Abstract:
Methods and devices quickly and accurately locate the sphenopalatine ganglion (SPG) while performing a sphenopalatine ganglion block procedure that introduces a medication to the SPG. The methods and devices also prevent the medication applied to the SPG from flowing down a patient&#39;s throat during the procedure.

Description:
FIELD OF THE DISCLOSURE 
       [0001]    The present disclosure relates generally to devices, methods and systems for treating headaches and cerebral neurovascular disorders, and more specifically, to devices, such as a surgical device, and methods for using such device, for delivering medication to the sphenopalatine ganglion. 
       BACKGROUND 
       [0002]    The sphenopalatine ganglion (SPG) is a collection (or bundle) of nerves that is located in a bony cavity within an individual&#39;s skull. The cavity is called the pterygopalatine fossa (or sphenopalatine fossa). There is an SPG and corresponding sphenopalatine fossa located on each side of the skull. 
         [0003]    The SPG and sphenopalatine fossa are accessible via an individual&#39;s nasal cavity. Individuals who suffer from pain associated with headaches and/or facial aches may elect to undergo a procedure referred to as a sphenopalatine ganglion block, which is a procedure that includes the application of a medication, such as anesthetic, by a trained professional to the SPG. Some of the conventional techniques for performing a sphenopalatine ganglion block procedure, however, are unpleasant to the individual. For example, upon application of the medication to the SPG, a large majority of the medication may flow down the individual&#39;s throat. Additionally, the medication is typically distasteful, which further exacerbates the unpleasantness. Furthermore, typical devices used to perform a sphenopalatine ganglion block procedure may not have the ability to accurately locate the SPG without the use of large external imaging systems, such as x-ray systems. 
       SUMMARY 
       [0004]    Accordingly, there is a need for a device, method and/or system such as a surgical device that has the capability to quickly and accurately locate the SPG while performing a sphenopalatine ganglion block procedure, as well as prevent the medication applied to the SPG from flowing down a patient&#39;s throat. The present disclosure discusses a method and device that satisfies such needs. 
         [0005]    The method may include delivering a medication to a sphenopalatine ganglion of a patient comprising the steps of inserting a device into a nasal cavity of a patient through a nostril, wherein the device comprises a handle comprising a proximal end and a distal end, an inflation device at least partially and integrally disposed within the handle, a flexible tubular member extending from the distal end of the handle, the flexible tubular member comprising a proximal end, a distal end, an inflation lumen coupled to the plunger and extending from the proximal end of the flexible tubular member, and a second lumen extending from the proximal end of the flexible tubular member to a port, an expandable member attached to the flexible tubular member, the expandable member comprising a proximal end and as distal end, wherein the inflation lumen opens into the expandable member, wherein the port is disposed proximally of the proximal end of the expandable member, and an illumination device disposed adjacent the distal end of the flexible tubular member and distally of the expandable member, and activating the illumination device, placing the expandable member adjacent the patient&#39;s choana, expanding the expandable member adjacent the patient&#39;s choana, introducing a medication to sphenopalatine ganglion through the port in the flexible tubular member, removing at least a portion of the medication from the port in the flexible tubular member, collapsing the expandable member, and removing the device from the nasal cavity. 
         [0006]    A device in accordance with this disclosure for accurately locating the SPG, while performing a sphenopalatine ganglion block procedure, and/or for preventing the medication applied to the SPG from flowing down a patient&#39;s throat, may include a handle comprising a proximal end and a distal end, an inflation device at least partially and integrally disposed within the handle, a flexible tubular member extending from the distal end of the handle, the flexible tubular member comprising a proximal end, a distal end, an inflation lumen coupled to the plunger and extending from the proximal end of the flexible tubular member, and a second lumen extending from the proximal end of the flexible tubular member to a port, an expandable member attached to the flexible tubular member, the expandable member comprising a proximal end and as distal end, wherein the inflation lumen opens into the expandable member, wherein the port is disposed proximally of the proximal end of the expandable member, and an illumination device disposed adjacent the distal end of the flexible tubular member and distally of the expandable member. 
         [0007]    The device may also or alternatively include a switch on the handle for activating the illumination device. 
         [0008]    The device may also or alternatively include a pressure relief valve disposed within the handle and coupled to the plunger and the inflation lumen. 
         [0009]    Another device for delivering a medication to a patient in accordance with this disclosure may comprise a handle comprising a proximal end and a distal end, an inflation device at least partially and integrally disposed within the handle, a flexible tubular member extending from the distal end of the handle, the flexible tubular member comprising a proximal end, a distal end, an inflation lumen extending from the proximal end, a second lumen extending from the proximal end to a port disposed proximally of the distal end of the flexible tubular member, an expandable member attached to the flexible tubular member, wherein the inflation lumens opens into the expandable member, wherein the port is disposed proximally of the expandable member, and a pressure relief valve disposed within the handle and coupled to the plunger and the inflation lumen. 
