Patent Publication Number: US-2021169566-A1

Title: Devices for therapeutic nasal neuromodulation and associated methods and systems

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims priority to U.S. Provisional Patent Application No. 62/160,289, filed May 12, 2015, which is incorporated by reference herein in its entirety. 
    
    
     TECHNICAL FIELD 
     The present technology relates generally to devices, systems, and methods for therapeutically modulating nerves in or associated with a nasal region of a patient. In particular, various embodiments of the present technology are related to therapeutic neuromodulation systems and methods for the treating rhinitis and other indications. 
     BACKGROUND 
     Rhinosinusitis is characterized as an inflammation of the mucous membrane of the nose and refers to a group of conditions, including allergic rhinitis, non-allergic rhinitis, chronic rhinitis, chronic sinusitis, and medical resistant rhinitis. Symptoms of rhinosinusitis include nasal blockage, obstruction, congestion, nasal discharge (e.g., rhinorrhea and/or posterior nasal drip), facial pain, facial pressure, and/or reduction or loss of smell. Allergic rhinitis can include further symptoms, such as sneezing, watery rhinorrhea, nasal itching, and itchy or watery eyes. Severe rhinitis can lead to exacerbation of coexisting asthma, sleep disturbances, and impairment of daily activities. Depending on the duration and type of systems, rhinosinusitis can fall within four subtypes: acute rhinosinusitis, recurrent rhinosinusitis, chronic rhinosinusitis with nasal polyposis (i.e., soft, non-cancerous growths on the lining of the nasal passages or sinuses), and chronic rhinosinusitis without nasal polyposis. Acute rhinosinusitis refers to symptoms lasting for less than twelve weeks, whereas chronic rhinosinusitis (with and without nasal polyposis) refers to symptoms lasting longer than twelve weeks. Recurrent rhinosinusitis refers to four or more episodes of acute rhinosinusitis within a twelve-month period, with resolution of symptoms between each episode. 
     There are numerous environmental and biological causes of rhinosinusitis. Non-allergic rhinosinusitis, for example, can be caused by environmental irritants (e.g., exhaust fumes, cleaning solutions, latex, perfume, dust, etc.), medications (e.g., NSAIDs, oral contraceptives, blood pressure medications including ACE inhibitors, antidepressants, etc.), foods (e.g., alcoholic beverages, spicy foods, etc.), hormonal changes (e.g., pregnancy and menstruation), and/or nasal septum deviation. Triggers of allergic rhinitis can include exposure to seasonal allergens (e.g., exposure to environmental allergens at similar times each year), perennial allergens that occur any time of year (e.g., dust mites, animal dander, molds, etc.), and/or occupational allergens (e.g., certain chemicals, grains, latex, etc.). 
     The treatment of rhinosinusitis can include a general avoidance of rhinitis triggers, nasal irrigation with a saline solution, and/or drug therapies. Pharmaceutical agents prescribed for rhinosinusitis include, for example, oral H1 antihistamines, topical nasal H1 antihistamines, topical intranasal corticosteroids, systemic glucocorticoids, injectable corticosteroids, anti-leukotrienes, nasal or oral decongestants, topical anticholinergic, chromoglycate, and/or anti-immunoglobulin E therapies. However, these pharmaceutical agents have limited efficacy (e.g., 17% higher than placebo or less) and undesirable side effects, such as sedation, irritation, impairment to taste, sore throat, dry nose, epistaxis (i.e., nose bleeds), and/or headaches. Immunotherapy, including sublingual immunotherapy (“SLIT”), has also been used to treat allergic rhinitis by desensitizing the patient to particular allergens by repeated administration of an allergen extract. However, immunotherapy requires an elongated administration period (e.g., 3-5 years for SLIT) and may result in numerous side effects, including pain and swelling at the site of the injection, urticarial (i.e., hives), angioedema, asthma, and anaphylaxis. 
     Surgical interventions have also been employed in an attempt to treat patients with drug therapy resistant, severe rhinitis symptoms. In the 1960&#39;s through 1980&#39;s, surgeries were performed to sever parasympathetic nerve fibers in the vidian canal to decrease parasympathetic tone in the nasal mucosa. More recent attempts at vidian neurectomies were found to be 50-88% effective for the treatment of rhinorrhea, with other ancillary benefits including improvements in symptoms of sneezing and nasal obstruction. These symptomatic improvements have also been correlated to histologic mucosal changes with reductions in stromal edema, eosinophilic cellular infiltration, mast cell levels, and histamine concentrations in denervated mucosa. However, despite the clinical and histologic efficacy of vidian neurectomy, resecting the vidian nerve failed to gain widespread acceptance largely due to the morbidities associated with its lack of anatomic and autonomic selectivity. For example, the site of neurectomy includes preganglionic secretomotor fibers to the lacrimal gland, and therefore the neurectomy often resulted in the loss of reflex tearing, i.e., lacrimation, which in severe cases can cause vision loss. Due to such irreversible complications, this technique was soon abandoned. Further, due passage of postganglionic pterygopalatine fibers through the retro-orbital plexus, the position of the vidian neurectomy relative to the target end organ (i.e., the nasal mucosa) may result in re-innervation via the autonomic plexus and otic ganglion projections traveling with the accessory meningeal artery. 
     The complications associated with vidian neurectomies are generally attributed to the nonspecific site of autonomic denervation. Consequently, surgeons have recently shifted the site of the neurectomy to postganglionic parasympathetic rami that may have the same physiologic effect as a vidian neurectomy, while avoiding collateral injury to the lacrimal and sympathetic fibers. For example, surgeons in Japan have performed transnasal inferior turbinate submucosal resections in conjunction with resections of the posterior nasal nerves (“PNN”), which are postganglionic neural pathways located further downstream than the vidian nerve. (See, Kobayashi T, Hyodo M, Nakamura K, Komobuchi H, Honda N, Resection of peripheral branches of the posterior nasal nerve compared to conventional posterior neurectomy in severe allergic rhinitis.  Auris Nasus Laryi.  2012 Feb. 15; 39:593-596.) The PNN neurectomies are performed at the sphenopalatine foramen, where the PNN is thought to enter the nasal region. These neurectomies are highly complex and laborious because of a lack of good surgical markers for identifying the desired posterior nasal nerves and, even if the desired nerves are located, resection of the nerves is very difficult because the nerves must be separated from the surrounding vasculature (e.g., the sphenopalatine artery). 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Many aspects of the present technology can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale. Instead, emphasis is placed on illustrating clearly the principles of the present technology. For ease of reference, throughout this disclosure identical reference numbers may be used to identify identical or at least generally similar or analogous components or features. 
         FIG. 1A  is a cut-away side view illustrating the anatomy of a lateral nasal wall. 
         FIG. 1B  is an enlarged side view of the nerves of the lateral nasal wall of  FIG. 1A . 
         FIG. 1C  is a front view of a left palatine bone illustrating geometry of microforamina in the left palatine bone. 
         FIG. 2  is a partially schematic view of a therapeutic neuromodulation system for therapeutically modulating nerves in a nasal region in accordance with an embodiment of the present technology. 
         FIGS. 3A-3E  are partial cut-away side views illustrating various approaches for delivering a distal portion of a therapeutic neuromodulation device to a target site within a nasal region in accordance with embodiments of the present technology. 
         FIG. 4  is an isometric view of a distal portion of a therapeutic neuromodulation device configured in accordance with an embodiment of the present technology. 
         FIGS. 5A-5G  are isometric views of electrode configurations of therapeutic neuromodulation devices for therapeutic neuromodulation in accordance with embodiments of the present technology. 
         FIGS. 6A and 6B  are partially schematic diagrams illustrating electrode configurations at a distal portion of a therapeutic neuromodulation device for nerve detection configured in accordance with embodiments of the present technology. 
         FIG. 7  is a graph illustrating threshold levels of electrical conductivity of nasal tissue with respect to temperature. 
         FIGS. 8 and 9  are isometric views of a distal portion of a therapeutic neuromodulation device configured in accordance with an embodiment of the present technology. 
         FIG. 10A  is an isometric view of a distal portion of a therapeutic neuromodulation device configured in accordance with another embodiment of the present technology, and  FIG. 10B  is an isometric view illustrating the therapeutic neuromodulation device of  FIG. 10A  at a treatment site. 
         FIGS. 11A-11D  are isometric views illustrating a distal portion of a therapeutic neuromodulation device configured in accordance with yet another embodiment of the present technology. 
         FIG. 12  is a side view of a distal portion of a therapeutic neuromodulation device configured in accordance with a further embodiment of the present technology. 
         FIG. 13  is a side view of a distal portion of a therapeutic neuromodulation device configured in accordance with a still further embodiment of the present technology. 
         FIG. 14  is an isometric side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 15  is an isometric side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 16  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 17  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 18  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 19  is a side view of a distal portion of a therapeutic neuromodulation device configured in accordance with an additional embodiment of the present technology. 
         FIG. 20  is a partial cut-away side view illustrating target sites proximate to ostia of nasal sinuses for a therapeutic neuromodulation device configured in accordance with embodiments of the present technology. 
     
    
    
     DETAILED DESCRIPTION 
     The present technology is generally directed to devices for therapeutic nasal neuromodulation and associated systems and methods. The disclosed devices are configured to provide an accurate and localized non-invasive application of energy to disrupt the parasympathetic motor sensory function in the nasal region. Specific details of several embodiments of the present technology are described herein with reference to  FIGS. 1A-20 . Although many of the embodiments are described with respect to devices, systems, and methods for therapeutically modulating nerves in the nasal region for the treatment of rhinitis, other applications and other embodiments in addition to those described herein are within the scope of the present technology. For example, at least some embodiments of the present technology may be useful for the treatment of other indications, such as the treatment of chronic sinusitis and epitaxis. It should be noted that other embodiments in addition to those disclosed herein are within the scope of the present technology. Further, embodiments of the present technology can have different configurations, components, and/or procedures than those shown or described herein. Moreover, a person of ordinary skill in the art will understand that embodiments of the present technology can have configurations, components, and/or procedures in addition to those shown or described herein and that these and other embodiments can be without several of the configurations, components, and/or procedures shown or described herein without deviating from the present technology. 
     With regard to the terms “distal” and “proximal” within this description, unless otherwise specified, the terms can reference relative positions of portions of a therapeutic neuromodulation device and/or an associated delivery device with reference to an operator and/or a location within the nasal cavity. For example, in referring to a delivery catheter suitable to deliver and position various prosthetic valve devices described herein, “proximal” can refer to a position closer to the operator of the device or access point at the entrance point of a patient&#39;s nostril, and “distal” can refer to a position that is more distant from the operator of the device or further from the access point at the entrance of the patient&#39;s nostril. Additionally, posterior, anterior, inferior and superior are used in accordance with standard medical terminology. 
     As used herein, the terms “therapeutic modulation” of nerves and “therapeutic neuromodulation” refer to the partial or complete incapacitation or other effective disruption of neural activity, including partial or complete ablation of nerves. Therapeutic neuromodulation, for example, can include partially or completely inhibiting, reducing, and/or blocking neural communication along neural fibers. 
     Anatomy of the Nasal Cavity 
       FIG. 1A  is a cut-away side view illustrating the anatomy of a lateral nasal wall, and  FIG. 1B  is an enlarged side view of the nerves of the lateral nasal wall of  FIG. 1A . The sphenopalatine foramen (“SPF”;  FIG. 1A ) is an opening or conduit defined by the palatine bone and the sphenoid bone through which the sphenopalatine vessels and the posterior superior nasal nerves travel into the nasal cavity. More specifically, the orbital and sphenoidal processes of the perpendicular plate of the palatine bone define the sphenopalatine notch, which is converted into the SPF by the articulation with the surface of the body of the sphenoid bone. 
     The location of the SPF is highly variable within the posterior region of the lateral nasal cavity, which makes it difficult to visually locate the SPF. Typically, the SPF is located in the middle meatus (“MM”;  FIG. 1A ); however, anatomical variations also result in the SPF being located in the superior meatus (“SM”;  FIG. 1A ) or at the transition of the superior and middle meatuses. In certain individuals, for example, the inferior border of the SPF has been measured at about 19 mm above the horizontal plate of the palatine bone (i.e., the nasal sill), which is about 13 mm above the horizontal lamina of the inferior turbinate (“IT”;  FIG. 1A ), and the average distance from the nasal sill to the SPF is about 64.4 mm, resulting in an angle of approach from the nasal sill to the SPA of about 11.4°. However, studies to measure the precise location of the SPF are of limited practical application due to the wide variation of its location. 
     The anatomical variations of the SPF are expected to correspond to alterations of the autonomic and vascular pathways traversing into the nasal cavity. In general, it is thought that the posterior nasal nerves (also referred to as lateral posterior superior nasal nerves) branch from the pterygopalatine ganglion (“PPG”; also referred to as the sphenopalatine ganglion;  FIG. 1A ) through the SPF to enter the lateral nasal wall of the nasal cavity, and the sphenopalatine artery passes from the pterygopalatine fossa through the SPF on the lateral nasal wall. The sphenopalatine artery branches into two main portions: the posterior lateral nasal branch and the posterior septal branch. The main branch of the posterior lateral nasal artery travels inferiorly into the inferior turbinate IT (e.g., between about 1.0 mm and 1.5 mm from the posterior tip of the inferior turbinate IT), while another branch enters the middle turbinate MT and branches anteriorly and posteriorly. 
     Beyond the SPF, studies have shown that over 30% of human patients have one or more accessory foramen that also carries arteries and nerves into the nasal cavity. The accessory foramena are typically smaller than the SPF and positioned inferior to the SPF. For example, there can be one, two, three or more branches of the posterior nasal artery and posterior nasal nerves that extend through corresponding accessory foramen. The variability in location, size, and quantity associated with the accessory foramen and the associated branching arteries and nerves that travel through the accessory foramen gives rise to a great deal of uncertainty regarding the positions of the vasculature and nerves of the sphenopalatine region. Furthermore, the natural anatomy extending from the SPF often includes deep inferior and/or superior grooves that carry neural and arterial pathways, which make it difficult to locate arterial and neural branches. For example the grooves can extend more than 5 mm long, more than 2 mm wide, and more than 1 mm deep, thereby creating a path significant enough to carry both arteries and nerves. The variations caused by the grooves and the accessory foramen in the sphenopalatine region make locating and accessing the arteries and nerves (positioned posterior to the arteries) extremely difficult for surgeons. 
