention. Thus, discussion of the features and advantages, and similar language, throughout this specification may, but do not necessarily, refer to the same embodiment. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In order that the advantages of the invention will be readily understood, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments that are illustrated in the appended drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings, in which: 
         FIG. 1  is a cutaway view illustrating one embodiment of the facial anatomy of a patient upon which the apparatus, system and method of the present invention may be employed; 
         FIG. 2  is a cutaway view illustrating a prior art method of treating headaches; 
         FIG. 3  is a cutaway view illustrating a prior art method of treating headaches; 
         FIG. 4  is a side view illustrating one embodiment of a sphenocath apparatus for treating headaches in accordance with the present invention; 
         FIG. 5A  is a side view illustrating one embodiment of a sphenocath apparatus with a stylus inserted into a lumen to straighten the sphenocath in accordance with the present invention; 
         FIG. 5B  is a side view illustrating one embodiment of a sphenocath with a stylus partially removed from the lumen such that the sphenocath curves according to an intrinsic curvature in accordance with the present invention; 
         FIG. 5C  is a side view illustrating one embodiment of a sphenocath apparatus with a catheter having an intrinsic curvature received within a sleeve to straighten the intrinsic curvature in accordance with the present invention; 
         FIG. 5D  is a side view illustrating one embodiment of a sphenocath with a catheter having an intrinsic curvature partially removed from a sleeve such that the intrinsic curvature curves in accordance with the present invention; 
         FIG. 6A  is a cutaway view illustrating one embodiment of a catheter with a keyed lumen in accordance with the present invention; 
         FIG. 6B  is a cutaway view illustrating one embodiment of a catheter with three lumens in accordance with the present invention; 
         FIG. 6C  is a cutaway view illustrating one embodiment of a catheter with four lumens in accordance with the present invention; 
         FIG. 7  is a cutaway view illustrating one embodiment of a sphenocath inserted within the nasal cavity of a patient in accordance with the present invention; 
         FIG. 8  is a cutaway view illustrating one embodiment of a sphenocath advanced into the sphenopalatine/pterygopalatine recess of a patient in accordance with the present invention; and 
         FIG. 9  is a side view illustrating one embodiment of a sphenocath apparatus for treating headaches in accordance with the present invention; 
         FIG. 10  is a schematic block diagram illustrating one embodiment of a method for treating headaches in accordance with the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Reference throughout this specification to “one embodiment,” “an embodiment,” or similar language means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases “in one embodiment,” “in an embodiment,” and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment. 
     Furthermore, the described features, structures, or characteristics of the invention may be combined in any suitable manner in one or more embodiments. In the following description, numerous specific details are provided to provide a thorough understanding of embodiments of the invention. One skilled in the relevant art will recognize, however, that the invention may be practiced without one or more of the specific details, or with other methods, components, materials, and so forth. In other instances, well-known structures, materials, or operations are not shown or described in detail to avoid obscuring aspects of the invention. 
     The schematic flow chart diagrams included herein are generally set forth as logical flow chart diagrams. As such, the depicted order and labeled steps are indicative of one embodiment of the presented method. Other steps and methods may be conceived that are equivalent in function, logic, or effect to one or more steps, or portions thereof, of the illustrated method. Additionally, the format and symbols employed are provided to explain the logical steps of the method and are understood not to limit the scope of the method. Although various arrow types and line types may be employed in the flow chart diagrams, they are understood not to limit the scope of the corresponding method. Indeed, some arrows or other connectors may be used to indicate only the logical flow of the method. For instance, an arrow may indicate a waiting or monitoring period of unspecified duration between enumerated steps of the depicted method. Additionally, the order in which a particular method occurs may or may not strictly adhere to the order of the corresponding steps shown. 
       FIG. 1  is an illustration of the environment in which the present invention may be practiced. In particular,  FIG. 1  depicts a cutaway view of the anatomical features of a typical human nasal cavity. One skilled in the art will recognize that certain anatomical features and structures of the human nasal cavity have been omitted to avoid obscuring the structures relevant to the practice of the current invention. To help orient the reader, the mouth  106  is illustrated with teeth  108  and tongue  110 . The anatomical structures relevant to the practice of the current invention include the palate  100  which separates the oral cavity  102  from the nasal cavity  104 , the inferior sinus turbinate  112 , the middle sinus turbinate  114  and tlhe superior sinus turbinate  116  as well as the nasal bone  122 . The middle sinus turbinate  114  and superior sinus turbinate  116  define the sphenopalatine/pterygopalatine recess  118 . Deep within the sphenopalatine/pterygopalatine recess  118  at the posterior  124  of the sphenopalatine/pterygopalatine recess  118  lies the sphenopalatine/pterygopalatine ganglia  120 . 