         [0010]    The phrases “at least one”, “one or more”, and “and/or” are open-ended expressions that are both conjunctive and disjunctive in operation. For example, each of the expressions “at least one of A, B and C”, “at least one of A, B, or C”, “one or more of A, B, and C”, “one or more of A, B, or C” and “A, B, and/or C” means A alone, B alone, C alone, A and B together, A and C together, B and C together, or A, B and C together. When each one of A, B, and C in the above expressions refers to an element, such as X, Y, and Z, or class of elements, such as X 1 -X n , Y 1 -Y m , and Z 1 -Z o , the phrase is intended to refer to a single element selected from X, Y, and Z, a combination of elements selected from the same class (e.g., X 1  and X 2 ) as well as a combination of elements selected from two or more classes (e.g., Y 1  and Z o ). 
         [0011]    The term “a” or “an” entity refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” may be used interchangeably herein. It is also to be noted that the terms “comprising”, “including”, and “having” may be used interchangeably. 
         [0012]    The term “means” as used herein shall be given its broadest possible interpretation in accordance with 35 U.S.C. Section 112(f). Accordingly, a claim incorporating the term “means” shall cover all structures, materials, or acts set forth herein, and all of the equivalents thereof Further, the structures, materials or acts and the equivalents thereof shall include all those described in the summary of the invention, brief description of the drawings, detailed description, abstract, and claims themselves. 
         [0013]    The term “medication” shall mean a substance used for medical treatment, such as a medicine or drug or remedy having in a specified formulation. The medicinal substance may also be referred to as a medicament. For the purposes of this disclosure a medication shall include anesthetics, including but not limited to local anesthetics and general anesthetics. 
         [0014]    The term “transillumination” shall mean the transmission of light through body tissue, such as the palate (including both the soft palate and hard palate). 
         [0015]    It should be understood that every maximum numerical limitation given throughout this disclosure is deemed to include each and every lower numerical limitation as an alternative, as if such lower numerical limitations were expressly written herein. Every minimum numerical limitation given throughout this disclosure is deemed to include each and every higher numerical limitation as an alternative, as if such higher numerical limitations were expressly written herein. Every numerical range given throughout this disclosure is deemed to include each and every narrower numerical range that falls within such broader numerical range, as if such narrower numerical ranges were all expressly written herein. 
         [0016]    The preceding is a simplified summary of the disclosure to provide an understanding of some aspects of the disclosure. This summary is neither an extensive nor exhaustive overview of the disclosure and its various aspects, embodiments, and configurations. It is intended neither to identify key or critical elements of the disclosure nor to delineate the scope of the disclosure but to present selected concepts of the disclosure in a simplified form as an introduction to the more detailed description presented below. As will be appreciated, other aspects, embodiments, and configurations of the disclosure are possible utilizing, alone or in combination, one or more of the features set forth above or described in detail below 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]    The accompanying drawings are incorporated into and form a part of the specification to illustrate several examples of the present disclosure. These drawings, together with the description, explain the principles of the disclosure. The drawings simply illustrate preferred and alternative examples of how the disclosure may be made and used and are not to be construed as limiting the disclosure to only the illustrated and described examples. Further features and advantages will become apparent from the following, more detailed, description of the various aspects, embodiments, and configurations of the disclosure, as illustrated by the drawings referenced below. 
           [0018]      FIG. 1  is a perspective view of an embodiment of a surgical device of the present disclosure; 
           [0019]      FIG. 2  is an alternate perspective view of the surgical device depicted in  FIG. 1 ; 
           [0020]      FIG. 3  is a top view of the surgical device depicted in  FIG. 1 ; 
           [0021]      FIG. 4  is a side view of the surgical device depicted in  FIG. 2 ; 
           [0022]      FIG. 4A  is an enlarged cross-sectional view of the distal end of the elongated flexible tubular member distal of the expandable member of the surgical device depicted in  FIG. 4 ; 
           [0023]      FIG. 4B  is a cross-sectional end view of the elongated flexible tubular member of the surgical device depicted in  FIG. 4  taken along line B-B; 
           [0024]      FIG. 4C  is a cross-sectional side view of the elongated flexible tubular member depicted in  FIG. 4B  taken along line C-C; 
           [0025]      FIG. 4D  is a cross-sectional view of the handle of the surgical device depicted in  FIG. 4 ; 
           [0026]      FIG. 5A  is a cross-sectional view of the plunger located within the handle of the surgical device depicted in  FIG. 4D , wherein the plunger is illustrated in an extended position; 
           [0027]      FIG. 5B  is a cross-sectional view of the plunger located within the handle of the surgical device depicted in  FIG. 4D , wherein the plunger is illustrated in a retracted position; 
           [0028]      FIG. 6A  is a cross-sectional view of a patient&#39;s head with an embodiment of a surgical device of the present disclosure, with the expandable member in a deflated state, entering the patient&#39;s nasal cavity; 
           [0029]      FIG. 6B  is a cross-sectional view of a patient&#39;s head with an embodiment of a surgical device of the present disclosure, with the expandable member in a deflated state, located in the patient&#39;s nasal cavity; 