     Recent microanatomic dissection of the pterygopalatine fossa (PPF) have further evidenced the highly variable anatomy of the region surrounding the SPF, showing that a multiplicity of efferent rami that project from the pterygopalatine ganglion (“PPG”;  FIG. 1 ) to innervate the orbit and nasal mucosa via numerous groups of small nerve fascicles, rather than an individual postganglionic autonomic nerves (e.g., the posterior nasal nerve). Studies have shown that at least 87% of humans have microforamina and micro rami in the palatine bone.  FIG. 1C , for example, is a front view of a left palatine bone illustrating geometry of microforamina and micro rami in a left palatine bone. In  FIG. 1C , the solid regions represent nerves traversing directly through the palatine bone, and the open circles represent nerves that were associated with distinct microforamina. Indeed,  FIG. 1C  illustrates that a medial portion of the palatine bone can include at least 25 accessory posterolateral nerves. 
     The respiratory portion of the nasal cavity mucosa is composed of a type of ciliated pseudostratified columnar epithelium with a basement membrane. Nasal secretions (e.g., mucus) are secreted by goblet cells, submucosal glands, and transudate from plasma. Nasal seromucous glands and blood vessels are highly regulated by parasympathetic innervation deriving from the vidian and other nerves. Parasympathetic (cholinergic) stimulation through acetylcholine and vasoactive intestinal peptide generally results in mucus production. Accordingly, the parasympathetic innervation of the mucosa is primarily responsible submucosal gland activation/hyper activation, venous engorgement (e.g., congestion), and increased blood flow to the blood vessels lining the nose. Accordingly, severing or modulating the parasympathetic pathways that innervate the mucosa are expected to reduce or eliminate the hyper activation of the submucosal glands and engorgement of vessels that cause symptoms associated with rhinosinusitis and other indications. 
     As discussed above, postganglionic parasympathetic fibers that innervate the nasal mucosa (i.e., posterior superior nasal nerves) were thought to travel exclusively through the SPF as a sphenopalatine neurovascular bundle. The posterior nasal nerves are branches of the maxillary nerve that innervate the nasal cavity via a number of smaller medial and lateral branches extending through the mucosa of the superior and middle turbinates ST, MT (i.e., nasal chonchea) and to the nasal septum. The nasopalatine nerve is generally the largest of the medial posterior superior nasal nerves. It passes antero-inferiorly in a groove on the vomer to the floor of the nasal cavity. From here, it passes through the incisive fossa of the hard palate and communicates with the greater palatine nerve to supply the mucosa of the hard palate. The posterior superior nasal nerves pass through the pterygopalatine ganglion PPG without synapsing and onto the maxillary nerve via its ganglionic branches. 
     Based on the understanding that the posterior nasal nerves exclusively traverse the SPF to innervate the nasal mucosa, surgeries have been performed to selectively sever the posterior nasal nerve as it exits the SPF. However, as discussed above, the sinonasal parasympathetic pathway actually comprises individual rami project from the pterygopalatine ganglion (PPG) to innervate the nasal mucosa via multiple small nerve fascicles (i.e., accessory posterolateral nerves), not a single branch extending through the SPF. These rami are transmitted through multiple fissures, accessory foramina, and microforamina throughout the palatine bone and may demonstrate anastomotic loops with both the SPF and other accessory nerves. Thus, if only the parasympathetic nerves traversing the SPF were severed, almost all patients (e.g., 90% of patients or more) would retain intact accessory secretomotor fibers to the posterolateral mucosa, which would result in the persistence of symptoms the neurectomy was meant to alieve. 
     Accordingly, embodiments of the present technology are configured to therapeutically modulate nerves at precise and focused treatment sites corresponding to the sites of rami extending through fissures, accessory foramina, and microforamina throughout the palatine bone (e.g., target region T shown in  FIG. 1B ). In certain embodiments, the targeted nerves are postganglionic parasympathetic nerves that go on to innervate the nasal mucosa. This selective neural treatment is also expected to decrease the rate of postoperative nasal crusting and dryness because it allows a clinician to titrate the degree of anterior denervation through judicious sparing of the rami orbitonasalis. Furthermore, embodiments of the present technology are also expected to maintain at least some sympathetic tone by preserving a portion of the sympathetic contributions from the deep petrosal nerve and internal maxillary periarteriolar plexi, leading to improved outcomes with respect to nasal obstruction. In addition, embodiments of the present technology are configured to target a multitude of parasympathetic neural entry locations (e.g., accessory foramen, fissures, and microforamina) to the nasal region to provide for a complete resection of all anastomotic loops, thereby reducing the rate of long-term re-innervation. 
     Selected Embodiments of Systems for Therapeutic Nasal Neuromodulation and Neural Mapping 
       FIG. 2  is a partially schematic view of a therapeutic neuromodulation system  200  (“system  200 ”) for therapeutically modulating nerves in a nasal region in accordance with an embodiment of the present technology. The system  200  includes a therapeutic neuromodulation catheter or device  202 , a console  204 , and a cable  206  extending therebetween. The therapeutic neuromodulation device  202  includes a shaft  208  having a proximal portion  208   a , a distal portion  208   b , a handle  210  at a proximal portion  208   a  of the shaft  208 , and a therapeutic assembly or element  212  at the distal portion  208   b  of the shaft  208 . The shaft  208  is configured to locate the distal portion  208   b  intraluminally at a treatment or target site within a nasal region proximate to postganglionic parasympathetic nerves that innervate the nasal mucosa. The target site may be a region, volume, or area in which the target nerves are located and may differ in size and shape depending upon the anatomy of the patient. For example, the target site may be a 3 cm area inferior to the SPF. In other embodiments, the target site may be larger, smaller, and/or located elsewhere in the nasal cavity to target the desired neural fibers. The therapeutic assembly  212  can include at least one energy delivery element  214  configured to therapeutically modulate the postganglionic parasympathetic nerves. In certain embodiments, for example, the therapeutic assembly  212  can therapeutically modulate the postganglionic parasympathetic nerves branching from the pterygopalatine ganglion and innervating the nasal region and nasal mucosa, such as parasympathetic nerves (e.g., the posterior nasal nerves) traversing the SPF, accessory foramen, and microforamina of a palatine bone. 
     As shown in  FIG. 2 , the therapeutic assembly  212  includes at least one energy delivery element  214  configured to provide therapeutic neuromodulation to the target site. In certain embodiments, for example, the energy delivery element  214  can include one or more electrodes configured to apply electromagnetic neuromodulation energy (e.g., RF energy) to target sites. In other embodiments, the energy delivery element  214  can be configured to provide therapeutic neuromodulation using various other modalities, such as cryotherapeutic cooling, ultrasound energy (e.g., high intensity focused ultrasound (“HIFU”) energy), microwave energy (e.g., via a microwave antenna), direct heating, high and/or low power laser energy, mechanical vibration, and/or optical power. In further embodiments, the therapeutic assembly  212  can be configured to deliver chemicals or drugs to the target site to chemically ablate or embolize the target nerves. For example, the therapeutic assembly  212  can include a needle applicator extending through an access portion of the shaft  208  and/or a separate introducer, and the needle applicator can be configured to inject a chemical into the target site to therapeutically modulate the target nerves, such as botox, alcohol, guanethidine, ethanol, phenol, a neurotoxin, or another suitable agent selected to alter, damage, or disrupt nerves. 
     In certain embodiments, the therapeutic assembly  212  can include one or more sensors (not shown), such as one or more temperature sensors (e.g., thermocouples, thermistors, etc.), impedance sensors, and/or other sensors. The sensor(s) and/or the energy delivery element  214  can be connected to one or more wires (not shown; e.g., copper wires) extending through the shaft  208  to transmit signals to and from the sensor(s) and/or convey energy to the energy delivery element  214 . 
     The therapeutic neuromodulation device  202  can be operatively coupled to the console  204  via a wired connection (e.g., via the cable  206 ) and/or a wireless connection. The console  204  can be configured to control, monitor, supply, and/or otherwise support operation of the therapeutic neuromodulation device  202 . The console  204  can further be configured to generate a selected form and/or magnitude of energy for delivery to tissue or nerves at the target site via the therapeutic assembly  212 , and therefore the console  204  may have different configurations depending on the treatment modality of the therapeutic neuromodulation device  202 . For example, when therapeutic neuromodulation device  202  is configured for electrode-based, heat-element-based, and/or transducer-based treatment, the console  204  can include an energy generator  216  configured to generate RF energy (e.g., monopolar, bipolar, or multi-polar RF energy), pulsed electrical energy, microwave energy, optical energy, ultrasound energy (e.g., intraluminally-delivered ultrasound and/or HIFU), direct heat energy, radiation (e.g., infrared, visible, and/or gamma radiation), and/or another suitable type of energy. When the therapeutic neuromodulation device  202  is configured for cryotherapeutic treatment, the console  204  can include a refrigerant reservoir (not shown), and can be configured to supply the therapeutic neuromodulation device  202  with refrigerant. Similarly, when the therapeutic neuromodulation device  202  is configured for chemical-based treatment (e.g., drug infusion), the console  204  can include a chemical reservoir (not shown) and can be configured to supply the therapeutic neuromodulation device  202  with one or more chemicals. 
     As further shown in  FIG. 2 , the system  200  can further include a controller  218  communicatively coupled to the therapeutic neuromodulation device  202 . In the illustrated embodiment, the controller  218  is housed in the console  204 . In other embodiments, the controller  218  can be carried by the handle  210  of the therapeutic neuromodulation device  202 , the cable  206 , an independent component, and/or another portion of the system  200 . The controller  218  can be configured to initiate, terminate, and/or adjust operation of one or more components (e.g., the energy delivery element  214 ) of the therapeutic neuromodulation device  202  directly and/or via the console  204 . The controller  218  can be configured to execute an automated control algorithm and/or to receive control instructions from an operator (e.g., a clinician). For example, the controller  218  and/or other components of the console  204  (e.g., memory) can include a computer-readable medium carrying instructions, which when executed by the controller  218 , causes the therapeutic assembly  202  to perform certain functions (e.g., apply energy in a specific manner, detect impedance, detect temperature, detect nerve locations or anatomical structures, etc.). A memory includes one or more of various hardware devices for volatile and non-volatile storage, and can include both read-only and writable memory. For example, a memory can comprise random access memory (RAM), CPU registers, read-only memory (ROM), and writable non-volatile memory, such as flash memory, hard drives, floppy disks, CDs, DVDs, magnetic storage devices, tape drives, device buffers, and so forth. A memory is not a propagating signal divorced from underlying hardware; a memory is thus non-transitory. 
     Further, the console  204  can be configured to provide feedback to an operator before, during, and/or after a treatment procedure via evaluation/feedback algorithms  220 . For example, the evaluation/feedback algorithms  220  can be configured to provide information associated with the temperature of the tissue at the treatment site, the location of nerves at the treatment site, and/or the effect of the therapeutic neuromodulation on the nerves at the treatment site. In certain embodiments, the evaluation/feedback algorithm  220  can include features to confirm efficacy of the treatment and/or enhance the desired performance of the system  200 . For example, the evaluation/feedback algorithm  220 , in conjunction with the controller  218 , can be configured to monitor temperature at the treatment site during therapy and automatically shut off the energy delivery when the temperature reaches a predetermined maximum (e.g., when applying RF energy) or predetermined minimum (e.g., when applying cryotherapy). In other embodiments, the evaluation/feedback algorithm  220 , in conjunction with the controller  218 , can be configured to automatically terminate treatment after a predetermined maximum time, a predetermined maximum impedance rise of the targeted tissue (i.e., in comparison to a baseline impedance measurement), a predetermined maximum impedance of the targeted tissue), and/or other threshold values for biomarkers associated with autonomic function. This and other information associated with the operation of the system  200  can be communicated to the operator via a display  222  (e.g., a monitor or touchscreen) on the console  204  and/or a separate display (not shown) communicatively coupled to the console  204 . 
     In various embodiments, the therapeutic assembly  212  and/or other portions of the system  200  can be configured to detect various parameters of the heterogeneous tissue at the target site to determine the anatomy at the target site (e.g., tissue types, tissue locations, vasculature, bone structures, foramen, sinuses, etc.), locate nerves and/or other structures, and allow for neural mapping. For example, the therapeutic assembly  212  can be configured to detect impedance, dielectric properties, temperature, and/or other properties that indicate the presence of neural fibers in the target region. As shown in  FIG. 2 , the console  204  can include a nerve monitoring assembly  221  (shown schematically) that receives the detected electrical and/or thermal measurements of tissue at the target site taken by the therapeutic assembly  212 , and process this information to identify the presence of nerves, the location of nerves, and/or neural activity at the target site. This information can then be communicated to the operator via a high resolution spatial grid (e.g., on the display  222 ) and/or other type of display. The nerve monitoring assembly  221  can be operably coupled to the energy delivery element  214  and/or other features of the therapeutic assembly  212  via signal wires (e.g., copper wires) that extend through the cable  206  and through the length of the shaft  208 . In other embodiments, the therapeutic assembly  212  can be communicatively coupled to the nerve monitoring assembly  221  using other suitable communication means. 
     The nerve monitoring assembly  221  can determine neural locations and activity before therapeutic neuromodulation to determine precise treatment regions corresponding to the positions of the desired nerves, during treatment to determine the effect of the therapeutic neuromodulation, and/or after treatment to evaluate whether the therapeutic neuromodulation treated the target nerves to a desired degree. This information can be used to make various determinations related to the nerves proximate to the target site, such as whether the target site is suitable for neuromodulation. In addition, the nerve monitoring assembly  221  can also compare the detected neural locations and/or activity before and after therapeutic neuromodulation, and compare the change in neural activity to a predetermined threshold to assess whether the application of therapeutic neuromodulation was effective across the treatment site. For example, the nerve monitoring assembly  221  can determine electroneurogram (ENG) signals based on recordings of electrical activity of neurons taken by the therapeutic assembly  212  before and after therapeutic neuromodulation. Statistically meaningful (e.g., measurable or noticeable) decreases in the ENG signal(s) taken after neuromodulation can serve as an indicator that the nerves were sufficiently ablated. 