     One skilled in the art will recognize that the medical community is not uniform in the terminology with regard to the sphenopalatine or pterygopalatine ganglia. Certain practitioners use sphenopalatine while others use pterygopalatine. Therefore, the present description will refer to the ganglia labeled  120  as the sphenopalatine/pterygopalatine ganglia  120 . Similarly, the recess labeled  118  will be referred to as the sphenopalatine/pterygopalatine recess  118 . However, this terminology is in no way limiting on the structure for which the present invention is intended. Where practitioners or scientist differentiate between the sphenopalatine ganglia or the pterygopalatine ganglia, the present disclosure will be understood to apply to either structure. 
     Sympathetic pain is a type of nerve pain that arises due to abnormalities in the function of the sympathetic nervous system. The majority of the “treatment resistant” headache population in the world suffers from what is now properly identified as “Sympathetic Mediated Cephalgia” a particular type of sympathetic pain. With sympathetic pain an abnormality in a group of nerves called a ganglion cause pain to an organ or body region. To treat sympathetic pain physicians can block a ganglion with the injection of medication into a specific area of the body. To therapeutically treat acute pain a physician injects a local anesthetic into the affected neuronal ganglion. This type of treatment may be referred to as a nerve block. 
     The sphenopalatine/pterygopalatine ganglia  120  is a neuronal structure located principally in the center of the head in the pterygopalatine fossa posterior to the middle turbinate  114 . The sphenopalatine/pterygopalatine ganglia  120  comprises the largest cluster of sympathetic neurons in the head outside of the brain. The sphenopalatine/pterygopalatine ganglia  120  interfaces and directs nerve impulses to the majority of the head&#39;s autonomic or parasympathetic pathways. Therefore, any abnormality or injury to this structure may cause severe pain. A nerve block of the sphenopalatine/pterygopalatine ganglia  120  is effective in relief in a variety of pain conditions ranging from headache to lower back pain. Additionally, other disease processes such as headache disorders and other neurological conditions can be arrested, or improved by local anesthetic blockade, and/or other pharmacological augmentation or mechanical alteration of the sphenopalatine/pterygopalatine ganglia  120  and surrounding structures. 
     Unfortunately, because of the anatomical position of the sphenopalatine/pterygopalatine ganglia  120 , the structure is very difficult to block with a local anesthetic solution. The anatormical location of the sphenopalatine/ptervgopalatine ganglia  120  is dangerously close to many vital and delicate mid brain structures. Although direct needle placement can be employed under fluoroscopic guidance to administer anesthetic to the sphenopalatine/pterygopalatine ganglia  120 , most practitioners will not attempt the procedure due to the technical difficulty and extreme dangers of an aberrant needle placement. 
     As shown in the prior art illustration depicted in  FIG. 2 , the sphenopalatine/pterygopalatine ganglia  120  lies deep within the sphenopalatine/pterygopalatine recess  118 . Conventional methods undertaken by pain specialists, neurologists, and neurosurgeons, include the use of an eight inch cotton-tipped applicator  200  saturated with a local anesthetic. Because a cotton-tipped applicator  200  is used, the procedure is referred to as the “Q-tip” procedure. The cotton-tipped applicator  200  is soaked in a vial of concentrated local anesthetic solution. In certain embodiments the anesthetic solution is lidocaine, cocaine, etidocaine or prilocalne, or other non-specified local anesthetic agents. The cotton-tipped applicator  200  is then advanced into the nostril  202  and through the nasal cavity  104 . To reach the sphenopalatine/pterygopalatine ganglia  120  in the sphenopalatine/pterygopalatine recess  118 , the cotton-tipped applicator  200  must be advanced into the nasal cavity  104  past the middle sinus turbinate  114  and into the sphenopalatine/pterygopalatine recess  118 . 