           [0030]      FIG. 6C  is a cross-sectional view of a patient&#39;s head with an embodiment of a surgical device of the present disclosure, with the expandable member in a deflated state, located in the patient&#39;s nasal cavity with the expandable member disposed adjacent the choana; 
           [0031]      FIG. 6D  is a cross-sectional view of a patient&#39;s head with an embodiment of a surgical device of the present disclosure, with the expandable member in an inflated state, located in the patient&#39;s nasal cavity with the expandable member disposed adjacent the choana; 
           [0032]      FIG. 6E  is a cross-sectional view of a patient&#39;s head with an embodiment of a surgical device of the present disclosure, with the expandable member in an inflated state, located in the patient&#39;s nasal cavity with the expandable member disposed adjacent the choana and medication accumulated in the patient&#39;s nasal cavity adjacent the SPG; 
           [0033]      FIG. 7  is flow chart depicting a method of performing a surgical technique using a surgical device of the present disclosure; and 
           [0034]      FIG. 8A  is an enlarged cross-sectional view of an alternative embodiment of the distal end of the elongated flexible tubular member distal of the expandable member of the surgical device depicted in  FIG. 4 ; 
           [0035]      FIG. 8B  is a cross-sectional end view of an alternative embodiment of the elongated flexible tubular member of the surgical device depicted in  FIG. 4  taken along line B-B; 
           [0036]      FIG. 8C  is a cross-sectional side view of the elongated flexible tubular member depicted in  FIG. 8B  taken along line C-C; and 
           [0037]      FIG. 9  is a cross-sectional side view of an alternative embodiment of the elongated flexible tubular member depicted in  FIG. 8C  with the expandable member depicted in the expandable state. 
       
    
    
       [0038]    It should be understood that the drawings are not necessarily to scale. In certain instances, details that are not necessary for an understanding of the disclosure or that render other details difficult to perceive may have been omitted. It should be understood, of course, that the disclosure is not necessarily limited to the particular embodiments illustrated herein. 
       DETAILED DESCRIPTION 
       [0039]    Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. 
         [0040]    Embodiments according to this disclosure provide a surgical device that can be deployed safely within a nasal cavity of a patient and apply a medication, such as a local anesthetic, to the patient&#39;s sphenopalatine ganglion.  FIG. 1-FIG .  4  depict a surgical device  100  having a handle  104  and an elongated flexible tubular member  108 . The handle  104 , which is ergonomically shaped, includes a proximal end and a distal end  144 . The proximal end of the handle includes two projecting abutments  136 ,  140  so that the user&#39;s hand remains comfortably on the handle  104  during use and the user&#39;s hand does not slide off the handle  104 . It may be preferable for the projecting abutments  136 ,  140  to be disposed on the top and bottom of the handle such that they are about 180 degrees opposed from one another, as illustrated in the  FIGS. 1 &amp; 2 , or it may be preferable for the projecting abutments  136 ,  140  to be disposed in a different orientation with respect to the handle, such as on the sides of the handle  104 . It may also be preferable to have less or more than two abutments. For example, it may be preferable to have a continuous abutment around the entire circumference of the handle  104  at or near its proximal end. 
         [0041]    As illustrated in  FIG. 4 , the handle  104  is curved. The proximal portion of the handle  104  has one longitudinal axis and the distal portion of the handle  104  has a different longitudinal axis. The longitudinal axis of the distal portion of the handle  104  may be offset at an angle of about 5 degrees about 60 degrees from the longitudinal axis of the proximal portion of the handle  104 . It may be preferable for the offset angle to be about 10 degrees about 45 degrees and even more preferable for the offset angle to be about 20 degrees to about 30 degrees. The longitudinal axes of the proximal and distal portions of the handle  104  smoothly intersect, thereby creating a handle with a curved profile. The distal end  144  of the of the handle portion  104  may also have a rounded configuration, which is more ergonomic to engage the patient&#39;s nostril(s) upon insertion of the device  100 , namely the elongated flexible tubular member  108 , thereto. 
         [0042]    The elongated flexible tubular member  108  includes a proximal end  120 , which is attached to the distal end of the  144  of the handle  104 . An expandable member  116 , such as a balloon, is located at, adjacent to or toward the distal end  124  of the flexible tubular member  108 .  FIGS. 1 &amp; 3  depict the expandable member  116  in an inflated state, and  FIGS. 2 &amp; 4  depict the expandable member  116  in a deflated state. The shape and size of the expandable member  116  may differ depending upon the patient&#39;s anatomy. For example, the size of the expandable member  116  may be smaller for children and larger for adults. It may be preferable for the expandable member  116  to have an inflated diameter of about 1 cm to 4 cm, with a possible preferential diameter of about 2.5 cm, and an inflated length of about 1 cm to 3, with a possible preferential inflated length of about 2.5 cm. 
         [0043]    As discussed in more detail below, the handle  104  includes an inflation device, such as a syringe  112 , integrated therein. The syringe  112  comprises a barrel  172 , a plunger  164  at least partially disposed within the barrel  172 , and a distal tip  176  at the end of the barrel  172 . When the plunger  164  is depressed, the expandable member  116  is expanded (inflated) with fluid, such as air, and when the plunger  164  is refracted, the expandable member  116  is collapsed (deflated). It shall be understood that either a pneumatic inflation device, which utilizes air as the fluid, or a hydraulic inflation device, which utilizes liquid (e.g., saline, water, etc.) as the fluid, can be used. 