     The system  200  can further include a channel  224  extending along at least a portion of the shaft  208  and a port  226  at the distal portion  208   b  of the shaft in communication with the port  226 . In certain embodiments, the channel  224  is a fluid pathway to deliver a fluid to the distal portion  208   b  of the shaft  208  via the port  226 . For example, the channel  224  can deliver saline solution or other fluids to rinse the intraluminal nasal pathway during delivery of the therapeutic assembly  212 , flush the target site before applying therapeutic neuromodulation to the target site, and/or deliver fluid to the target site during energy delivery to reduce heating or cooling of the tissue adjacent to the energy delivery element  214 . In other embodiments, the channel  224  allows for drug delivery to the treatment site. For example, a needle (not shown) can project through the port  226  to inject or otherwise deliver a nerve block, a local anesthetic, and/or other pharmacological agent to tissue at the target site. 
     The therapeutic neuromodulation device  202  provides access to target sites deep within the nasal region, such as at the immediate entrance of parasympathetic fibers into the nasal cavity to therapeutically modulate autonomic activity within the nasal cavity. In certain embodiments, for example, the therapeutic neuromodulation device  202  can position the therapeutic assembly  212  inferior to the SPF at the site of access foramen and/or microforamina (e.g., as shown in  FIGS. 1B and 1C ). By manipulating the proximal portion  208   a  of the shaft  208  from outside the entrance of the nose, a clinician may advance the shaft  208  through the tortuous intraluminal path through the nasal cavity and remotely manipulate the distal portion  208   b  of the shaft  208  via the handle  210  to position the therapeutic assembly  212  at the target site. In certain embodiments, the shaft  208  can be a steerable device (e.g., a steerable catheter) with a small bend radius (e.g., a 5 mm bend radius, a 4 mm bend radius, a 3 mm bend radius or less) that allows the clinician to navigate through the tortuous nasal anatomy. The steerable shaft can further be configured to articulate in at least two different directions. For example, the steerable shaft  208  can include dual pull wire rings that allow a clinician to form the distal portion  208   b  of the shaft  208  into an “S”-shape to correspond to the anatomy of the nasal region. In other embodiments, the articulating shaft  208  can be made from a substantially rigid material (e.g., a metal material) and include rigid links at the distal portion  208   b  of the shaft  208  that resist deflection, yet allow for a small bend radius (e.g., a 5 mm bend radius, a 4 mm bend radius, a 3 mm bend radius or less). In further embodiments, the steerable shaft  208  may be a laser-cut tube made from a metal and/or other suitable material. The laser-cut tube can include one or more pull wires operated by the clinician to allow the clinician to deflect the distal portion  208   b  of the shaft  208  to navigate the tortuous nasal anatomy to the target site. 
     In various embodiments, the distal portion  208   b  of the shaft  208  is guided into position at the target site via a guidewire (not shown) using an over-the-wire (OTW) or a rapid exchange (RX) technique. For example, the distal end of the therapeutic assembly  212  can include a channel for engaging the guidewire. Intraluminal delivery of the therapeutic assembly  212  can include inserting the guide wire into an orifice in communication with the nasal cavity (e.g., the nasal passage or mouth), and moving the shaft  208  and/or the therapeutic assembly  212  along the guide wire until the therapeutic assembly  212  reaches a target site (e.g., inferior to the SPF). 
     In further embodiments, the therapeutic neuromodulation device  202  can be configured for delivery via a guide catheter or introducer sheath (not shown) with or without using a guide wire. The introducer sheath can first be inserted intraluminally to the target site in the nasal region, and the distal portion  208   b  of the shaft  208  can then be inserted through the introducer sheath. At the target site, the therapeutic assembly  212  can be deployed through a distal end opening of the introducer sheath or a side port of the introducer sheath. In certain embodiments, the introducer sheath can include a straight portion and a pre-shaped portion with a fixed curve (e.g., a 5 mm curve, a 4 mm curve, a 3 mm curve, etc.) that can be deployed intraluminally to access the target site. In this embodiment, the introducer sheath may have a side port proximal to or along the pre-shaped curved portion through which the therapeutic assembly  212  can be deployed. In other embodiments, the introducer sheath may be made from a rigid material, such as a metal material coated with an insulative or dielectric material. In this embodiment, the introducer sheath may be substantially straight and used to deliver the therapeutic assembly  212  to the target site via a substantially straight pathway, such as through the middle meatus MM ( FIG. 1A ). 
     Image guidance may be used to aid the clinician&#39;s positioning and manipulation of the distal portion  208   b  of the shaft  208  and the therapeutic assembly  212 . For example, as described in further detail below with respect to  FIGS. 3A-3E , an endoscope (not shown) can be positioned to visualize the target site, the positioning of the therapeutic assembly  212  at the target site, and/or the therapeutic assembly  212  during therapeutic neuromodulation. In certain embodiments, the distal portion  208   b  of the shaft  208  is delivered via a working channel extending through an endoscope, and therefore the endoscope can provide direct in-line visualization of the target site and the therapeutic assembly  212 . In other embodiments, an endoscope is incorporated with the therapeutic assembly  212  and/or the distal portion  208   b  of the shaft  208  to provide in-line visualization of the assembly  212  and/or the surrounding nasal anatomy. In still further embodiments, image guidance can be provided with various other guidance modalities, such as image filtering in the infrared (IR) spectrum to visualize the vasculature and/or other anatomical structures, computed tomography (CT), fluoroscopy, ultrasound, optical coherence tomography (OCT), and/or combinations thereof. Further, in some embodiments, image guidance components may be integrated with the therapeutic neuromodulation device  202  to provide image guidance during positioning of the therapeutic assembly  212 . 
     Once positioned at the target site, the therapeutic modulation may be applied via the energy delivery element  214  and/or other features of the therapeutic assembly  212  to precise, localized regions of tissue to induce one or more desired therapeutic neuromodulating effects to disrupt parasympathetic motor sensory function. The therapeutic assembly  212  can selectively target postganglionic parasympathetic fibers that innervate the nasal mucosa at a target or treatment site proximate to or at their entrance into the nasal region. For example, the therapeutic assembly  212  can be positioned to apply therapeutic neuromodulation at least proximate to the SPF ( FIG. 1A ) to therapeutically modulate nerves entering the nasal region via the SPF. The therapeutic assembly  212  can also be positioned to inferior to the SPF to apply therapeutic neuromodulation energy across accessory foramen and microforamina (e.g., in the palatine bone) through which smaller medial and lateral branches of the posterior superior lateral nasal nerve enter the nasal region. The purposeful application of the energy at the target site may achieve therapeutic neuromodulation along all or at least a portion of posterior nasal neural fibers entering the nasal region. The therapeutic neuromodulating effects are generally a function of, at least in part, power, time, and contact between the energy delivery elements and the adjacent tissue. For example, in certain embodiments therapeutic neuromodulation of autonomic neural fibers are produced by applying RF energy at a power of about 2-20 W (e.g., 5 W, 7 W, 10 W, etc.) for a time period of about 1-20 sections (e.g., 5-10 seconds, 8-10 seconds, 10-12 seconds, etc.). The therapeutic neuromodulating effects may include partial or complete denervation via thermal ablation and/or non-ablative thermal alteration or damage (e.g., via sustained heating and/or resistive heating). Desired thermal heating effects may include raising the temperature of target neural fibers above a desired threshold to achieve non-ablative thermal alteration, or above a higher temperature to achieve ablative thermal alteration. For example, the target temperature may be above body temperature (e.g., approximately 37° C.) but less than about 90° C. (e.g., 70-75° C.) for non-ablative thermal alteration, or the target temperature may be about 100° C. or higher (e.g., 110° C., 120° C., etc.) for the ablative thermal alteration. Desired non-thermal neuromodulation effects may include altering the electrical signals transmitted in a nerve. 
     Hypothermic effects may also provide neuromodulation. As described in further detail below, for example, a cryotherapeutic applicator may be used to cool tissue at a target site to provide therapeutically-effective direct cell injury (e.g., necrosis), vascular injury (e.g., starving the cell from nutrients by damaging supplying blood vessels), and sublethal hypothermia with subsequent apoptosis. Exposure to cryotherapeutic cooling can cause acute cell death (e.g., immediately after exposure) and/or delayed cell death (e.g., during tissue thawing and subsequent hyperperfusion). Embodiments of the present technology can include cooling a structure positioned at or near tissue such that the tissue is effectively cooled to a depth where the targeted postganglionic parasympathetic nerves reside. For example, the cooling structure is cooled to the extent that it causes therapeutically effective, cryogenic posterior nasal nerve modulation. 
     In certain embodiments, the system  200  can determine the locations of the nerves, accessory foramen, and/or microforamina before therapy such that the therapeutic neuromodulation can be applied to precise regions including parasympathetic neural fibers. For example, the system  200  may identify a target site that has a length and/or width of about 3 mm inferior to the SPF, and the therapeutic assembly  212  can apply therapeutic neuromodulation to the identified target site via one or more applications of therapeutic neuromodulation. In other embodiments, the target site may be smaller or larger (e.g., a 3 cm-long target region) based on the detected locations of neural fibers and foramena. This neural and anatomical mapping allows the system  200  to accurately detect and therapeutically modulate the postganglionic parasympathetic neural fibers that innervate the mucosa at the numerous neural entrance points into the nasal cavity. Further, because there are not any clear anatomical markers denoting the location of the SPF, accessory foramen, and microforamina, the neural mapping allows the operator to identify and therapeutically modulate nerves that would otherwise be unidentifiable without intricate dissection of the mucosa. In addition, anatomical mapping can also allow the operator to identify certain structures that the operator may wish to avoid during therapeutic neural modulation (e.g., certain arteries). 
     Sufficiently modulating at least a portion of the parasympathetic nerves is expected to slow or potentially block conduction of autonomic neural signals to the nasal mucosa to produce a prolonged or permanent reduction in nasal parasympathetic activity. This is expected to reduce or eliminate activation or hyperactivation of the submucosal glands and venous engorgement and, thereby, reduce or eliminate the symptoms of rhinosinusitis. Further, because the system  200  applies therapeutic neuromodulation to the multitude of branches of the posterior nasal nerves rather than a single large branch of the posterior nasal nerve branch entering the nasal cavity at the SPF, the system  200  provides a more complete disruption of the parasympathetic neural pathway that affects the nasal mucosa and results in rhinosinusitis. Accordingly, the system  200  is expected to have enhanced therapeutic effects for the treatment of rhinosinusitis and reduced re-innervation of the treated mucosa. 
     In other embodiments, the system  200  can be configured to therapeutically modulate nerves and/or other structures to treat different indications. As discussed in further detail below, for example, the system  200  can be used to locate and/or therapeutically modulate nerves that innervate the para-nasal sinuses to treat chronic sinusitis. In further embodiments, the system  200  and the devices disclosed herein can be configured therapeutically modulate the vasculature within the nasal anatomy to treat other indications, such as epistaxis (i.e., excessive bleeding from the nose). For example, the system  200  and the therapeutic neuromodulation devices described herein can be used to apply therapeutically effective energy to arteries (e.g., the sphenopalatine artery and its branches) as they enter the nasal cavity (e.g., via the SPF, accessory foramen, etc.) to partially or completely coagulate or ligate the arteries. In other embodiments, the system  200  can be configured to partially or completely coagulate or ligate veins and/or other vessels. For such embodiments in which the therapeutic assembly  212  ligates or coagulates the vasculature, the system  200  would be modified to deliver energy at significantly higher power (e.g., about 100 W) and/or longer times (e.g., 1 minute or longer) than would be required for therapeutic neuromodulation. In various embodiments, the system  100  could apply the anatomical mapping techniques disclosed herein to locate or detect the targeted vasculature and surrounding anatomy before, during, and/or after treatment. 
       FIGS. 3A-3E  are partial cut-away side views illustrating various approaches for delivering a distal portion of the therapeutic neuromodulation device  202  of  FIG. 2  to a target site within a nasal region in accordance with embodiments of the present technology. As shown in  FIG. 3A , in various embodiments the distal portion  208   b  of the shaft  208  extends into the nasal passage NP, through the inferior meatus IM between the inferior turbinate IT and the nasal sill NS, and around the posterior portion of the inferior turbinate IT where the therapeutic assembly  212  is deployed at a treatment site. As shown in  FIG. 3A , the treatment site can be located proximate to the access point or points of postganglionic parasympathetic nerves (e.g., branches of the posterior nasal nerve and/or other parasympathetic neural fibers that innervate the nasal mucosa) into the nasal cavity. In other embodiments, the target site can be elsewhere within the nasal cavity depending on the location of the target nerves. An endoscope  330  and/or other visualization device is delivered proximate to the target site by extending through the nasal passage NP and through the middle meatus MM between the inferior and middle turbinates IT and MT. From the visualization location within the middle meatus MM, the endoscope  330  can be used to visualize the treatment site, surrounding regions of the nasal anatomy, and the therapeutic assembly  212 . 
     As further shown in  FIG. 3A , the shaft  208  of the therapeutic neuromodulation device  202  can include a positioning member  332  positioned proximal to the therapeutic assembly  212  and the target site. In the illustrated embodiment, the positioning member  332  is a balloon that is expanded in an opening (e.g., in one of the meatuses) against opposing structures (e.g., between the turbinates) to consistently hold the distal portion  208   b  of the shaft  208  in a desired position relative to the target site and provide stability for deployment of the therapeutic assembly  212 . In other embodiments, the positioning member  332  may include other expandable structures (e.g., a mesh baskets) or anchor features that can be deployed to maintain a desired position of the shaft  208  within the nasal cavity. In further embodiments, the positioning member  332  can be positioned distal to the therapeutic assembly  212  and expanded in a region distal to the therapeutic assembly  212  and the treatment site. In still further embodiments, the positioning member  332  is positioned on an introducer sheath (not shown) through which the shaft  208  and/or other devices (e.g., a fluid line for delivery of saline or local anesthetics, an endoscope, a sensor, etc.) can pass. The positioning member  332  can be positioned proximal to the target site (e.g., similar to the position shown in  FIG. 3A ) or distal to the treatment site. When positioned distally, the introducer sheath can include a side exit port through which the therapeutic assembly  212  and other features can be deployed at the target site. When the positioning member  332  is positioned on the introducer sheath, the positioning member  332  can provide stability for delivery and deployment of the distal portion  208   b  of the shaft  208  and the therapeutic assembly  212 . The positioning member  332  can be incorporated on the shaft  208 , an associated introducer sheath, and/or other deliver features of the system  200  ( FIG. 2 ) when the therapeutic assembly  212  is delivered through different intraluminal passageways. 