       FIG. 3  illustrates the tortuous path the cotton-tipped applicator  200  of the prior art must traverse to reach the sphenopalatine/pterygopalatine recess  118 . To perform the procedure the patient is placed in a supine position. The cotton-tipped applicator  200  is soaked in a vial of concentrated local anesthetic solution. The physician then inserts the cotton-tipped applicator  200  into the patients nostril  202  and through the nasal cavity  104 . Advancing the straight, rigid cotton-tipped applicator  200  into the sphenopalatine/pterygopalatine recess  118  can be difficult and painful for the patient as the cotton-tipped applicator  200  must be inserted almost parallel to the patient&#39;s face to clear the anterior ridge  302  of the middle sinus turbinate  114 . The cotton-tipped applicator  200  must then make an almost 90° bend to avoid the inferior surface  304  of the nasal bone  122  and access the sphenopalatine/pterygopalatine recess  118 . The cotton-tipped applicator  200  is left in the patient&#39;s sphenopalatine/ptervgopaiatine recess  118  for approximately minutes to allow diffusion of the local anesthetic through the sinus mucosa to depolarize the sphenopalatine/pterygopalatine ganglia  120  to block nerve transmission. 
     The use of a straight and rigid cotton-tipped applicator  200  that must make some fairly tortuous directional changes around some very sensitive, richly vascular, friable, highly innervated structures complicates the procedure to the point that many practitioners will not attempt it. Known complications include extreme patient discomfort, nosebleeds and the complications associated with nosebleeds including venous-irritating nuisances, arterial hemorrhaging, aspiration, hematochezia or even death. Other complications include local anesthetic toxicity, seizure, iatrogenic foreign bodies such as a broken cotton-tipped applicator  200 , sinus mucosal tears and infection. 
     Anesthetic blockade of any neuronal structure requires direct physical interaction between the anesthetic solution and the targeted tissue. Therefore, to work, the cotton-tipped applicator  200  must deliver the anesthetic solution directly to the sphenopalatine/pterygopalatine ganglion  120 . The correct placement of the cotton-tipped applicator  200  is technically challenging and many practitioners simply miss the desired structure, the sphenopalatine/pterygopalatine ganglion  120  when attempting to perform the procedure. To help make the complicated bend required to reach the sphenopalatine/pterygopalatine recess  118  many practitioners will soak the top 2 inches of the cotton-tipped applicator  200  and manipulate the stem to render it flexible so that the patient is less agitated and bleeding risks are lessened. Even with a flexible cotton-tipped applicator  200  the procedure is difficult. Common failure placements include the inferior surface  304  of the nasal bone  122  and the anterior ridge  302  of the middle sinus turbinate  114 . When the cotton-tipped applicator  200  is misplaced, a “wring-out” effect may occur wherein the anesthetic is wrung out of the cotton-tipped applicator before it is delivered to the sphenopalatine/pterygopalatine ganglion  120  resulting in an ineffective procedure. Further, as discussed above, the rich vascular and neuronal structure of the nasal cavity  104  makes any misplacement of the cotton-tipped applicator  200  both dangerous and painful. 
       FIG. 4  illustrates a sphenocath  400  including a catheter  402  having an insertion end  405  and a manipulation end  407 . In certain embodiments the catheter  402  includes multiple lumens  401  and  403 . The catheter  402  has an intrinsic curvature  404 , a spray orifice  406 , depth indicators  408 , a straightening member  409  such as stylus  410  with a pull tab  412 , a medication delivery port  414 , a syringe  416 , a rotational direction indicator  418  and a rotation tab  420 . 
     In certain embodiments the sphenocath  400  comprises a soft sialastic double lumen catheter  402  which is about 24 cm long. One of skill in the art will recognize that the length of the catheter  402  may be varied according to the anatomy of the patient. One of the lumens  401  or  403  is configured to deliver an anesthetic or medication to the sphenopalatine/pterygopalatine recess  118 . In certain embodiments the other lumen  401  or  403  is closed distally approximately 1.5 cm from spay orifice  406 . For example, in certain embodiments lumen  401  comprises a housing for stylus  410  and is closed at its distal end near the spray orifice  406 . The stylus  410  is slideably received within the lumen  401  and may be removed from within the lumen  401  by pulling on the pull tab  410 . 