         [0044]    The handle  104  also includes a switch  128  for activating an illumination device  216 , such as a light-emitting diode (LED) disposed at or toward the distal end  124  of the elongated flexible tubular member  108 . The switch  216  activates a power source, such as a battery, that is coupled to the illumination device  216  by two or more conductors (e.g., wires)  224 ,  228 . The wires  224 ,  228  are disposed within lumens  224 ,  228  that travel from the proximal end to the distal end of the elongated flexible tubular member  108 . As discussed above, the expandable member  116  is also disposed at or near or toward the distal end  124  of the elongated flexible tubular member  108 . It is preferable for the illumination device  216  to be disposed distally of the expandable member  116  along the elongated flexible tubular member  108 , thereby allowing the illumination device  216  to project light in a manner that is unobstructed by the expandable member  116 . That is, it is preferable for the expandable member  116  to be disposed proximally of the illumination device  216  along the elongated flexible tubular member  108 . For example, it may be preferable for the distal end of the expandable member  116  to be disposed about 0 to 1 mm and potentially even more preferable to be disposed at the distal end  124  of the elongated flexible tubular member  108 . 
         [0045]    Referring to  FIG. 4 , there is depicted a side view of an embodiment of the surgical device  100  of the present disclosure.  FIG. 4A  is an enlarged cross-sectional view of the distal end  124  of the elongated flexible tubular member  108  illustrating a portion of the expandable member  116  in a deflated state. The distal end  124  of the elongated flexible tubular member  108  includes a cover  220  coupled to it. The cover  220  is constructed of a transparent material, such as polycarbonate. The cover  220  protects the illumination device  216 . The cover  220  may also be shaped such that its edges are curved, thereby providing an atraumatic end to the surgical device. The cover  220  can be coupled directly to the distal face  222  of the elongated flexible tubular member  108  and/or it can be coupled to the perimeter of the distal end  124  of the elongated flexible tubular member  108 . The tip  220  may preferably be coupled to the distal end  124  of the elongated flexible tubular member  108  by an adhesive compound. Alternative means of coupling the tip  220  to the distal end  124  of the elongated flexible tubular member  108  includes mechanical means, such as pressed fittings, snap on fittings, or a threaded arrangement between the tip  220  and the elongated flexible tubular member  108 . 
         [0046]    Continuing to refer to  FIG. 4A , there is depicted an illumination device  216 , which is also coupled to the distal face  222  of the elongated flexible tubular member  108  such that the illumination device projects light distally of the elongated flexible tubular member  108 . Similar to tip  220 , the illumination device  216  is coupled to the distal end  124  of the elongated flexible tubular member  108  by an adhesive. It may also be preferable for the tip  220  to surround at least a portion of the illumination device  216 , thereby protecting the illumination device  216 . The illumination device is powered by a power source, such as a battery, via one or more wires  224 ,  228  that couple the power source to the illumination device  216 . The wires  224 ,  228  are disposed within lumens  224 ,  228  that travel from the proximal end to the distal end of the elongated flexible tubular member  108 . 
         [0047]    Referring to  FIG. 4B , there is depicted a cross-sectional view of the elongated flexible tubular member  108  of the surgical device  100  depicted in  FIG. 4  taken along line B-B. The elongated flexible tubular member  108  comprises a plurality of lumens. Although a different number of lumens may be used,  FIG. 4B  illustrates four lumens: lumen  148  is used to transport the medication to/from the medication port  160  located proximally of the expandable member  116 ; lumen  200  is used to transport fluid (e.g., air, water, saline, etc.) to/from the inflation port, which open into the expandable member  116 ; and two lumens  204 ,  208  provide channels for the wires  224 ,  228  to travel. All four lumens  148 ,  200 ,  204  &amp;  208  have openings at the proximal end of the elongated flexible tubular member  108 . Not all four lumens, however, may have openings at the distal end of the elongated flexible tubular member  108 . For example, the lumen  148  used to transport the medication may have an opening at the proximal end of the elongated flexible tubular member  108  and an opening (or port) at  160 , which is located proximally of the expandable member  116 . Additionally, the lumen  200  used to transport fluid to inflate the expandable member  116  may have a have an opening at the proximal end of the elongated flexible tubular member  108  and an opening (or port) at  212 , which opens into the expandable member  116 . Lumens  204 ,  208  may have an opening at the proximal end of the elongated flexible tubular member  108  and an opening at or near the distal end of the elongated flexible tubular member  108 , thereby allowing the wires  224 ,  228  to travel all or the majority of the length of the elongated flexible tubular member  108  to the illumination device  216 . 
         [0048]    Alternatively, the elongated flexible tubular member  108  may not have lumens  204 ,  208 . For example, if the elongated flexible tubular member  108  is constructed (e.g., molded) in a manner such that the wires  224 ,  228  are integral with the elongated flexible tubular member  108 , then lumens  204 ,  208  may not be needed. Additionally, the elongated flexible tubular member  108  may have additional lumens  206 ,  210 . 