       FIG. 3B  illustrates a differ embodiment in which the distal portion  208   b  of the shaft  208  extends into the nasal passage NP, through the middle meatus MM between the inferior turbinate IT and the middle turbinate, and in posterior direction where the therapeutic assembly  212  is deployed at a treatment site. In this embodiment, the endoscope  330  and/or other visualization device is delivered alongside the shaft  208  through the same intraluminal pathway as the therapeutic assembly  212 . The pathway through the middle meatus MM may provide for generally straight access to the target site depending on the specific region of interest and anatomical variations of the patient. Accordingly, an approach through the middle meatus MM may require less steering and/or articulation of the shaft  208  and the endoscope  330 . Further, because the distal portion  208   b  of the shaft  208  and the endoscope  330  travel along the same delivery path, the endoscope can provide in-line or side-by-side visualization of the therapeutic assembly  212 . 
     Similar to the embodiment shown in  FIG. 3B ,  FIG. 3C  illustrates another intraluminal pathway in which the distal portion  208   b  of the shaft  208  and the endoscope  330  travel next to each other such that the endoscope  330  can provide in-line or side-by-side visualization of the distal portion  208   b  of the shaft  208 , the therapeutic assembly  212 , and/or the nasal anatomy. In the embodiment shown in  FIG. 3C , however, the intraluminal pathway extends through the inferior meatus IM to a posterior treatment site. 
     As shown in  FIG. 3D , in other embodiments the distal portion  208   b  of the shaft  208  extends to the treatment site via the middle meatus MM, and the endoscope  330  extends through the inferior meatus IM to a position proximate to the target site. In this embodiment, the endoscope  330  may have an articulating, steerable, or curved distal end that directs the endoscope  330  superiorly to visualize the nasal anatomy and the therapeutic assembly  332  at the target site. For example, the distal end portion of the endoscope  330  can be configured to bend at least 30° to visualize the treatment site. 
     As shown in  FIG. 3E , in further embodiments the distal portion  208   b  of the shaft  208  can be delivered to the treatment site via the mouth. In this embodiment, therapeutic neuromodulation can be applied at a treatment site posterior to the nasal cavity (e.g., posterior to the SPF). The endoscope  330  (not shown) can extend into the nasal passage NP, through the middle meatus MM or the inferior meatus IM to a position proximate to the treatment site. Alternatively, the endoscope  330  (not shown) can travel along the same pathway as the shaft  208 . 
       FIG. 4  is an isometric view of a distal portion of a therapeutic neuromodulation device  402  configured in accordance with an embodiment of the present technology. The therapeutic neuromodulation device  402  can be used in conjunction with the system  200  described above with respect to  FIGS. 2-3E . As shown in  FIG. 4 , the therapeutic neuromodulation device  402  can include a shaft  408  having a proximal portion (not shown) and a distal portion  408   b , and a therapeutic assembly  412  at the distal portion  408   b  of the shaft  408 . The therapeutic assembly  412  is transformable between a low-profile delivery state to facilitate intraluminal delivery of the therapeutic assembly  412  to a treatment site within the nasal region and an expanded state (shown in  FIG. 4 ). The therapeutic assembly  412  includes a plurality of struts  440  that are spaced apart from each other to form a frame or basket  442  when the therapeutic assembly  412  is in the expanded state. The struts  440  can carry one or more energy delivery elements, such as a plurality of electrodes  444 . In the expanded state, the struts  440  can position at least two of the electrodes  444  against tissue at a target site within the nasal region (e.g., proximate to the palatine bone inferior to the SPF). The electrodes  444  can apply bipolar or multi-polar radiofrequency (RF) energy to the target site to therapeutically modulate postganglionic parasympathetic nerves that innervate the nasal mucosa proximate to the target site. In various embodiments, the electrodes  444  can be configured to apply pulsed RF energy with a desired duty cycle (e.g., 1 second on/0.5 seconds off) to regulate the temperature increase in the target tissue. 
     In the embodiment illustrated in  FIG. 4 , the basket  442  includes eight branches  446  spaced radially apart from each other to form at least a generally spherical structure, and each of the branches  446  includes two struts  440  positioned adjacent to each other. In other embodiments, however, the basket  442  can include fewer than eight branches  446  (e.g., two, three, four, five, six, or seven branches) or more than eight branches  446 . In further embodiments, each branch  446  of the basket  442  can include a single strut  440 , more than two struts  440 , and/or the number of struts  440  per branch can vary. In still further embodiments, the branches  446  and struts  440  can form baskets or frames having other suitable shapes for placing the electrodes  444  in contact with tissue at the target site. For example, when in the expanded state, the struts  440  can form an ovoid shape, a hemispherical shape, a cylindrical structure, a pyramid structure, and/or other suitable shapes. 
     As shown in  FIG. 4 , the therapeutic assembly  412  can further include an internal or interior support member  448  that extends distally from the distal portion  408   b  of the shaft  408 . A distal end portion  450  of the support member  448  can support the distal end portions of the struts  440  to form the desired basket shape. For example, as shown in  FIG. 4 , the struts  440  can extend distally from the distal portion  408   b  of the shaft  408  and the distal end portions of the struts  440  can attach to the distal end portion  450  of the support member  448 . In certain embodiments, the support member  448  can include an internal channel (not shown) through which electrical connectors (e.g., wires) coupled to the electrodes  444  and/or other electrical features of the therapeutic element  412  can run. In various embodiments, the internal support member  448  can also carry an electrode (not shown) at the distal end portion  450  and/or along the length of the support member  448 . 
     The basket  442  can transform from the low-profile delivery state to the expanded state ( FIG. 4 ) by manipulating a handle (e.g., the handle  210  of  FIG. 2 ) and/or other feature at the proximal portion of the shaft  408  and operably coupled to the basket  442 . For example, to move the basket  442  from the expanded state to the delivery state, an operator can push the support member  448  distally to bring the struts  440  inward toward the support member  448 . An introducer or guide sheath (not shown) can be positioned over the low-profile therapeutic assembly  412  to facilitate intraluminal delivery or removal of the therapeutic assembly  412  from or to the target site. In other embodiments, the therapeutic assembly  412  is transformed between the delivery state and the expanded state using other suitable means. 
     The individual struts  440  can be made from a resilient material, such as a shape-memory material (e.g., Nitinol) that allows the struts  440  to self-expand into the desired shape of the basket  442  when in the expanded state. In other embodiments, the struts  440  can be made from other suitable materials and/or the therapeutic assembly  412  can be mechanically expanded via a balloon or by proximal movement of the support member  448 . The basket  442  and the associated struts  440  can have sufficient rigidity to support the electrodes  444  and position or press the electrodes  444  against tissue at the target site. In addition, the expanded basket  442  can press against surrounding anatomical structures proximate to the target site (e.g., the turbinates, the palatine bone, etc.) and the individual struts  440  can at least partially conform to the shape of the adjacent anatomical structures to anchor the therapeutic element  412  at the treatment site during energy delivery. In addition, the expansion and conformability of the struts  440  can facilitate placing the electrodes  444  in contact with the surrounding tissue at the target site. 
     At least one electrode  444  is disposed on individual struts  440 . In the illustrated embodiment, two electrodes  444  are positioned along the length of each strut  440 . In other embodiments, the number of electrodes  444  on individual struts  440  be only one, more than two, zero, and/or the number of electrodes  444  on the different struts  440  can vary. The electrodes  444  can be made from platinum, iridium, gold, silver, stainless steel, platinum-iridium, cobalt chromium, iridium oxide, polyethylenedioxythiophene (“PEDOT”), titanium, titanium nitride, carbon, carbon nanotubes, platinum grey, Drawn Filled Tubing (“DFT”) with a silver core made by Fort Wayne Metals of Fort Wayne, Ind., and/or other suitable materials for delivery RF energy to target tissue. 
     In certain embodiments, each electrode  444  can be operated independently of the other electrodes  444 . For example, each electrode can be individually activated and the polarity and amplitude of each electrode can be selected by an operator or a control algorithm (e.g., executed by the controller  218  of  FIG. 2 ). Various embodiments of such independently controlled electrodes  444  are described in further detail below with reference to  FIGS. 5A-5G . The selective independent control of the electrodes  444  allows the therapeutic assembly  412  to deliver RF energy to highly customized regions. For example, a select portion of the electrodes  444  can be activated to target neural fibers in a specific region while the other electrodes  444  remain inactive. In certain embodiments, for example, electrodes  444  may be activated across the portion of the basket  442  that is adjacent to tissue at the target site, and the electrodes  444  that are not proximate to the target tissue can remain inactive to avoid applying energy to non-target tissue. Such configurations facilitate selective therapeutic modulation of nerves on the lateral nasal wall within one nostril without applying energy to structures in other portions of the nasal cavity. 
     The electrodes  444  can be electrically coupled to an RF generator (e.g., the generator  216  of  FIG. 2 ) via wires (not shown) that extend from the electrodes  444 , through the shaft  408 , and to the RF generator. When each of the electrodes  444  is independently controlled, each electrode  444  couples to a corresponding wire that extends through the shaft  408 . In other embodiments, multiple electrodes  444  can be controlled together and, therefore, multiple electrodes  444  can be electrically coupled to the same wire extending through the shaft  408 . The RF generator and/or components operably coupled (e.g., a control module) thereto can include custom algorithms to control the activation of the electrodes  444 . For example, the RF generator can deliver RF power at about 200-300 W to the electrodes  444 , and do so while activating the electrodes  444  in a predetermined pattern selected based on the position of the therapeutic element  412  relative to the treatment site and/or the identified locations of the target nerves. In other embodiments, the RF generator delivers power at lower levels (e.g., less than 15 W, 15-50 W, 50-150 W, etc.) and/or higher power levels. 
     As shown in  FIG. 4 , the therapeutic assembly  412  can further include one or more temperature sensors  452  disposed on the struts  440  and/or other portions of the therapeutic assembly  412  and configured to detect the temperature adjacent to the temperature sensor  452 . The temperature sensors  452  can be electrically coupled to a console (e.g., the console  204  of  FIG. 2 ) via wires (not shown) that extend through the shaft  408 . In various embodiments, the temperature sensors  452  can be positioned proximate to the electrodes  444  to detect the temperature at the interface between tissue at the target site and the electrodes  444 . In other embodiments, the temperature sensors  452  can penetrate the tissue at the target site (e.g., a penetrating thermocouple) to detect the temperature at a depth within the tissue. The temperature measurements can provide the operator or the system with feedback regarding the effect of the therapeutic neuromodulation on the tissue. For example, in certain embodiments the operator may wish to prevent or reduce damage to the tissue at the treatment site (e.g., the nasal mucosa), and therefore the temperature sensors  452  can be used to determine if the tissue temperature reaches a predetermined threshold for irreversible tissue damage. Once the threshold is reached, the application of therapeutic neuromodulation energy can be terminated to allow the tissue to remain intact. In certain embodiments, the energy delivery can automatically terminate based on an evaluation/feedback algorithm (e.g., the evaluation/feedback algorithm  220  of  FIG. 2 ) stored on a console (e.g., the console  204  of  FIG. 2 ) operably coupled to the temperature sensors  452 . 
       FIGS. 5A-5G  are isometric views of examples of electrode configurations of therapeutic neuromodulation devices (identified individually as first through fourth therapeutic neuromodulation devices  502   a - 502   d , respectively; referred to collectively as therapeutic neuromodulation devices  502 ) for therapeutic neuromodulation in accordance with embodiments of the present technology. The therapeutic neuromodulation devices  502  of  FIGS. 5A-5G  can include features generally similar to the features of the therapeutic neuromodulation device  402  of  FIG. 4 . For example, the therapeutic neuromodulation devices  502  include a plurality of struts  440  that form a basket  442  when in an expanded state, and a plurality of electrodes  444  disposed on one or more of the struts  440 . In the illustrated embodiments, the first through third therapeutic neuromodulation device  502   a - c  shown in  FIGS. 5A-5E  include a single strut  440  corresponding to each branch  446  of the basket  442 , whereas the fourth therapeutic neuromodulation device  502   d  shown in  FIGS. 5F and 5G  includes two adjacent struts  440  in each branch  446  of the basket  442 . In other embodiments, however, the branches  446  of the therapeutic neuromodulation devices  502  may have different quantities of struts  440 , and apply RF energy in the same manner as described below with reference to  FIGS. 5A-5G . As shown in  FIGS. 5A-5G , the electrodes  444  can be independently controlled and activated via instructions from a controller (e.g., the controller  218  of  FIG. 2 ) or a generator (e.g., the generator  216  of  FIG. 2 ) to apply RF energy across selected regions or segments of the therapeutic assembly  412 . 
     In the embodiment shown in  FIG. 5A , two electrodes  444  of the therapeutic assembly  412  are activated in the first therapeutic neuromodulation device  502   a . More specifically, a first electrode  444   a  on a first strut  440   a  is activated at a positive polarity, and a second electrode  444   b  on a second strut  440   b  spaced radially apart from the first strut  440   a  is activated at a negative polarity. The remainder of the electrodes  444  remain inactive. Accordingly, as indicated by the arrows, current can flow from the first electrode  444   a  to the second electrode  444   b  through the target tissue across a circumferential or peripheral segment of the therapeutic assembly  412 . This configuration may be used to therapeutically modulate nerves positioned proximate to the peripheral segment. In other embodiments, different or additional electrodes  444  can be activated to have a selected polarity to apply therapeutic neuromodulation across selected regions of the therapeutic assembly  412  in a predetermined manner. 