     As discussed in further detail below with reference to  FIGS. 7 and 8 , the sphenocath  400  is inserted into the nasal cavity  104  of a patient lying in a supine position. Depth indicators  408  identify when the sphenocath  400  has been inserted into a patients nasal cavity  104  at a depth sufficient to pass the middle sinus turbinate  114 . In certain embodiments additional depth indicators (not shown) may indicate a depth sufficient to identify when the tip of the sphenocath  400  is within the sphenopalatine/pterygopalatine recess  118 . One skilled in the art will appreciate that depth indicators  408  may vary depending on anatomical variables of the patient such as age and/or gender. The depth indicators  408  may comprise a visual cue such as a line or other such indicator or the depth indicators  408  may comprise a physical structure configured to arrest further insertion of the sphenocath  400 . In certain embodiments the sphenocath  400  may be individually sized to fit only one size of a patient. Thus, the sphenocath  400 , in certain embodiments, may comprise a large, medium or small size to be used with patients with large, medium or small anatomies. In another embodiment the depth indicators  408  are adjustable such that the depth indicators  408  can be slid along the sphenocath  400  to a position which indicates a depth sufficient to identify when the tip of the sphenocath  400  is within the sphenopalatine/pterygopalatine recess  118  of a particular patient. 
     The intrinsic curvature  404  of the catheter  402  causes the catheter  402  to bend such that the insertion end  405  of the catheter  402  lies in a first plane as indicated by line  411  while the manipulation end  407  of the catheter  402  lies in a second plane as indicated by line  413 . The catheter  402  smoothly transitions between the first plane  411  and the second plane  413  such that the intrinsic curvature  404  conforms to a patient&#39;s nasal anatomy. The intrinsic curvature  404  allows the catheter  402  to be inserted into a patient&#39;s sphenopalatine/pterygopalatine recess  118  to direct a medication to the patient&#39;s sphenopalatine/pterygopalatine ganglia  120 . 
     Rotational direction indicator  418  identifies the rotational configuration of the sphenocath  400 . Because the end of the sphenocath  400  has an intrinsic curvature  404 , it is beneficial for the physician to know which direction the curvature is pointing to manipulate the sphenocath  400  into the sphenopalatine/pterygopalatine recess  118 . In certain embodiments the rotational direction indicator  418  is configured to signal the physician that the intrinsic curvature  404  and thus the spray orifice  406  is pointing in a downward angle when the rotational direction indicator  418  is pointing up. While the embodiment illustrated in  FIG. 4  shows the rotational direction indicator  418  as a separate structure, one skilled in the art will recognize that the rotational direction may simply be a line on top of the sphenocath indicating which direction the spray orifice  406  is pointing. In one embodiment, such as the embodiment shown in  FIG. 4 , the rotational direction indicator  418  may also comprise a rotation tab  420  to assist the physician in manipulating the sphenocath  400  into the sphenopalatine/pterygopalatine recess  118  by providing the physician a leverage point to rotate the sphenocath  400  and align the spray orifice with the sphenopalatine/pterygopalatine recess  118  or sphenopalatine/ptervgopalatine ganglia  120 . 
     Once the sphenocath  400  is manipulated into the sphenopalatine/pterygopalatine recess  118  the syringe  416  injects an antithetic or medication into the medication delivery port  414  and through one of the lumens  401  or  403 . The spray orifice  406  is in fluid communication with the lumen ( 401  or  403 ) that receives the medication, thus, as the physician injects or dispenses the medication into medication delivery port, the medication travels through the lumen ( 401  or  403 ), through the spray orifice  406 , and into the sphenopalatine/pterygopalatine recess  118 . One skilled in the art will recognize that any metered medicinal or anesthetic delivery means may be substituted for the syringe  416  without departing from the scope of the present invention. 
     The spray orifice  406  may be configured to deliver a stream of medication or anesthetic. In one embodiment the spray orifice  406  may be configured to disperse the medication or anesthetic such that the area surrounding the sphenopalatine/pterygopalatine ganglia  120  is completely saturated with anesthetic or medication. In certain embodiments the spray orifice  406  may be configured to administer the medication or anesthetic in a controlled fine mist. Further, one of skill in the art will recognize that in certain embodiments the spray orifice  606  may be adjustable such that the physician may dispense the medication in a broader or narrower pattern as dictated by the procedure and the patient&#39;s nasal anatomy. 