         [0049]    Another alternative embodiment may include an additional lumen in the elongated flexible tubular member  108  through which an imaging device may be inserted or incorporated. For instance, the surgical device  100  may include a reusable endoscope that is inserted through an opening (not shown) in the handle  104  and travels through the additional lumen in the elongated flexible tubular member  108  such that the endoscope is adjacent the illumination device  216  in the cover  220 . Referring to  FIGS. 8A ,  8 B &amp;  8 C, there is depicted such an alternative embodiment of the flexible tubular member  108 ′ that includes lumen  202 ′, which extends from the proximal end to the distal end of the flexible tubular member  108 ′, and is configured to have an endoscope or other imaging device inserted thereto. Lumen  148 ′ will be used to transport the medication to/from the medication port  160 ′ located proximally of the expandable member  116 ; two lumens  204 ,  208  provide channels for the wires  224 ,  228  to travel to/from the illumination device  220 ; lumen  206 ′ is used to transport fluid (e.g., air, water, saline, etc.) to/from the inflation port, which open into the expandable member  116 ; and lumen  208 ′ is an additional lumen. Although it is not shown in the figures, it may also be desirable for the cover and/or the distal end of the flexible tubular member to have an optical divider that separates the light emitted by the illumination device from directly entering the endoscope or imaging device. 
         [0050]    Regarding the placement of the opening  160  for delivering the medication, it may be preferable for the opening  160  to be disposed about 1 mm to 10 mm from the proximal end of the expandable member  116  and possibly more preferably to be disposed about 2 mm to 5 mm from the proximal end of the expandable member  116 . Locating the opening  160  proximally of the proximal end of the expandable member  116  allows the medication to collect within the nasal cavity above the expandable member  116 , while the expandable member  116  is inflated. It may be preferable for the medication to collect within the nasal cavity and form a pool of medication such that the level of medication rises to sphenopalatine fossa and/or the mucosa overlaying the SPG. Depending upon the size of the patient&#39;s nasal cavity, the volume of medication introduced to the nasal cavity and used to create such a pool may be between 2 milliliters to 15 milliliters, and potentially preferable for about 5 milliliters to 10 milliliters. 
         [0051]    Referring to  FIG. 4D ,  FIG. 5A  and  FIG. 5B , an inflation device, such as a syringe  112 , is integrated into the handle  104 . The syringe  112  is used to inflate and deflate the expandable member  116 . Integrating the inflation device in the handle  104  reduces the likelihood of a clinician confusing which port(s) to connect the devices (i.e., syringes) used to introduce the medication and the inflation fluid. That is, by including an inflation device, such as the syringe  112 , in the handle  104 , a clinician will know and/or be instructed to use the integrated syringe  112  to inflate the expandable member  116  and an external syringe (not shown) to introduce the medication. Stated differently, a clinician will only have to introduce one fluid, namely the medication, through an external syringe, thereby reducing potential confusion as to which fluid to introduce and/or into which port. Alternatively, the syringe used to introduce the medication may be integrated into the handle  104  in lieu of the syringe  112  used to inflate and deflate the expandable member  116 . A further alternative embodiment may include a handle  104  with two clearly marked integrated syringes—one syringe for the medication and another syringe for the inflation fluid. 
         [0052]    The syringe  112  comprises a barrel  172 , a plunger  164  at least partially disposed within the barrel  172 , and a distal tip  176  having an opening at the distal end of the barrel  172 . The plunger  164  has a shaft portion  166  and a proximal end  162  and distal end  168  at the respective ends of the shaft portion  166 . The proximal end  162  and a distal end  168  may be coupled to the shaft portion  166  or be integrally formed thereto. The proximal portion  162  may also have a handgrip or finger grip, such as a ring  158 , for a clinician to ergonomically and comfortably depress and retract the barrel  172 . When the plunger  164  is depressed, the expandable member  116  is inflated, and when the plunger  164  is retracted, the expandable member  116  is deflated. 
         [0053]    It may also be preferable for the barrel  172  to have an opening (port)  170  adjacent, at or toward its proximal end. When the surgical device  100  is manufactured, it is assembled and/or packaged at a certain atmospheric pressure depending upon the geographic location of the manufacturing and/or packaging facility. The atmospheric pressure of the surgical site where the surgical device  100  is used, however, may be different than that at the manufacturing and/or packaging facility. Including the opening  170  within the barrel  172  allows the pressure within barrel to equalize with the pressure of the surgical site prior to use. It may also be preferable to ship the surgical device  100  in a configuration such that the plunger  164  is in a partially or fully retracted position such, thereby allowing the opening  170  to be located distally of the distal end  168  of the plunger  164 . Shipping the surgical device in this configuration may enhance the time for the pressure within the chamber of the barrel to equalize with the atmospheric pressure at the surgical site more quickly. 