     In the embodiment shown in  FIG. 5B , the first therapeutic neuromodulation device  502   a  is configured to have three selectively active electrodes  444 . A first electrode  444   a  on a first strut  440   a  is activated at a positive polarity, and second and third electrodes  444   b  and  444   c  on corresponding second and third struts  440   b  and  440   c  are activated at a negative polarity. The remainder of the electrodes  444  remain inactive. As indicated by the arrows, current can flow through the tissue from the first electrode  444   a  to the second and third electrodes  444   b  and  444   c  across a segment of the therapeutic assembly  412 , and therefore therapeutically modulate nerves positioned proximate to the peripheral segment. In the illustrated embodiment, the second and third activated electrodes  444   b  and  444   c  are positioned on struts  440   b ,  440   c  that are radially spaced apart from but adjacent to the first strut  440   a  carrying the first active electrode  444   a . In other embodiments, however, electrodes  444  positioned on struts  440  spaced further from the first strut  440   a  to apply energy across a larger and/or wider segment of the therapeutic assembly  412 . 
     In the embodiment shown in  FIG. 5C , all of the electrodes  444  in a first hemispherical region  501   a  of the therapeutic assembly  412  are activated, while the electrodes  444  of the second hemispherical region  501   b  are not activated. A first electrode on a first strut  440   a  is selectively activated at a positive polarity, and a plurality of electrodes  444  (identified individually as second through fifth electrodes  444   b - 444   e , respectively) within the first hemispherical region  501   a  are selectively activated at a negative polarity such that RF energy is applied across the first hemispherical region  501   a . This electrode activation configuration may be used to apply RF energy across one side of the basket  442  to therapeutically modulate nerves on the lateral nasal wall in one nostril. When the therapeutic assembly  412  is positioned in the other nostril, a different set of electrodes  444  can be activated across a hemispherical region of the therapeutic assembly  412  based on the orientation of the basket  442  with respect to the lateral nasal wall. Further, because the basket  442  has a generally symmetrical shape (e.g., circular, oval, etc.) and because the electrodes  444  can be selectively activated, the orientation of the basket  442  with respect to the target site on the lateral nasal wall does not matter. Instead, the operator can deploy the therapeutic assembly  412  at the target site irrespective of orientation, and selectively activate the electrodes  444  in a desired arrangement to apply RF energy across the target site. 
     In the embodiment shown in  FIG. 5D , the second therapeutic neuromodulation device  502   b  is configured to selectively control the polarity of a plurality of the electrodes  444  across at least a portion of the therapeutic assembly  412  to apply RF energy in a sesquipolar fashion (i.e., the sequential or transient bipolar pairing of electrodes). In the illustrated embodiment, a first electrode  444   a  is biased at a positive polarity and second through seventh electrodes  444   b - 444   g  are controlled to have negative polarities. The second through seventh electrodes  444   b - 444   g  are spaced substantially equal distances apart from the first electrode  444   a  such that the electrodes  444  are dimensionally predisposed to multiplex in sequence. In operation, the first through seventh electrodes  444   a - 444   g  are concurrently activated. However, rather than all of the negative electrodes  444  pairing or multiplexing with the positive first electrode  444   a  simultaneously, the first electrode  444   a  will pair with the individual negative electrodes  444  in a sequential manner based on the path of least resistance. This path of least resistance is dictated by the natural anatomy of the treatment site in contact with the electrodes  444 . For example, based on the anatomy at the target site, the first electrode  444   a  may initially pair with the second electrode  444   b . After this initial pairing preference has dissipated, a second pairing (e.g., with the third electrode  444   c ) will occur based on the path of least resistance. The first electrode  444   a  will continue to sequentially pair with the remaining activated negative electrodes in a similar manner until a threshold is reached and the electrodes  444  are in a state of equilibrium in which there is homogenized current flow between all of the electrode pairs. With each sequential pairing, the therapeutic assembly  412  increases the size of the ablation zone (i.e., the region in which therapeutic neuromodulation energy is applied). As indicated by the numbers  1 - 6  in  FIG. 5D , this sequential pairing of the electrodes  444  may occur in a circular direction (e.g., in a counter clockwise or clockwise direction) based on the impedance changes between the electrodes  444 . In other embodiments, the sequential pairing of electrodes  444  may occur in a different pattern based on the anatomical surroundings and/or the positioning of the electrodes  444 . For example, in the illustrated embodiment, the activated electrodes  444  are positioned in a quadrant of the therapeutic element  412  with equal radial distances between the individual electrode pairs. In other embodiments, the activated electrodes  444  can be positioned across larger or smaller regions of the therapeutic element  412  to apply energy across larger or smaller treatment regions. 
     The sesquipolar application of RF energy allows the therapeutic assembly  412  to intelligently apply RF energy across a target site to therapeutically modulate nerves proximate to the treatment site. For example, when in an equidistant radial relationship to each other, the naturally occurring impedance changes between the electrode pairs cause the therapeutic assembly  412  to radially increase the zone of energy application with each pairing. In other embodiments, the electrodes  444  can be configured to sequentially pair with each other in a manner such that the zone of energy application increases in a transverse and/or longitudinal manner based on the naturally occurring impedance changes between the electrodes  444 . Further, due to the sequential impedance-based pairing of the electrodes  444 , the sesquipolar arrangement of the therapeutic assembly  412  can inherently limit the energy applied to tissue at the target site because once the impedance exceeds a threshold in one electrode pairing, the next electrode pairing will occur with a lower impedance. In other embodiments, a controller (e.g., the controller  218  of  FIG. 2 ) can include instructions (e.g., software) that provides for the sequential pairing of electrodes in a radial, transverse, longitudinal, and/or spiral manner. 
     In further embodiments, portions of the struts  440  themselves can define the electrodes  444 . In this embodiment, the struts  440  are made from an electrically conductive material and coated with an insulative material (e.g., poly-xylene polymers, including Paralyene C). Portions of the struts  440  can remain uncoated to define electrodes  444 . The locations of the uncoated portions of the struts  440  (i.e., the electrodes  444 ) can be selected to provide a desired neuromodulation pattern. For example, the uncoated portions can be spaced equally apart from a central electrode  444  to allow for sesquipolar RF application. In this embodiment, the conductive struts  440  serve as the electrical connectors and, therefore, the therapeutic assembly  412  does not require as many wires as if the electrodes  444  were separate elements positioned on the struts  440 . 
     In the embodiment shown in  FIG. 5E , the third therapeutic neuromodulation device  502   c  includes a return electrode  503  at the distal end portion  450  of the support member  448  and selective polarity control of the individual electrodes  444  on the struts  440  to provide radial multiplexing of the electrodes  444 . The return electrode  503  has a negative polarity, and the other electrodes  444  have a positive polarity. In the illustrated embodiment, all of the electrodes  444  are activated, but in other embodiments the electrodes  444  can be selectively activated based on a desired energy application zone. As indicated by the arrows, this configuration applies RF energy across a distal hemispherical region of the basket  442 . In other embodiments, the return electrode  503  can be positioned elsewhere on the therapeutic assembly  412 , and the electrodes  444 ,  503  can be used to apply RF energy across different regions of the basket  442 . In further embodiments, the return electrode  503  can be activated in conjunction with two or more of the electrodes  444  on the struts to apply RF energy in a sesquipolar manner. 
     In the embodiment shown in  FIG. 5F , the fourth therapeutic neuromodulation device  502   d  includes branches  446  having two adjacent struts  440 , and the electrodes  444  on the adjacent struts are spaced apart from each other in a longitudinal direction and selectively activated to apply energy in a radial direction across discrete zones. For example, a first electrode  444   a  on a first strut  440   a  of a first branch  446   a  may be selectively activated to have a first polarity and a second electrode  444   b  on the adjacent second strut  440   b  of the first branch  446   a  may be selectively activated to have a second polarity opposite the first polarity. As indicated by the arrows in  FIG. 5F , the first and second electrodes  444   a  and  444   b  can then apply bipolar RF energy in a radial direction within a specific region of the therapeutic assembly  412 . 
     As further shown in  FIG. 5F , the individual struts  440  can include multiple electrodes  444  disposed thereon, and the adjacent strut  440  in the same branch  446  can have a corresponding quantity of electrodes  444  to allow for bipolar coupling of each of the electrode pairs along discrete regions of the branch  446 . In certain embodiments, the electrodes of one strut  440  can all have the same polarity (e.g., coupled to a first wire; not shown), and the electrodes  444  of the adjacent strut  440  in the same branch  446  can all have the opposite polarity (e.g., coupled to a second wire; not shown). In other embodiments, the electrodes  444  on an individual strut  440  can be independently controlled to have a desired polarity. 
     In various embodiments, the electrode pairing configurations shown in  FIG. 5F  can be used to detect impedance across selected regions of the therapeutic assembly  412  defined by the bipolar electrode pairs. The impedance measurements can then be used to identify the presence of neural fibers in the selected regions. If nerves are detected in one or more specific regions associated with an electrode pair, the same electrode pair can be used to apply RF energy to that region and therapeutically modulate the nerves in that region. 
     In the embodiment shown in  FIG. 5G , the fourth therapeutic neuromodulation device  502   d  is configured to selectively control the polarity of a plurality of the electrodes  444  across at least a portion of the therapeutic assembly  412  to apply RF energy in a multi-polar manner in a circular or spiral pattern. As shown in  FIG. 5G , electrodes  444  of one branch  446  can be activated to have negative polarities and electrodes  444  of another branch  446  can be activated to have positive polarities. The arrangement of the electrodes  444  and the variable distances between the electrodes  444  can differ such that the energy application zone has a different shape or pattern. In other embodiments, the positive and negative electrodes  444  are spaced apart from each other at variable distances. Impedance changes resulting from the surrounding anatomical structures causes the electrodes to pair with each other in a sequential manner and, thereby, continuously increase the zone or region in which energy is applied in a radial direction and in a generally spiral manner. 
     Energy generally travels deeper into the adjacent target tissue the further the positive and negative electrode pairs are spaced apart from each other. Thus, the depth of influence of the therapeutic neuromodulation energy is expected to increase as the coupled electrode pairs are spaced further apart from each other on the basket  442 . In the embodiment illustrated in  FIG. 5G , for example, electrode pairs at the distal and proximal regions of the basket  442  apply energy to shallower depths in the target tissue than the electrode pairs positioned on the medial region of the basket  442 . Accordingly, the electrodes pairs positioned closer together can therapeutically modulate nerves at shallower depths than the electrode pairs spaced further apart from each other. As shown in the illustrated embodiment, some of the electrodes  444  and/or entire branches  446  of the basket  442  can remain inactive to achieve the desired depth of energy application and/or neuromodulation pattern. 
     Selected Embodiments of Neural Detection and Mapping 
     Various embodiments of the present technology can include features that measure bio-electric, dielectric, and/or other properties of heterogeneous tissue at target sites within the nasal region to determine the presence, location, and/or activity of neural fibers and, optionally, map the locations of the detected nerves. The features discussed below can be incorporated into any of the systems and/or devices disclosed herein to provide an accurate depiction of nerves at the target site. 
     Neural detection can occur (a) before the application of a therapeutic neuromodulation energy to determine the presence or location of nerves at the target site and/or record baseline levels of neural activity; (b) during therapeutic neuromodulation to determine the effect of the energy application on the neural fibers at the treatment site; and/or (c) after therapeutic neuromodulation to confirm the efficacy of the treatment on the targeted nerves. Due to the anatomical variations of the number and locations of the parasympathetic neural fibers that innervate the nasal cavity and the numerous access points (e.g., the SPF, accessory foramen, and microforamina) through which they enter the nasal cavity, such neural detection and mapping can provide an accurate representation of the neural anatomy to adequately treat the parasympathetic nerves, not just the one or two main branches of the posterior nasal nerves traversing the SPF. 
     In certain embodiments, the systems disclosed herein can use bioelectric measurements, such as impedance, resistance, voltage, current density, and/or other parameters (e.g., temperature) to determine the anatomy, in particular the neural anatomy, at the target site. The location of the neural anatomy can then be used to determine where the treatment site(s) should be with respect to various anatomical structures for therapeutically effective neuromodulation of the targeted parasympathetic nasal nerves. For example, the information can be used to determine the treatment site(s) with respect to the location of the turbinates or meatuses. 
     The bioelectric properties can be detected via electrodes (e.g., the electrodes  444  of the therapeutic neuromodulation devices  402 - 502   d  of  FIGS. 4-5G ). The electrode pairings on a device (e.g., the therapeutic assemblies  412  described with respect to  FIGS. 4-5G ) can be selected to obtain the bioelectric data at specific zones or regions and at specific depths of the targeted regions.  FIGS. 6A and 6B , for example, are partially schematic diagrams illustrating configurations of electrodes  644  for nerve detection configured in accordance with embodiments of the present technology. As shown in  FIG. 6A , the further the electrodes  644  are apart from each other, the deeper into the tissue the current flows. Accordingly, electrodes  644  can be selectively activated based on the depth at which the desired measurements should be taken. As shown in  FIG. 6B , the spacing between the electrodes  644  along a plane (e.g., the surface of the tissue, can affect the region in which the measurements are taken. Thus, electrodes  644  can be selectively activated to obtain information (e.g., impedance) at a desired depth and across a desired region. In other embodiments, the bioelectric properties can be detected using optical coherent tomography (OCT), ultrasound, and/or other suitable detection modalities. 
     The measurement of bioelectric properties can provide information associated not only with neural fiber locations, but also the identification of gross anatomy (e.g., turbinates, meatuses, bone, etc.), which can be used to facilitate system delivery and identification of the target nerves with respect to the gross anatomy. For example, gross target identification can be determined by evaluating of the incident electromagnetic field on soft and hard tissues within the nasal region, which is in turn dependent upon the local geometry and the dielectric properties of those features. For example, because of the layered structure of the anatomy of the nasal cavity (e.g., nasal mucosa, submucosa, periosteum, and bony plates), there are large distinctions in the relative conductance of the soft and hard tissues that can be used to differentiate the “deeper” mucosal tissue on the turbinates from the “shallow” tissue off the turbinates. 