       FIG. 5A  illustrates one embodiment of the catheter  402  portion of the sphenocath  400  with a rigid member  501  inserted into one of the lumens  401  or  403 . The rigid member  501  in the embodiments illustrated in  FIGS. 5A and 5B  is a stylus  410  inserted into lumen  401  such that the sphenocath  400  is forced straight by the stylus  410 . The stylus  410  comprises a rod, wire other rigid device having sufficient strength to straighten the intrinsic curve  404  of the catheter  402 . With the sphenocath  410  straightened the catheter  402  can be inserted into the nasal cavity  104  until it reaches a point past the anterior ridge  302  of the middle sinus turbinate  114 . 
       FIG. 5B  illustrates an embodiment of the catheter  402  portion of the sphenocath  400  with the rigid member  501 , in this case the stylus  410 , partially removed from lumen  401 . As the stylus  410  is removed from lumen  401 , the catheter  402  bends due to the intrinsic curvature  404  of the catheter  402 . Thus, once the sphenocath  400  has been inserted deep enough into the patient&#39;s nasal cavity  104  such that the tip has passed the middle sinus turbinate  114 , the stylus  410  is withdrawn from lumen  401  to allow the catheter to bend at the intrinsic curvature  404 . The sphenocath  400  may then be inserted all the way into the sphenopalatine/pterygopalatine recess  118  to deliver the anesthetic or medication to the sphenopalatine/pterygopalatine ganglia  120  or surrounding anatomical structure. In certain embodiments the radius of the intrinsic curvature  404  is sufficient to allow the catheter  402  to bend within the nasal cavity  104  to align the spray orifice  406  with the sphenopalatine/pterygopalatine recess  118 . In one embodiment the intrinsic curvature  404  may bend between about 450 and about 90° to allow the catheter  402  to be placed within the sphenopalatine/pterygopalatine recess  118  without hitting the inferior surface  304  of the nasal bone  122  of the patient. 
       FIG. 5C  illustrates another embodiment of the catheter  402  portion of the sphenocath  400  with a rigid member  501  which surrounds the catheter  402 . In this embodiment, the rigid member  501  is a sleeve  504  surrounding the catheter  402 . In certain embodiments the sleeve  504  is sufficiently rigid to straighten the intrinsic curvature  404  when the catheter  402  is received within the sleeve  504 . One of skill in the art will recognize that in certain embodiments, such as where a sleeve  504  is used in place of a stylus  410 , the sphenocath  400  may include a single lumen catheter  402  rather than the multiple lumren catheter  402  illustrated in  FIGS. 5A-5D . As discussed below with reference to  FIGS. 6A-6C , in other embodiments, the catheter  402  may be configured with as many additional lumenas as may be required for additional complex procedures such as fiber optics for visually guiding the catheter into the sphenopalatine/pterygopalatine recess  118  or vacuum tubes configured to aspirate substances from within the sphenopalatine/pterygopalatine recess  118 . 
       FIG. 5D  illustrates an embodiment of the catheter  402  portion of the sphenocath  400  with the sleeve  504  partially withdrawn from the catheter  402  to expose the intrinsic curvature  404  of the catheter  402 . As the sleeve  504  is removed from catheter  402  in the direction of arrow  506  the intrinsic curvature  404  of the catheter is no longer straightened by the sleeve  504 . Therefore, the catheter  402  bends at the intrinsic curvature  404 . Thus, once the sphenocath  400 , including the sleeve  504 , has been inserted deep enough into the patient&#39;s nasal cavity  104  such that the spray orifice  406  has passed the middle sinus turbinate  114 , the sleeve  504  is withdrawn from catheter  402  to allow the catheter to bend at the intrinsic curvature  404 . The sphenocath  400  may then be inserted all the way into the sphenopalatine/pterygopalatine recess  118  to deliver the anesthetic or medication to the sphenopalatine/ptervgopalatine ganglia  120  or surrounding anatomical structure. 