         [0054]    During use of the surgical device  100 , clinicians may also repeatedly depress and retract the plunger  164 . Such repeated action has the potential to overinflate the expandable member  116 . Inclusion of the opening  170  within the barrel  172  allows the pressure within barrel&#39;s chamber  174  to equalize with the atmospheric pressure upon retraction of the plunger  164 , thereby reducing the likelihood of overinflating the expandable member  116 . That is, upon depression of the plunger  164 , the pressure within the chamber  174 , as well as the pressure within the expandable member  116 , increases above atmospheric pressure at the surgical site. Upon each retraction of the plunger  164 , the pressure within the chamber  174 , as well as the pressure within the expandable member  116 , decreases back to atmospheric pressure prior to another depression of the plunger  164  because the fluid within the chamber  174  is vented to the atmosphere via the opening  170 . 
         [0055]    Venting the fluid within the chamber  174  also allows the expandable member  116  to deflate (or further deflate) upon application of pressure to the exterior of the expandable member  116 . For example, upon retraction of the plunger  164 , the pressure within the expandable member  116  may not immediately cause the expandable member  116  to completely deflate. That is, the expandable member  116  may retain a certain amount of fluid after retraction of the plunger, thereby allowing the expandable member  116  to remain partially inflated. Accordingly, when the surgical device  100 , including the expandable member  116 , is initially removed from the patient&#39;s nasal cavity, the expandable member  116  may be partially inflated. Inclusion of opening  170  within chamber  174  allows the expandable member  116  to further deflate upon removal of the surgical device  100 , including the expandable member  116 , from the patient&#39;s nasal cavity. Allowing the expandable member  116  to further deflate upon removal of the surgical device  100  assists in reducing the likelihood of the expandable member  116  causing discomfort to the patient. 
         [0056]    Continuing to refer to  FIG. 4D , a pressure relief valve  188  is disposed between the syringe  112  and the expandable member  116 . Inclusion of the pressure relief valve  188  into the inflation circuit reduces the possibility of over pressurizing and over expanding the expandable member  116 , particularly during a clinician&#39;s repeated depression and retraction of the plunger  164 . The pressure relief valve  188  is a valve used to control or limit the pressure in a circuit, such as the inflation circuit. The pressure is relieved by allowing the pressurized fluid (e.g., air) to flow to an auxiliary passage, preferably in the valve, out of the circuit. The pressure relief valve is designed or set to open at a predetermined set pressure to protect the expandable member  116  from being subjected to pressures that exceed the desired clinical limits. When the set pressure is exceeded, the pressure relief valve is forced open and a portion of the fluid is diverted through the auxiliary route vented to the atmosphere. As the fluid is diverted, the pressure inside the circuit decreases. Once the pressure within the pressure relief valve reduces back to or below the predetermined set pressure, the valve will close. For example, the predetermined set pressure may be set between about 5 psi (0.345 bar) to 15 psi (1.034 bar) or possibly between about 8 psi (0.552 bar) to 12 psi (0.827 bar) or nominally about 10 psi (0.690 bar). 
         [0057]    The pressure relief valve  188 , particularly the proximal end of the pressure relief valve  188 , is coupled to the distal tip  176  of the syringe  112 . The distal end of the pressure relief valve  188  is, in turn, coupled to the tube  192  that is coupled to the inflation lumen  148  in the elongated flexible tubular member  108 . Alternatively, the tube  192  may be omitted by directly coupling the distal end of the pressure relief valve  188  to the inflation lumen  148  in the elongated flexible tubular member  108 . 
         [0058]      FIG. 4D  also illustrates a female luer adaptor  132  attached to the surgical device  100 . The female luer adaptor  132  allows a clinician to connect an auxiliary syringe (not shown) having a male luer the mates with the female luer adaptor  132 . The auxiliary syringe will include the medication that is introduced through the surgical device  100  proximal of the expandable member to the mucosa overlaying the SPG. Upon actuation (e.g., depression) of the auxiliary syringe, the medication travels from the auxiliary syringe to the female luer adaptor  132  through a tube  184  to the medication lumen  200  and eventually to opening  160 . Alternatively, the tube  184  may be omitted by directly coupling the female luer adaptor  132  to the medication lumen  200 . 
         [0059]    Regardless of whether a tube  184  is included, the medication is preferably introduced through the surgical device  100  after the expandable member  116  is expanded because expanding the expandable member  116  reduces the likelihood of the medication from flowing down the patient&#39;s throat. As discussed above, after the medication is introduced into the nasal cavity through opening  160 , the medication collects within the nasal cavity above the expandable member, when the expandable member  116  is expanded adjacent the choana. It may be preferable for the medication to collect within the nasal cavity and form a pool of medication such that the level of medication rises to sphenopalatine fossa and/or the mucosa overlaying the SPG. Once the desired medication level is attained, it may be desirable for the medication to remain in the patient&#39;s nasal cavity for a period of time to maximize the medication&#39;s exposure to the mucosa overlaying the SPG and the SPG itself. For example, it may be desirable for the medication to remain in the patient&#39;s nasal cavity at a level to overlay the mucosa of the SPG, for a period of time from about 5 minutes to 35 minutes, including any time interval (e.g., 1 minute, 2 minutes, 3 minutes, 4 minutes, 5 minutes, etc.) there between. It may be more desirable for such time period to be about 10 minutes to 30 minutes, and even more desirable for such time period to be about 15 minutes to 25 minutes, and even further desirable for such time period to be about 20 minutes. 