     In certain embodiments, measurements for neuro-mapping can be obtained by applying a constant current to electrodes and measuring the voltage differences between adjacent pairs of electrodes to produce a spectral profile or map the tissues at the target site. Impedance data can be obtained while applying high, medium, and/or low frequencies to the target tissue. At high frequencies, the current passes directly through cell membranes, and the resultant measurements are indicative of the tissue and liquids both inside and outside the cells. At low frequencies, cell membranes impede current flow to provide different defining characteristics of the tissue. Accordingly, bioimpedance can be used to measure targeted shapes or electrical properties of tissue and/or other structures of the nasal cavity. In addition, complex neural mapping can be performed using frequency difference reconstruction, which requires measurement data (e.g., impedance) at two different frequencies. 
     When detecting neural locations and activity via bioelectric properties, the spatial orientation, direction, and activity of the detected nerve bundles can be used to further identify and characterize the nerves. For example, the measured bioelectric properties can distinguish between terminating axons (i.e., entering a detection region, but not exiting), branching axons (i.e., entering the detection region and increasing in number upon exiting the detecting region), travelling axons (i.e., entering and exiting the detection region within no change in geometry or numerical value), and/or other properties of nerves. In addition, axon orientations relative to the electrode array can be identified to indicate whether the neural fibers extend parallel (X direction), perpendicular (Y direction), depth penetrating (Z direction), and/or any relative position or angulation to these parameters. This information can then be used to selectively treat specific neural fibers. For example, selected electrode configurations can be applied to treat a specific region and/or the therapeutic assembly can be moved or manipulated to treat the nerves from a different orientation or location. 
     In certain embodiments, temperature measurements can be taken to determine the effect of therapeutic neuromodulation on nasal tissue.  FIG. 7 , for example, is a graph illustrating threshold levels of electrical conductivity of nasal tissue with respect to temperature. A first curve  701  depicts the electrical conductivity (a) of tissue in response to temperature and indicates that a temperature of about 70° C. corresponds to a first threshold of the irreversible change in impedance of the tissue. A second curve  703  shows that the electrical conductivity of the tissue permanently increases significantly (i.e., impedance decreases) after the tissue has been exposed to temperatures of 70° C., as it may during therapeutic neuromodulation. If the therapeutic neuromodulation was stopped when the tissue temperature was detected to be about 70° C., it is expected that there would be a permanent measurable change in the conductivity of the tissue without reaching a phase in which the tissue is structurally changed or damaged (e.g., due to vaporization, desiccation, etc.). However, if the tissue is exposed to temperatures above a second thermal threshold of about 90° C., the tissue undergoes a high degree of tissue desiccation, and thus a significant decrease in electrical conductivity (i.e., and a higher level of in the electrical impedance). A third curve  705  illustrates this lower electrical conductivity of the tissue after exposure to temperatures above 90° C. Accordingly, in various embodiments, systems disclosed herein can be configured to stop neuromodulation when the temperature reaches about 70° C. (e.g., 70-80° C.) to avoid structural changes or damage to the mucosa, but still providing what is expected to be therapeutically effective neuromodulation. 
     Neural detection and mapping can provide a pre-procedural assessment of the neural anatomy, a mid-procedure assessment and feedback on temporal changes in tissue during neuromodulation, and/or a post procedural assessment of the neural activity as a confirmation of effectiveness. In various embodiments, the bioelectric measurements taken pre-, mid-, and post-procedurally can be taken multiple times during each stage of the procedure to assess and confirm findings. Pre-procedural assessment can be used to evaluate the bioelectric properties of the native/host tissue to determine a baseline for subsequent actions and as a reference guide against source biological signatures to identify anatomical targets of interest (e.g., nerves, microforamina, etc.). This information can be determined by placing a multi-electrode array in a known spatial configuration to detect and then map electro-anatomical characteristics (e.g., variations in the impedance of different tissue types). The resultant anatomical mapping can comprise a composition of multiple (high density) activation sequence in multiple planes, relying on the variations in impedance to identify different tissue types and structures. During the procedure, the impedance measurements can be used to confirm that the electrodes maintain good contact with tissue at the target site. During and after the procedure, the data can be used to determine whether the mid- or post-procedural recorded spectra has a shape consistent with the expected tissue types. Post-procedurally, the information can be used to determine whether the targeted nerves were therapeutically treated. 
     In other embodiments, the action potentials of neural fibers can be detected via electrodes and or other contacts to dynamically map the locations and/or activity of nerves in the target region. For example, the recorded action potentials can be used to numerically measure, map, and/or produce images of fast neuronal depolarization to generate an accurate picture of neural activity. In general, the depolarization of the neuronal membrane can cause drops in voltage of about 110 μV, has about 2 ms, and have an impedance/resistance from 1000 Ωcm to 250 Ωcm. In further embodiments, the metabolic recovery processes associated with action potential activity (i.e., to restore ionic gradients to normal) can also be detected and used for dynamically mapping nerves at the target site. The detection of the bioelectric properties associated with these features has the advantage that the changes are much larger (e.g., approximately a thousand times larger) and, therefore, easier to measure. 
     In various embodiments, a nontherapeutic stimulation (e.g., RF energy) can be applied to the tissue at the detection region via two or more electrodes of an electrode array to enhance the recording of action potentials. The stimulating energy application can temporarily activate the neural fibers and the resultant action potential can be recorded. For example, two or more electrodes of a therapeutic assembly can deliver a stimulating pulse of energy, and two or more other electrodes can be configured to detect the resultant action potential. The stimulating energy pulses are expected to enhance the action potential signal, making it easier to record. 
     Selected Embodiments of Therapeutic Neuromodulation Devices 
       FIGS. 8 and 9  are isometric views of a distal portion of a therapeutic neuromodulation device  802  (“device  802 ”) configured in accordance with an embodiment of the present technology. The device  802  can include various features generally similar to the features of the therapeutic neuromodulation devices  402  and  502   a - d  described above with reference to  FIGS. 4-5G . For example, the device  802  includes a therapeutic assembly  812  at a distal portion  408   b  of a shaft  408 . The therapeutic assembly  812  includes a plurality of struts  440  that form branches  446  and define an expandable frame or basket  442 , and one or more electrodes  444  disposed on one or more of the struts  440 . As shown in  FIGS. 8 and 9 , the device  902  can further include an expandable member  856  (e.g., a balloon) carried by the support member  448  and expandable within the basket  442 . The expandable member  856  can include a plurality of electrodes  858  disposed on the outer surface of the expandable member  856 . The electrodes  858  can be used for detection of bioelectric features (e.g., impedance) to allow for mapping of the neural anatomy at the target site before, during, and/or after therapeutic neuromodulation via the other electrodes  444 . In other embodiments, the electrodes  858  can be configured to apply energy for therapeutic neuromodulation. 
     As shown in  FIGS. 8 and 9 , the electrodes  858  can be positioned on the expandable member  856  in a substantially symmetrical manner and a uniform distribution. This provides an expansive array with which impedance and/or other properties can be detected across the tissue and, therefore, may provide a more detailed mapping of the tissue and nerves at the treatment site. In other embodiments, the electrodes  858  can be clustered toward the medial portion of the expandable member  856  and/or around different portions of the expandable member  856 . In certain embodiments, the electrodes  858  can be selectively activated at a specific polarity, and therefore the electrode array can be configured in a variety of static configurations and a dynamically change sequences (e.g., sesquipolar application of current) that may be advantageous for mapping functions. 
     In operation, the expandable member  856  can be inflated or otherwise expanded ( FIG. 9 ) to place at least a portion of the electrodes  858  into contact with tissue at the target site. The electrodes  858  can measure various bioelectric properties of the tissue (e.g., impedance, action potentials, etc.) to detect, locate, and/or map the nerves at the treatment site. In certain embodiments, the electrodes  444  on the struts  440  and/or a portion of the electrodes  858  on the expandable member  856  can apply a stimulating pulse of RF energy, and the electrodes  858  can detect the resultant neural response. After mapping, the expandable member  856  can be deflated or collapsed ( FIG. 8 ), and the electrodes  444  on the struts  440  can apply therapeutically effective neuromodulation energy to the target site. For example, the ablation pattern of the electrodes  444  can be based on the neural locations identified via the information detected from the sensing electrodes  858  on the expandable member  856 . In other embodiments, the expandable member  856  may remain expanded during neuromodulation, and the electrodes  858  can detect neural activity during the neuromodulation procedure or the electrodes  858  can themselves be configured to apply neuromodulation energy to the treatment site. After applying the neuromodulation energy, the electrodes  858  on the expandable member  856  can again be placed into contact with tissue at the target site, and used to record bioelectric properties (e.g., impedance). The detected properties (e.g., impedances) taken before, during, and/or after neuromodulation can be compared to each other to determine whether the neuromodulation was therapeutically effective. If not, the electrodes  444  can again apply therapeutic neuromodulation energy to the same treatment site, or the configuration of the active electrodes  444  can be changed to apply therapeutic neuromodulation energy in a different pattern or sequence, and/or the therapeutic assembly  812  can be moved to a different treatment site. 
       FIG. 10A  is an isometric view of a distal portion of a therapeutic neuromodulation device  1002  (“device  1002 ”) configured in accordance with another embodiment of the present technology, and  FIG. 10B  is an isometric view illustrating the therapeutic neuromodulation device  1002  of  FIG. 10A  at a treatment site. The device  1002  can include various features generally similar to the features of the therapeutic neuromodulation devices  402 ,  502   a - d , and  802  described above with reference to  FIGS. 4-5G, 8 and 9 . For example, the device  1002  includes a shaft  1008  and a therapeutic assembly  1012  at a distal portion  1008   b  of the shaft  1008 . The therapeutic assembly  1012  includes a plurality of struts  1040  that form branches  1046  and define an expandable frame or basket  1042 , and one or more electrodes  1044  disposed on one or more of the struts  1040 . As shown in  FIG. 10A , the device  1002  can further include a secondary or return electrode  1060  disposed along the distal portion of the shaft  1008 . In the illustrated embodiment, the return electrode  1060  is a ring electrode having a ring-like shape, but in other embodiments the return electrode  1060  may have other shapes or configurations. 
     The return electrode  1060  may be biased at a negative polarity, and at least a portion of the electrodes  1044  on the struts  1040  and/or on other portions of the therapeutic assembly  1012  may be biased at a positive polarity. As indicated by the arrows in  FIG. 10A , bipolar RF energy can flow across a region spanning from the therapeutic assembly  1012  to the return electrode  1060  on this distal portion  1008   b  of the shaft  1008 . In various embodiments, the RF energy can be applied in a sesquipolar manner (i.e., imbalanced bipolar energy). 
     As shown in  FIG. 10B , the therapeutic assembly  1012  can be positioned inferior to the SPF and superior to the inferior turbinate IT and at least a portion of the microforamina MF and nerves N traversing the palatine bone. The return electrode  1060  can be positioned inferior to the inferior turbinate IT and at least a portion of the microforamina MF and nerves N traversing the palatine bone. RF energy can then be applied across a wide region spanning from the therapeutic assembly  1012  to the return electrode  1060 . As shown in  FIG. 10B , for example, the device  1002  can apply energy across the top and bottom portions of the inferior turbinate, where a high density of microforamina reside. 
       FIGS. 11A-11D  are isometric views illustrating distal portions of therapeutic neuromodulation devices  1102  (referred to individually as a first device  1102   a  and a second device  1102   b ) configured in accordance with further embodiments of the present technology. The first device  1102   a  can include various features generally similar to the features of the therapeutic neuromodulation devices  402 ,  502   a - d ,  802  and  1002  described above with reference to  FIGS. 4-5G and 8-10B . For example, the first device  1102   a  includes a shaft  1108  and a therapeutic assembly  1112  at a distal portion  1108   b  of the shaft  1108 . The therapeutic assembly  1112  includes a flexible membrane  1162  that carries a plurality of electrodes  1144  and/or other energy delivery elements arranged in an array across the flexible membrane  1162 . 
     As shown in  FIGS. 11A-11C , the flexible membrane  1162  can be configured to transform from a low-profile delivery state ( FIG. 11A ), to an expanded state ( FIG. 11B ) via self-expansion or mechanical expansion means, and back to the low-profile delivery or retrieval state ( FIG. 11C ) for removal of the device from the nasal cavity. In the expanded state shown in  FIG. 11B , the flexible membrane can conform to the irregular anatomy of the nasal space (e.g., turbinates, sinus, and/or other para-nasal) to enhance the contact area between the flexible membrane  1162  (and the electrodes  1144  disposed thereon) with the non-planar anatomy. The flexible membrane  1162  can be made from a flexible and dynamic material to support the electrodes  1144 . For example, in certain embodiments the flexible membrane  1162  can comprise polymer filaments and/or other materials that add support and structure to the flexible membrane  1162 . In various embodiments, the flexible membrane  1162  can have pre-set geometry to retain a predetermined shape. For example, the flexible membrane  1162  and/or the electrode array on the flexible membrane  1162  can retain spherical curvature (e.g., as shown in  FIG. 11A ). 
     In various embodiments, the shaft  1108  can be movable relative to the flexible membrane  1162  to allow for deployment and recapture of the flexible membrane  1162 . For example, the flexible membrane  1162  may be curled or otherwise folded into a circular shape when in the delivery state ( FIG. 11A ). To move to the expanded state ( FIG. 11B ), components of the shaft  1108  can be rotated and/or moved axially relative to the flexible membrane  1162  to unwind or otherwise expand the flexible membrane  1162  such that the flexible membrane  1162  at least partially opens and conforms to the structures of the surrounding anatomy to place the electrodes  1144  into contact with tissue at the target site. To recapture the device to the retracted state ( FIG. 11C ), the shaft  1108  can again be moved axially or rotational manner to close wind or otherwise fold the flexible membrane  1162 . 
     As shown in  FIGS. 11A-11C , the electrodes  1144  may be interconnected through a plurality of connectors  1164 , such as nano-ribbons, nano-wires, direct inking, multidirectional printing/deposition, and/or other suitable electrical connectors. In various embodiments, the interconnections  1164  between the electrodes  1144  can include periodic undulating conduits or lines having a “U”, “S”, or elliptical shapes. These undulating connectors  1164  may form a multidimensional spring within the flexible membrane  1162  and/or impose a predetermined shape on the flexible membrane  1162  that facilitates apposition of the flexible membrane  1162  to the tissue at the target site to improve energy conductivity/transference. 