       FIG. 6A  through  FIG. 6C  illustrate various embodiments of a cross section of the catheter  402  of the sphenocath  400 . In certain embodiments, such as the embodiment illustrated in  FIG. 6A  one of the lumens may be keyed to receive the stylus  410  in only one direction such as lumen  602 . By keying lumen  602  to receive the stylus  410  in only one configuration, the pull tab of the stylus  410 , such as pull tab  502  of  FIGS. 5A and 513 , may be configured to indicate the rotational direction of the spray orifice  406 . Further, by keying one of the lumens to receive the stylus  410  in only one direction the entire sphenocath  400  may be rotated by the pull tab  502 . Thus, in certain embodiments the rotational direction indicator  418  and a rotation tab  420  may be omitted where one of the lumens is keyed to receive the stylus  410  in only one direction. While the catheter  402  illustrated in  FIG. 6   a  comprises a round structure with two lumens  602  and  604 , one skilled in the art will recognize the catheter  402  structure may comprise any number of shapes such as the shapes illustrated in  FIGS. 6B and 6C . One skilled in the art will recognize that the shape illustrated in  FIG. 6A  through  FIG. 6C  are for illustrative purposes only and are in no way limiting of the shapes which may comprise the catheter  402  and lumens  602 ,  604 ,  606 ,  608 ,  610 ,  612 ,  614 ,  616 ,  618  and  620 . 
     In certain embodiments an additional orientation identifier  622  may be disposed on the top surface of the catheter  402 . In one embodiment the orientation identifier  622  serves as an additional visual cue to assists the physician in determining the rotational orientation of the sphenocath  400  so that the physician will know which direction the intrinsic curvature  404  will bend when the stylus  410  is removed. 
     In the embodiments illustrated in  FIG. 6A  the catheter  402  comprises two lumens  602  and  604 . In the embodiment illustrated in  FIG. 6B  the catheter  402  comprises three lumens  606 ,  608  and  610  and in the embodiment illustrated in  FIG. 6C  the catheter  402  comprises four lumens  612 ,  614 ,  618  and  620 . One skilled in the art will recognize that the catheter  402  may be configured with as many additional lumens as may be required for additional complex procedures such as fiber optics for visually guiding the catheter into the sphenopalatine/pterygopalatine recess  118  or vacuum tubes configured to aspirate substances from within the sphenopalatine/pterygopalatine recess  118 . 
       FIG. 7  illustrates one embodiment of the present invention wherein the sphenocath  400  is inserted through the nostril  202  into the nasal canal  104  and past the anterior ridge  302  of the middle sinus turbinate  114 . To maintain a straight sphenocath  400  the stylus  410  is fully inserted into lumen  401  (note that either lumen  401  or  403  may be configured to receive the stylus  410 ). Depth indicator  408  is configured to signal the physician when the spray orifice  406  of the sphenocath  400  is sufficiently deep enough within the patient&#39;s nasal cavity  104  to clear the anterior ridge  302  of the middle sinus turbinate  114 . 
       FIG. 8  illustrates one embodiment of the present invention wherein spray orifice  406  of the sphenocath  400  has passed the middle sinus turbinate  114  and the stylus  410  has been partially withdrawn from within lumen  401 . As the stylus is withdrawn from lumen  401  the catheter  402  bends due to intrinsic curvature  404  of the catheter  402 . The sphenocath  400  can then be further inserted into the nasal cavity  104  deeper within the sphenopalatine/pterygopalatine recess  118 . In certain embodiments a second depth indicator  802  may be disposed on the sphenocath  400  to identify the correct depth for administering the anesthetic or medication to the sphenopalatine/pterygopalatine ganglia  120  or surrounding anatomical structure. Once the sphenocath  400  is inserted to the correct depth the syringe  416  or other dispensing means delivers a desired amount of medication or anesthetic into the medication delivery port  414 , through the lumen  403  to be dispersed at the spray orifice  406  to the sphenopalatine/pterygopalatine ganglia  120 . Because the patient is in a supine position the medication or anesthetic pools in the sphenopalatine/ptervgopalatine recess  118 . 
     The schematic flow chart diagram that follows is generally set forth as a logical flow chart diagram. As such, the depicted order and labeled steps are indicative of one embodiment of the presented method. Other steps and methods may be conceived that are equivalent in function, logic, or effect to one or more steps, or portions thereof, of the illustrated method. Additionally, the format and symbols employed are provided to explain the logical steps of the method and are understood not to limit the scope of the method. Although various arrow types and line types may be employed in the flow chart diagrams, they are understood not to limit the scope of the corresponding method. Some arrows or other connectors may be used to indicate only the logical flow of the method. For instance, an arrow may indicate a waiting or monitoring period of unspecified duration between enumerated steps of the depicted method. Additionally, the order in which a particular method occurs may or may not strictly adhere to the order of the corresponding steps shown. 