         [0060]    To assist in maintaining the preferable level of medication for the desired time period, the auxiliary syringe may remain connected to the female luer adaptor  132  during such time period. After the medication has contacted the mucosa and the SPG for a sufficient period, the clinician may retract the auxiliary syringe, thereby removing some or all of the medication from the patient&#39;s nasal cavity through the same opening  160  used to introduce the medication. That is, by retracting the syringe, a negative pressure or suction force is created in the medication circuit, thereby pulling the medication located within the patient&#39;s nasal cavity through the opening  160  and back into the same or different auxiliary syringe. After the medication is withdrawn from the patient&#39;s nasal cavity, the expandable member  116  is collapsed, and the surgical device  100  may be removed. As discussed in more detail below, the benefit of including the expandable member  116  with the surgical device  100  allows the clinician to create a blockage within the patient&#39;s throat and fill a portion of the nasal cavity such that medication directly contacts the mucosa overlaying the SPG for a sustained period while preventing the medication from flowing down the patient&#39;s throat. 
         [0061]    Referring to  FIG. 7 , there is depicted a flow chart  700  representing at least some of the steps for performing a sphenopalatine ganglion block procedure utilizing the surgical device  100  of the present disclosure. Some of the steps of the flow chart  700  are illustrated in  FIGS. 6A-6E . Step  704 , which is illustrated in  FIG. 6A , includes inserting the surgical device  100  into the patient&#39;s nasal cavity through one of the patient&#39;s nostrils (i.e., left nostril or right nostril). Specifically, the distal portion of the distal end  124  of the elongated flexible tubular member  108  is preferably inserted into the patient&#39;s nostril, while the expandable member  116  is entirely or partially deflated, and directed into the channel below the inferior turbinate and above the hard palate. It may also be preferable at the time of insertion of the surgical device  100  or shortly thereafter, that the illumination device  216  be activated. Upon activating the illumination device  216 , light will transmit through the patient&#39;s hard palate. For example, when the distal end  124  of the elongated flexible tubular member  108  (and the illumination device  216 ) is located within the patient&#39;s nasal cavity as depicted in  FIG. 6A , the illumination device  216  will be located at or below the posterior inferior turbinate and above the hard palate and be visible to a clinician viewing the interior of the oral cavity (patient&#39;s mouth), particularly the bottom of the palate (roof of the patient&#39;s mouth), and the light will appear to be transilluminating therefrom within the patient&#39;s head. 
         [0062]    Referring to  FIG. 6B , while continuing to activate the illumination device  216  and while the expandable member  116  is entirely or partially deflated, the distal portion of the distal end  124  of the elongated flexible tubular member  108  is inserted further into the patient&#39;s nasal cavity. When the distal end  124  of the elongated flexible tubular member  108  (and the illumination device  216 ) is located within the patient&#39;s nasal cavity as depicted in  FIG. 6B , the illumination device  216  will continue to be located below the anterior of the inferior turbinate above the anterior of the hard palate further towards the soft palate in comparison location depicted in  FIG. 6A   
         [0063]    Referring to  FIG. 6C , while continuing to activate the illumination device  216  and while the expandable member  116  is entirely or partially deflated, the distal portion of the distal end  124  of the elongated flexible tubular member  108  is even inserted further into the patient&#39;s nasal cavity. When the distal end  124  of the elongated flexible tubular member  108  is located within the patient&#39;s nasal cavity as depicted in  FIG. 6C , the illumination device  216  will be located above the soft palate, namely the nasopharynx, and the light will appear to be transilluminating therefrom. At this point, step  704  of  FIG. 7  has been completed because the expandable member  116  is located at the desired position, namely in the nasopharynx adjacent the choana, 
         [0064]    Referring to  FIG. 6D , when the illumination device  216  and the expandable member  116  are located in the nasopharynx adjacent the choana, the expandable member  116  is expanded by depressing plunger  164  of the syringe  112 , as depicted in step  712  of  FIG. 7 , thereby blocking the choana. Once the choana is blocked, medication is introduced to the nasal cavity through the opening  160  of the flexible tubular member  108 . As the medication is introduced, the expanded expandable member  116  prevents the flow of medication down the patient&#39;s throat. And because the patient&#39;s head it typically tilted backwards during this procedure, the medication collects proximally above the expandable member  116 . Accordingly, the medication begins to accumulate within the nasal cavity. Upon a certain volume, such as 5 milliliters to 10 milliliters of medication being introduced to the nasal cavity through the opening  160 , the level of medication rises within the nasal cavity, namely the sphenopalatine fossa, such that the medication contacts the mucosa overlaying the SPG. Introducing the medication in this fashion and maintaining the desired level of medication provides for direct and sustained contact with the mucosa overlaying the SPG. The medication is absorbed by the permeable mucosa overlying the SPG. In comparison to spraying the mucosa with the medication, the device(s) and method(s) of the present disclosure provide direct and sustained contact with the mucosa and SPG, which is a more effective treatment. Also, varying the medication and contact times may further increase the effectiveness of the treatment. Varying the medication and contact times also provide the clinician the flexibility to personalize the patient&#39;s treatment. Another example of the way in which the clinician may utilize the device(s) and method(s) of the present disclosure to personalize the patient&#39;s treatment includes inflating the inflatable member to a certain pressure. 