     The electrodes  1144  may be surface mounted on the flexible membrane  1162  or embedded within a multi-layered composite structure of the flexible membrane  1162 . In various embodiments, the electrodes  1144  may be relatively small in size, having diameters ranging from 50-2,000 microns. The electrodes  1144  may be configured to deliver energy in a mono-polar, bipolar, or multipolar manner. For example, multipolar electrodes can be used in a bipolar arrangement and in a quad-polar arrangement to facilitate a linear and an angulated (diagonal) energy connectivity between the electrodes  1144 . 
     The electrodes  1144  can be connected to a connection pad (not shown) housed within the shaft  1108  and/or features connected to proximal portions of the shaft  1108 , such as a handle or console. The electrodes  1144  can be connected to the connection pad through a conductive connector cable (e.g., a metallic cable, a polymeric cable, and/or combinations thereof). 
     In certain embodiments, the flexible membrane  1162  may also house a feedback system (not shown) to control the delivery of the RF energy and maintain predefined treatment parameters. For example, the electronic circuits of the flexible membrane  1162  may include thermal sensors that provide temperature feedback to control energy dissipation and depth penetration of the RF energy. The features of electronic circuits of the flexible membrane  1162  may also measure resistance and temperature at the treatment site to determine the effects of the therapeutic energy application. This information may be used to regulate energy application and avoid collateral damage to host tissue. For example, energy delivery via the electrodes  1144  may be automatically terminated if the detected temperature and/or resistance reaches a predetermined threshold maximum (e.g., a threshold temperature associated with tissue damage). Energy delivery via the electrodes  1144  may be automatically or manually adjusted if the detected temperature and/or resistance is below a predetermined threshold range indicative of parameters associated with therapeutically effective modulation of the parasympathetic nasal nerves. In other embodiments, the feedback system can be incorporated to components communicatively coupled with the electrodes  1144  and any additional sensors on the flexible membrane  1162 . For example, the feedback system can be stored on the console  204  of  FIG. 2  and executed by the controller  218  ( FIG. 2 ). 
     In the embodiment shown in  FIG. 11D , the second device  1102   b  can include various features generally similar to the features of the first device  1102   a  described above with reference to  FIGS. 11A-11C . For example, the device  1102   b  of  FIG. 11D  includes the flexible membrane  1162  that carries a plurality of electrodes  1144  and associated electrical connectors  1164  disposed on or embedded in the flexible membrane  1162 . The device  1102   b  further includes an expandable frame  1166  carrying the flexible membrane  1162 . The frame  1166  may have a U-shape and can be made from a shape memory material (e.g., Nitinol). In other embodiments, the frame may have different shapes and/or be made from different materials suitable for supporting the flexible membrane  1162 . 
     In operation, the frame  1166  facilitates the deployment of the flexible membrane  1162  against the anatomy of the nasal cavity, and provides support for the flexible membrane  1162  and the associated array of electrodes  1144 . The U-shaped frame  1166  can enhance the ability of the flexible membrane  1162  to contact the non-planar anatomy at the target site. In various embodiments, for example, the frame  1166  may act as a cantilever spring to establish a positive directional apposition of the membrane  1162  to the target surface tissue to improve energy conductivity/transference from the electrodes  1144  to the target tissue. 
       FIG. 12  is a side view of a distal portion of a therapeutic neuromodulation device  1202  (“device  1202 ”) configured in accordance with a further embodiment of the present technology. The device  1202  includes include various features generally similar to the features of the therapeutic neuromodulation devices  402 ,  502   a - d ,  802 ,  1002  and  1102  described above with reference to  FIGS. 4-5G and 8-11 . For example, the device  1202  includes a shaft  1208  and a therapeutic assembly  1212  including a plurality of energy delivery elements, such as electrodes  1244 , at a distal portion  1208   b  of the shaft  1208 . In the illustrated embodiment, the therapeutic assembly  1212  includes four electrodes  1244  are arranged along a spiral/helical section  1268  at the distal portion  1208   b  of the shaft  1208 . In other embodiments, however, the therapeutic assembly  1212  may include one, two, three, or more than four electrodes  1244 , and/or may include different energy delivery elements. The therapeutic assembly  1212  can also include a temperature sensor  1252  (e.g., a thermocouple) and/or other type of sensor to detect various properties at the treatment site before, during, and/or after applying therapeutic neuromodulation energy, and provide feedback that may be used to control the operation of the therapeutic assembly  1212 . Such sensors can be incorporated in any of the other embodiments of therapeutic assemblies disclosed herein. 
     During delivery of the therapeutic assembly  1212 , the spiral/helical section  1168  of the shaft  1208  is positioned in a low-profile delivery state in which the section  1268  is substantially straitened or flattened within an introducer sheath and/or via mechanical components associated with the shaft  1208 . At the target site, the operator can transform the spiral/helical section  1268  to an expanded state (shown in  FIG. 12 ) to place one or more of the electrodes  1244  in contact with the target tissue. One or more of the electrodes  1244  can then be selectively activated to apply RF energy (e.g., monopolar and/or bipolar RF energy) to tissue at a target site in the nasal region to therapeutically modulate nerves proximate to the treatment site. In other embodiments, the distal section of the shaft  1208  can have other suitable shapes, sizes, and/or configurations that facilitate placing the electrodes  1244  in contact with tissue at the target site. For example, in further embodiments, the distal portion  1208   b  of the shaft  1208  can have a semi-circular, curved, bent, or straight shape and/or the therapeutic assembly  1212  can include multiple support members configured to carry one or more of the electrodes  1244 . 
       FIG. 13  is a side view of a distal portion of a therapeutic neuromodulation device  1302  (“device  1302 ”) configured in accordance with a still further embodiment of the present technology. The device  1302  includes include various features generally similar to the features of the therapeutic neuromodulation devices  402 ,  502   a - d ,  802 ,  1002 ,  1102  and  1202  described above with reference to  FIGS. 4-5G and 8-12 . For example, the device  1302  includes a shaft  1308  and a therapeutic assembly  1312  including a plurality of energy delivery elements, such as an array of electrodes  1344 , at a distal portion  1308   b  of the shaft  1308 . In the embodiment illustrated in  FIG. 13 , the therapeutic assembly  1312  includes a balloon  1370  that carries the electrodes  1344 . A support member  1372  can extend through the length of the balloon  1370  to support the balloon  1370  and, optionally, include a channel through which a guidewire (not shown) can extend to facilitate delivery of the therapeutic assembly  1312  to the target site. In other embodiments, the support member  1372  may be omitted. 
     The electrodes  1344  can be made from conductive ink that is printed, sprayed, and/or otherwise disposed on the surface of the balloon  1370 . Such conductive ink electrodes facilitates the use of complex electrode configurations. In addition, thermocouples (not shown) can also be incorporated onto the surface of the balloon  1370  using conductive ink and/or other suitable methods. In other embodiments, the electrodes  1344  can be made from foil and adhered to the surface of the balloon  1370 . In further embodiments, the electrodes  1344  can be made from other suitable materials that may be disposed on the surface of the balloon  1370  and/or embedded within the material of the balloon  1370 . 
     The balloon  1370  can be made from various different materials and have various different shapes. As shown in  FIG. 13 , for example, the balloon  1370  can have an ovoid shape when in the expanded state, which is expected to improve the conformance to anatomical variations at the target site within the nasal cavity. In other embodiments, the balloon  1370  can have a circular shape, a spherical shape, an irregular shape, and/or other suitable shape for expansion within the nasal anatomy. The balloon  1370  can be made from a compliant material (e.g., a urethane material) that allows the balloon  1370  to conform to anatomical variances when expanded within the nasal region. In other embodiments, the balloon may be made from a non-compliant material (e.g., polyethylene terephthalate, nylon, etc.) that allows the balloon  1370  to have a defined shape when expanded and facilitates the attachment of electrodes  1344  to the balloon surface. In further embodiments, the balloon  1370  may be dip-coated and form a bulbous tip at the distal end of the shaft  1308 . 
     The balloon  1370  may be inflated with a fluid via an opening or port  1374  in the support member  1372  and/or an opening in the shaft  1308  in fluid communication with the interior of the balloon  1370 . For example, the support member  1372  and/or the shaft  1308  can include a channel extending along the length of the shaft  1308  and connected to a fluid supply at the proximal portion of the shaft  1308  such that fluid can be delivered to the balloon  1370 . The balloon  1370  can inflate against the nasal anatomy at the target site to places the electrodes  1344  in contact with tissue at the target site. 
     At the target site, the electrodes  1344  deliver RF energy to tissue to therapeutically modulate nerves at the treatment site. In certain embodiments, the array of electrodes  1344  can be arranged on the balloon  1370  and/or selectively activated to apply transverse bipolar RF energy across a radial regions of the balloon  1370  (i.e., extending around circumferential portions of the balloon  1370 ). In other embodiments, the array of electrodes  1344  can be arranged on the balloon  1370  and/or selectively activated to apply longitudinal bipolar RF energy across longitudinal regions of the balloon  1370  (i.e., extending between proximal and distal portions of the balloon  1370 ). 
     In various embodiments, the therapeutic assembly  1312  may include features that facilitate with positioning of the balloon  1370  within the nasal anatomy and proper placement of the electrodes  1344  at the treatment site. As shown in  FIG. 13 , for example, an endoscope  1371  may be positioned on the surface of the balloon  1370  to provide direct, in-line visualization of the balloon  1370  and the target site during placement at the target site. The therapeutic assembly  1312  can also include graduated markings  1373  along the support member  1372  and/or the surface of the balloon  1370  to depict spatial orientation and/or depth positioning of the therapeutic assembly  1312 . 
     In certain embodiments, the balloon  1370  can be configured to allow for a slow perfusion of fluid through the balloon wall to cool the electrodes  1344  while energy is applied to the target tissue. For example, such a “weeping” balloon  1370  can include laser-driller holes and/or other small openings or pores along at least a portion of the balloon  1370  to allow for the slow perfusion of a fluid (e.g., saline solution) through the balloon wall. When the balloon perfuses saline solution, the saline solution is expected to improve the electrical conductivity between the electrodes  1344  and the target tissue and may enhance the effect of the RF energy on the nerves at the target site. In other embodiments, a cooled fluid can be circulated through the balloon  1470  during activation of the electrodes  1444  to cool the electrodes  1444  and the surrounding tissue during energy delivery. 
       FIG. 14  is a side view of a distal portion of a therapeutic neuromodulation device  1402  (“device  1402 ”) configured in accordance with an additional embodiment of the present technology. The device  1402  includes include various features generally similar to the features of the therapeutic neuromodulation device  1302  described above with reference to  FIG. 13 . For example, the device  1402  includes a shaft  1408  and a therapeutic assembly  1412  at a distal portion  1408   b  of the shaft  1408 . The therapeutic assembly  1412  includes a balloon  1470 , a support member  1472  supporting the balloon  1470 , and a plurality of energy delivery elements, such as an array of electrodes  1444  disposed on the balloon  1470 . In the embodiment illustrated in  FIG. 14 , the electrodes  1444  are part of a flex circuit  1476  adhered to the surface of the balloon  1470 . The flex circuit  1476  facilitates the creation of complex electrode arrays that can create highly customizable neuromodulation patterns. In certain embodiments, for example, the flex circuit  1476  can include a conductive return electrode along the surface of the balloon  1470  and a plurality of electrodes on a proximal or distal portion of the balloon  1470  (e.g., a conical end portion of the balloon  1470 ). In addition, the flex circuit  1476  can incorporate thermocouples and/or thermistors into the circuitry on the surface of the balloon  1470  to detect temperature at the treatment site before, during, and/or after energy application. 
       FIG. 15  is an isometric side view of a distal portion of a therapeutic neuromodulation device  1502  (“device  1502 ”) configured in accordance with an additional embodiment of the present technology. The device  1502  includes include various features generally similar to the features of the therapeutic neuromodulation devices  1302  and  1402  described above with reference to  FIGS. 13 and 14 . For example, the device  1502  includes a shaft  1508  and a therapeutic assembly  1512  at a distal portion  1508   b  of the shaft  1508 . The therapeutic assembly  1512  includes a plurality of balloons  1578  positioned around an inner support member  1580 , and a plurality of energy delivery elements, such as electrodes  1544  disposed on one or more of the balloons  1578 . In certain embodiments, the balloons  1578  are independently inflatable. This allows for asymmetrical or variable inflation of the balloons  1578  and, thereby, enhances the ability of the therapeutic assembly  1512  to conform to the irregular geometry of the nasal region at the target site and facilitates apposition of the electrodes  1544  against tissue at the target site. 
     In the illustrated embodiment, four independently inflated balloons  1578  are positioned around the perimeter of the inner support member  1580 . In other embodiments, however, the device  1502  can include less than four balloons  1578  or more than four balloons  1578  arranged around the inner support member  1580 . In further embodiments, the balloons  1578  can have different sizes and/or shapes, and can be positioned along various portions of the inner support member  1580 . In still further embodiments, the balloons  1578  re configured as struts that are attached at end portions to the inner support member  1580  and extend outwardly away from the inner support member  1580  when inflated (e.g., in a similar manner as the struts  440  of the therapeutic neuromodulation device  402  of  FIG. 4 ). 
     During energy delivery, the electrodes  1544  can be configured to apply bipolar RF energy across the electrodes  1544  on different balloons  1578  and/or between electrodes  1544  on the same balloon  1578 . In other embodiments, the electrodes  1544  apply energy in a sesquipolar manner. For example, the inner support member  1580  can include a return electrode (not shown), and the electrodes  1544  on two or more of the balloons  1578  may be activated for sesquipolar RF energy delivery. 