       FIG. 9  illustrates another embodiment of a sphenocath  900  having a catheter  902  portion which includes an intrinsic curvature  904  near an insertion end  906  and a rotation tab  908  near a manipulation end  910 . In certain embodiments the sphenocath  900  also includes a medication delivery port  912  located near the manipulation end  910  and a spray orifice  914  located at the insertion end  906 . 
     In the embodiment illustrated in  FIG. 9 , the medication delivery port  912  includes a Luer fitting  916  keyed to fit a syringe (not shown). The medication delivery port  912  is fluidly connected to the catheter  902  portion through a stylet tube  918 . In certain embodiments the stylet tube  918  is sufficiently rigid to straighten the intrinsic curvature  904  in the insertion end  906  of the catheter  902  when the stylet tube  918  is inserted into the catheter  902  in the direction of arrow  920 . As the stylet tube  918  is withdrawn from the catheter  902  in a direction opposite arrow  920 , past a point where the stylet tube  918  support the intrinsic curvature  904 , the catheter  902  bends due to the intrinsic curvature  904 . For example, once the stylet tube  918  is withdrawn from the catheter  902  past a certain point (such as point  922 ) the catheter  902  bends in the direction shown due to the intrinsic curvature  904 . In certain embodiments the catheter  902  may begin to bend immediately as the stylet tube  918  is withdrawn from the catheter  902 . In other embodiments catheter  902  only bends once the stylet tube  918  has been removed past a point  922  where the intrinsic curvature  904  begins. 
     In certain embodiments the manipulation end  910  of the spenocath  900  includes a rotation tab  908  for directing the spray orifice  914  in the direction of the sphenopalatine/pterygopalatine recess  118  when the spray orifice  914  has passed the middle sinus turbinate  114 . The rotation tab  908  may be aligned with the intrinsic curvature  904  in a predefined orientation to signal to the physician the direction of the spray orifice  916  when the sphenocath  900  is disposed within a patient&#39;s nasal cavity  104 . As discussed above, the sphenocath  900  may include depth indicators  924  to signal a proper depth within the nasal cavity  104  to insert the sphenocath  900  into sphenopalatine/pterygopalatine recess  118 . 
       FIG. 10  is a schematic flow chart diagram illustrating one embodiment of a method  1000  for treating sympathetic mediated cephalgia (headaches.) In one embodiment the method starts  1002  and the patient is placed in a supine position. In certain embodiments, the patient may already be in the supine position. In other embodiments, the physician may wish to administer the treatment with the patient in a standing or seated position and thus, this step may be omitted. 
     The physician inserts  1006  a stylus, such as stylus  410  into a lumen within a sphenocath such as the sphenocath  400  of  FIG. 4 . The stylus  410  may act to straighten the sphenocath  400  to allow for easy insertion into a patients nasal cavity  104 . In certain embodiments the stylus  410  may already be inserted within the lumen and thus this step may be omitted. 
     The sphenocath  400  is inserted  1008  into the patient&#39;s nostril  202  and advanced through the nasal cavity  104  to a position wherein the spray orifice  406  of the sphenocath  400  has passed the middle sinus turbinate  114 . The stylus  410  is withdrawn  1010  from the sphenocath  400  such that the sphenocath  400  curves due to an intrinsic curvature  404  of the catheter  402 . The sphenocath  400  is advanced  1012  into the sphenopalatine/pterygopalatine recess  118 . Anesthetic is dispensed  1014  into the sphenopalatine/pterygopalatine recess  118 . 
     The anesthetic may cause a temporary loss of sensation in the nasal cavity and may, in certain instances, drain into the patients throat causing a loss of sensation in the patients throat. Therefore, in certain embodiments the physician may monitor  1016  the patient in the supine position for a period of time to make sure that the patient does not have any adverse reactions to the anesthetics. In one embodiment the patient may be observed  1018  to determine the efficacy of the procedure and the method ends  1020 . 
     The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the bforegoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.