         [0065]    As mentioned above, it may be preferable for the patient&#39;s head to be tilted backwards during the procedure. Referring to  FIG. 6E , it may be preferable for the patient&#39;s head to be tilted at an angle (a) between 0 degrees and 90 degrees, and more preferable for the patient&#39;s head to be tilted at an angle (a) between 15 degrees and 75 degrees, and further preferable for the patient&#39;s head to be tilted at an angle (a) between 30 degrees and 60 degrees, and even further preferable for the patient&#39;s head to be tilted at an angle (a) of about 45 degrees. Tilting the patient&#39;s head during the procedure allows the medication  602  to collect above the inflatable member  116  and contact the mucosa overlaying the SPG. 
         [0066]    It may also be desirable to prevent the medication from being introduced or sprayed into the nasal cavity in an unknown direction. That is, it may be desirable to control the introduction of the medication into the nasal cavity such that the medication collects within the nasal cavity above the expandable member, forms a pool of medication  602 , and the level of medication raises to sphenopalatine fossa and/or the mucosa overlaying the SPG without randomly spraying the medication into the nasal cavity. Controlling the introduction of the medication in this manner increases the likelihood that that medication reaches the mucosa overlaying the SPG and the SPG itself. Referring to  FIG. 9 , there is a means for controlling the direction from which the medication exits the flexible tubular member  108  and is introduced to the nasal cavity. Such means may include a deflector  902  that directs the flow of medication exiting the flexible tubular member  108  toward the expandable member  116 . Directing the flow of medication toward the expandable member  116  reduces the likelihood that the medication will be distributed, via spraying, in an unknown direction. As illustrated in  FIG. 9 , the deflector  902  is coupled to the flexible tubular member  108 . The deflector  902  can be located exteriorly of the flexible tubular member  108 , such as in the form of a sleeve that surrounds the opening  160 , thereby forcing the outflow of medication towards the inflatable member  116 . The deflector  902  can also be integral with the flexible tubular member  108 , such that the portion of the flexible tubular member  108  adjacent the opening  160  directs the outflow of medication towards the inflatable member  116 . The deflector  902  may also be a separate component that is inserted at least partially within the flexible tubular member  108  and directs the outflow of medication towards the inflatable member  116 . 
         [0067]    Referring to step  720  of  FIG. 7 , it may be preferable for the medication to remain within the nasal cavity and contact the mucosa overlaying the SPG, as well as the SPG, for a predetermined period of time (e.g., about 20 minutes), as discussed above. Referring to step  730 , upon the SPG being directly exposed to the medication for the desired period, the medication is removed from the nasal cavity by suctioning the medication through the opening  160  with an auxiliary syringe. Once the medication is removed, the expandable member  116  may be collapsed by retracting the plunger  164  of the syringe  112 , as depicted in step  728  of  FIG. 7 . As set forth in step  732 , after the medication is removed and the expandable member  116  is collapsed, the surgical device  100  may be removed from the nasal cavity. 
         [0068]    The procedure discussed above with respect to  FIG. 7  performs a sphenopalatine ganglion block for one SPG located on one (i.e., left or right) side of the patient&#39;s head. Upon completing the sphenopalatine ganglion block for one side of the head, the same procedure can be repeated by inserting the distal end of the elongated flexible tubular member  108  into the patient&#39;s other nostril and applying the medication to the other SPG. 
         [0069]    The foregoing discussion has been presented for purposes of illustration and description. The foregoing is not intended to limit the disclosure to the form or forms disclosed herein. In the foregoing Summary for example, various features of the disclosure are grouped together in one or more aspects, embodiments, and/or configurations for the purpose of streamlining the disclosure. The features of the aspects, embodiments, and/or configurations of the disclosure may be combined in alternate aspects, embodiments, and/or configurations other than those discussed above. This method of disclosure is not to be interpreted as reflecting an intention that the claims require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects lie in less than all features of a single foregoing disclosed aspect, embodiment, and/or configuration. Thus, the following claims are hereby incorporated into this Detailed Description, with each claim standing on its own as a separate preferred embodiment of the disclosure. 
         [0070]    Moreover, though the description has included description of one or more aspects, embodiments, and/or configurations and certain variations and modifications, other variations, combinations, and modifications are within the scope of the disclosure, e.g., as may be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative aspects, embodiments, and/or configurations to the extent permitted, including alternate, interchangeable and/or equivalent structures, functions, ranges or steps to those claimed, whether or not such alternate, interchangeable and/or equivalent structures, functions, ranges or steps are disclosed herein, and without intending to publicly dedicate any patentable subject matter.