       FIG. 16  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device  1602  (“device  1602 ”) configured in accordance with an additional embodiment of the present technology. The device  1602  includes various features generally similar to the features of the therapeutic neuromodulation devices described above. For example, the device  1602  includes a shaft  1608  and a therapeutic assembly  1612  at a distal portion  1608   b  of the shaft  1608 . In the embodiment illustrated in  FIG. 16 , the therapeutic assembly  1612  is configured to apply cryotherapeutic cooling to therapeutically modulate nerves at the target site. As shown in  FIG. 16 , the cryotherapeutic assembly  1612  can include an expansion chamber  1682  (e.g., a balloon, inflatable body, etc.) in fluid communication with one or more supply tubes or lumens  1684  via corresponding orifices  1686  in the supply lumens  1684 . The supply lumens  1682  can extend along at least a portion of the shaft  1608  and be configured to transport a refrigerant in an at least a partially liquid state to the distal portion  1608   b  of the shaft  1608 . An exhaust tube or lumen  1689  (e.g., defined by a portion of the shaft  1608 ) can be placed in fluid communication with the interior of the expansion chamber  1682  via an outlet  1688  such that the exhaust lumen  1689  can return the refrigerant to the proximal portion of the shaft  1608 . For example, in one embodiment, a vacuum (not shown) at the proximal portion of the shaft  1608  may be used to exhaust the refrigerant from the expansion chamber  1682  via the exhaust lumen  1689 . In other embodiments, the refrigerant may be transported to the proximal portion of the shaft  1608  using other suitable mechanisms known to those having skill in the art. 
     During cryotherapy, the orifices  1686  of the supply lumens  1684  can restrict refrigerant flow to provide a high pressure differential between the supply lumen  1684  and the expansion chamber  1682 , thereby facilitating the expansion of the refrigerant to the gas phase within the expansion chamber  1682 . The pressure drop as the liquid refrigerant passes through the orifices  1682  causes the refrigerant to expand to a gas and reduces the temperature to a therapeutically effective temperature that can modulate neural fibers proximate a treatment site within the nasal cavity. In the illustrated embodiment, the expansion chamber  1682  includes heat transfer portions  1691  that contact and cool tissue at the target site at a rate sufficient to cause cryotherapeutic neuromodulation of postganglionic parasympathetic neural fibers that innervate the nasal mucosa. For example, the therapeutic assembly  1602  can operate at temperatures of −40° C., −60° C., −80° C., or lower. In other embodiments, the therapeutic assembly  1602  can operated at higher cryotherapeutic temperatures (e.g., 5° C. and −15° C., −20° C., etc.). 
     The refrigerant used for cryogenic cooling in the device  1602  can be a compressed or condensed gas that is stored in at least a substantially liquid phase, such as nitrous oxide (N 2 O), carbon dioxide (CO 2 ), hydrofluorocarbon (e.g., FREON made available by E. I. du Pont de Nemours and Company of Wilmington, Del.), and/or other suitable fluids that can be stored at a sufficiently high pressure to be in at least a substantially liquid phase at about ambient temperature. For example, R-410A, a zeotropic, but near-azeotropic mixture of difluoromethane (CH 2 F 2 ; also known as HFC-32 or R-32) and pentafluoroethane (CHF 2 CF 3 ; also known as HFC-125 or R-125), can be in at least a substantially liquid phase at about ambient temperature when contained at a pressure of about 1.45 MPa (210 psi). Under proper conditions, these refrigerants can reach cryotherapeutic temperatures at or near their respective normal boiling points (e.g., approximately −88° C. for nitrous oxide) to effectuate therapeutic neuromodulation. 
     In other embodiments, the therapeutic assembly  1612  can include a cryotherapeutic applicator rather than the expansion chamber  1682  of  FIG. 16 . Such a cryotherapeutic applicator can be used for very targeted treatment of the nerves. 
     As further shown in  FIG. 16 , the device  1602  can also include a support member  1690  extending through the expansion chamber  1682  and configured to carry the distal portion of the expansion chamber  1682 . The support member  1690  can also include a channel extending along its length and an opening  1692  at the distal end portion of the support member  1690  to facilitate delivery of the therapeutic assembly  1612  to the treatment site via a guidewire GW. 
       FIG. 17  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device  1702  (“device  1702 ”) configured in accordance with an additional embodiment of the present technology. The device  1702  includes various features generally similar to the features of the therapeutic neuromodulation devices described above. For example, the device  1702  includes a shaft  1708  and a therapeutic assembly  1712  at a distal portion  1708   b  of the shaft  1708 . In the embodiment illustrated in  FIG. 17 , the therapeutic assembly  1712  is configured to apply direct conductive heating to thermally therapeutically modulate nerves at the target site. As shown in  FIG. 17 , the therapeutic assembly  1712  can include a balloon  1770  in fluid communication with a supply tube or lumen  1794  (e.g., defined by a portion of the shaft  1708 ) via an outlet at a distal portion of the supply lumen  1794 . The supply lumen  1794  can extend along at least a portion of the shaft  1708  and be insulated to transport a heated fluid (e.g., heated saline) to the balloon  1770  at the distal portion  1708   b  of the shaft  1708 . An exhaust or return tube or lumen  1796  (e.g., defined by a portion of the shaft  1708 ) can be placed in fluid communication with the interior of the balloon  1770  via an outlet such that the return lumen  1796  can exhaust the fluid to the proximal portion of the shaft  1708  (e.g., using a vacuum at the proximal portion of the shaft  1708 ). 
     During thermal therapeutic neural modulation, the supply lumen  1794  can supply a heated fluid to the balloon  1770 , and the exhaust lumen  1796  can be used to exhaust the fluid from the balloon  1770  such that the heated fluid circulates through the balloon  1770  (e.g., as indicated by the arrows). The heated fluid can be heated to a therapeutically effective temperature that causes time-dependent thermal damage (e.g., determined using the Arrhenius equation) to the target tissue at a treatment site within the nasal cavity and modulates neural fibers within or proximate to the heated target tissue. In the illustrated embodiment, for example, the wall of the balloon  1770  and/or portions thereof can contact and heat tissue at the target site at a rate and time sufficient to cause thermal damage to the target tissue to provide therapeutic neuromodulation of postganglionic parasympathetic neural fibers that innervate the nasal mucosa. 
     As shown in  FIG. 17 , the device  1702  can also include a support member  1790  extending through the balloon  1770  and configured to carry the distal portion of the balloon  1770 . The support member  1790  can also include a channel extending along its length and an opening  1792  at the distal end portion of the support member  1790  that can be used to facilitate delivery of the therapeutic assembly  1712  to the treatment site via a guidewire GW. 
       FIG. 18  is a cross-sectional side view of a distal portion of a therapeutic neuromodulation device  1802  (“device  1802 ”) configured in accordance with an additional embodiment of the present technology. The device  1802  includes various features generally similar to the features of the therapeutic neuromodulation devices described above. For example, the device  1802  includes a shaft  1808  and a therapeutic assembly  1812  at a distal portion  1808   b  of the shaft  1808 . The therapeutic assembly  1812  can include an inflatable balloon  1870  and a support member  1890  extending through the balloon  1870 . The support member  1890  may also include a channel with an opening  1892  that allows for guidewire delivery of the therapeutic assembly  1812  to the treatment site. 
     Similar to the therapeutic assembly  1712  of  FIG. 17 , the therapeutic assembly  1812  can apply therapeutically effective heating to tissue at a target site to cause time-dependent thermal tissue damage (e.g., determined using the Arrhenius equation) and modulate neural fibers within or proximate to the heated target tissue. In the embodiment illustrated in  FIG. 18 , however, heating is supplied via a heating element  1898  positioned within the balloon  1880  and carried by the support member  1890  and/or another feature of the therapeutic assembly  1812 . The heating element  1898  may be a plate or other structure heated using resistive heating (via a generator) and/or other suitable heating mechanism. In operation, the heat from the heating element  1898  can transfer from the heating element  1898  to the fluid within the balloon  1870 , and then through the wall of the balloon  1870  to the adjacent tissue at the treatment site. The fluid heated by the heating element  1898  can be heated to a therapeutically effective temperature that causes thermal damage to the target tissue at a treatment site within the nasal cavity and modulates neural fibers within or proximate to the heated target tissue. In certain embodiments, the balloon  1870  can include conductive features (e.g., metallic panels) on its surface to concentrate the heating effect at targeted regions of the balloon  1870 . 
     In other embodiments, the balloon  1870  can be heated via capacitive coupling to reach therapeutically effective temperatures that causes thermal damage to the target tissue at a treatment site within the nasal cavity and modulate neural fibers within or proximate to the heated target tissue. For example, the balloon  1870  can be inflated with an isotonic solution, and the balloon  1870  can be ionically agitated at a high frequency to allow capacitive energy to discharge across the membrane of the balloon  1870  to the target tissue. 
       FIG. 19  is a side view of a distal portion of a therapeutic neuromodulation device  1902  (“device  1902 ”) configured in accordance with an additional embodiment of the present technology. The device  1902  includes various features generally similar to the features of the therapeutic neuromodulation devices described above. For example, the device  1902  includes a shaft  1908  and a therapeutic assembly  1912  at a distal portion  1908   b  of the shaft  1908 . In the embodiment illustrated in  FIG. 19 , the therapeutic assembly  1912  is configured to apply plasma or laser ablation to therapeutically modulate nerves at the target site. As shown in  FIG. 19 , the therapeutic assembly  1912  can include an ablation element  1999  (e.g., an electrode) on a distal end portion of the shaft  1908 . The ablation element  1999  can apply high energy laser pulses to ionize molecules within the first few portion of the pulse. This process leads to a small bubble or field of plasma (e.g., 100-200 μm) that can be used to desiccate or otherwise destroy tissue and nerves at the target site. The ablation element  1999  can operate at temperatures lower than 100° C. and can limit the thermal effects on surrounding tissue. 
     In other embodiments, the ablation element  1999  can perform laser ablation of nerves at the target site. For example, a nerve tracer (e.g., indocyanine green (ICG)) can be injected at the target site to dye nerves at the target site. The ablation element  1999  can be a laser that is tuned to absorb the spectrum of the nerve tracer and, thereby, ablate the dyed nerves in the target site. 
     Selected Embodiments of Therapeutic Neuromodulation for the Treatment of Chronic Sinusitis 
       FIG. 20  is a partial cut-away side view illustrating target sites proximate to ostia of nasal sinuses for a therapeutic neuromodulation device configured in accordance with embodiments of the present technology. Any of the therapeutic modulation devices and system described above can be used to therapeutically modulate nerves that innervate the para-nasal sinuses to treat chronic sinusitis and/or similar indications. Referring to  FIG. 20 , the para-nasal sinuses include the frontal sinuses FS, the sphenoidal sinuses SS, the maxillary sinuses (“MS”; not shown), and the ethmoidal sinuses or ethmoidal cells (not shown), which include the posterior ethmoidal cells (“PEC”), the middle ethmoidal cells (“MEC”), and the anterior ethmoidal cells (“AEC”). Each sinus opens to the nasal cavity at one or more discrete ostia.  FIG. 20  illustrates the general locations of the ostium of the frontal sinus, the sphenoidal sinus, the maxillary sinus, and the ostia of posterior, middle, and anterior ethmoidal cells. 
     Parasympathetic nerves innervate the mucosa of the sinuses and stimulate the production of mucus in the sinuses. Hyperactivity of the parasympathetic nerves innervating the sinuses can cause hyper production of mucus and the soft tissue engorgement. The inflammation of the soft tissue proximate to the sinuses can cause can obstruct the conduit between a sinus and the nasal cavity and block the ostium to the sinus. In addition, the hyperactive mucosa and/or the blockage of the ostium can cause the pooling of mucosal secretions within the sinus occurs due to the lack of drainage from the sinus. This can lead to infection and, eventually, a chronic sinusitis state. 
     Therapeutic modulation the parasympathetic nerves that control autonomic function of the sinuses is expected to reduce or eliminate the hyperactive mucosal secretions and soft tissue engorgement and, thereby, treat chronic sinusitis or related indications. Any of the therapeutic neuromodulation devices described above can be used to apply therapeutically effective neuromodulation energy at or proximate to the ostia of the affected sphenoidal, maxillary, frontal, and/or ethmoidal sinuses to modulate the autonomic function of the sinuses. For example, therapeutic neuromodulation devices can be used to apply RF energy, microwave energy, ultrasound energy, cryotherapeutic cooling, therapeutic heating, plasma ablation, and/or laser ablation to treatment sites at and around the ostia of the sinuses. Similar to the devices described above, the therapeutic neuromodulation devices can be delivered intraluminally via the nasal passage and through the superior, middle, and/or inferior meatuses to access the ostium or ostia of the desired sinus. In various embodiments, neural mapping techniques similar to those described above with respect to  FIGS. 6A-9  can be used to locate or detect the parasympathetic nerves that innervate the ostia before, during, and/or after treatment. The application of therapeutic neuromodulation at the target sites proximate to the sinus ostia can disrupt the parasympathetic signals to the sinus tissues, leading to the opening of the ostia and the ability to drain fluid. 
     CONCLUSION 
     This disclosure is not intended to be exhaustive or to limit the present technology to the precise forms disclosed herein. Although specific embodiments are disclosed herein for illustrative purposes, various equivalent modifications are possible without deviating from the present technology, as those of ordinary skill in the relevant art will recognize. In some cases, well-known structures and functions have not been shown and/or described in detail to avoid unnecessarily obscuring the description of the embodiments of the present technology. Although steps of methods may be presented herein in a particular order, in alternative embodiments the steps may have another suitable order. Similarly, certain aspects of the present technology disclosed in the context of particular embodiments can be combined or eliminated in other embodiments. Furthermore, while advantages associated with certain embodiments may have been disclosed in the context of those embodiments, other embodiments can also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages or other advantages disclosed herein to fall within the scope of the present technology. Accordingly, this disclosure and associated technology can encompass other embodiments not expressly shown and/or described herein. 
     Throughout this disclosure, the singular terms “a,” “an,” and “the” include plural referents unless the context clearly indicates otherwise. Similarly, unless the word “or” is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of “or” in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the terms “comprising” and the like are used throughout this disclosure to mean including at least the recited feature(s) such that any greater number of the same feature(s) and/or one or more additional types of features are not precluded. Directional terms, such as “upper,” “lower,” “front,” “back,” “vertical,” and “horizontal,” may be used herein to express and clarify the relationship between various elements. It should be understood that such terms do not denote absolute orientation. Reference herein to “one embodiment,” “an embodiment,” or similar formulations means that a particular feature, structure, operation, or characteristic described in connection with the embodiment can be included in at least one embodiment of the present technology. Thus, the appearances of such phrases or formulations herein are not necessarily all referring to the same embodiment. Furthermore, various particular features, structures, operations, or characteristics may be combined in any suitable manner in one or more embodiments.