WO2025166346A1

WO2025166346A1 - Devices and systems for delivery of a dressing in a nasal cavity

Info

Publication number: WO2025166346A1
Application number: PCT/US2025/014313
Authority: WO
Inventors: Johannes Jacobs; John Drontle; Damon Dennis TAN; Jake BALLANDBY
Original assignee: Stryker Corp
Current assignee: Stryker Corp
Priority date: 2024-02-01
Filing date: 2025-02-03
Publication date: 2025-08-07
Anticipated expiration: 2026-08-01

Abstract

In an example, a nasal dressing delivery device includes a handle, an inner shaft extending distally from the handle, and an outer sheath extending distally of the handle. The inner shaft includes a plurality of prongs that are moveable between a closed state and an open state. The inner shaft is disposed in a lumen of the outer sheath. The outer sheath is moveable relative to the inner shaft. When the outer sheath is in a proximal position, at least a portion of the prongs are distal of the outer sheath such that the prongs transition from the closed state to the open state. When the outer sheath is in a distal position, the outer sheath covers the at least the portion of the prongs such that the outer sheath maintains the prongs in the closed state and prevents the prongs from transitioning to the open state.

Description

Devices, Systems, and Methods for Delivery of a Dressing in a Nasal Cavity CROSS-REFERENCE TO RELATED APPLICATION [0001] The present application claims the benefit of priority to U.S. Provisional Application No. 63/548,644, filed February 1, 2024, the contents of which is hereby incorporated by reference in its entirety. FIELD The present disclosure relates to nasal dressings and, in particular, to delivery devices, systems, and methods for delivering a nasal dressing to a nasal cavity. BACKGROUND Nasal dressings can be used to assist with healing after a medical procedure is performed in a nasal cavity. For example, a nasal dressing can be delivered to a nasal cavity to assist with support and stabilization of tissue in the nasal cavity, help control bleeding, absorb drainage (e.g., blood, mucus, and/or other fluids), and/or deliver a drug to help promote healing. BRIEF DESCRIPTION OF THE FIGURES The novel features believed characteristic of the illustrative embodiments are set forth in the appended claims. The illustrative embodiments, however, as well as a preferred mode of use, further objectives and descriptions thereof, will best be understood by reference to the following detailed description of an illustrative implementation of the present disclosure when read in conjunction with the accompanying figures, wherein: Figure 1A depicts a nasal dressing delivery device in an open state, according to an example. Figure 1B depicts a nasal dressing delivery device in a closed state, according to an example. Figure 2A depicts the nasal dressing delivery system including a nasal dressing and a nasal dressing deliver device in the closed state, according to an example. Figure 2B depicts the nasal dressing delivery system including a nasal dressing and a nasal dressing deliver device in the open state, according to an example. Figure 3A depicts a first stage of a process of loading a nasal dressing in a nasal dressing delivery device, according to an example. Figure 3B depicts a second stage of a process of loading the nasal dressing in the nasal dressing delivery device, according to an example. Figure 3C depicts a third stage of the process of loading a nasal dressing in a nasal dressing delivery device, according to an example. Figure 3D depicts the nasal dressing delivery device inserted in a nasal cavity, according to an example. Figure 3E depicts a first stage of a process of delivering a nasal dressing to a target site using a nasal dressing delivery device, according to an example. Figure 3F depicts a second stage of a process of delivering the nasal dressing to a target site using the nasal dressing delivery device, according to an example. Figure 3G depicts a third stage of the process of delivering a nasal dressing to a target site using a nasal dressing delivery device, according to an example. Figure 3H depicts the nasal dressing delivered to the target site and the nasal dressing delivery tool being withdrawn from the nasal cavity, according to an example. Figure 4A depicts a distal portion of a nasal dressing delivery device, according to another example. Figure 4B depicts the distal portion of the nasal dressing delivery device shown in Figure 4A and a nasal dressing, according to another example. Figure 5A depicts a perspective view of the nasal dressing delivery device, according to another example. Figure 5B depicts an exploded view of the nasal dressing delivery device shown in Figure 5A, according to an example. Figure 6A depicts a nasal dressing according to an example. Figure 6B depicts a nasal dressing according to another example. Figure 6C depicts a nasal dressing according to another example. Figure 6D depicts a nasal dressing according to another example. Figure 7A depicts a side view of a nasal dressing delivery device with an outer sheath in a distal position, according to an example. Figure 7B depicts the side view of the nasal dressing delivery device shown in Figure 7A with a portion of a handle omitted, according to an example. Figure 7C depicts a side view of the nasal dressing delivery device shown in Figure 7A with the outer sheath in a proximal position and a plurality of prongs in the open state, according to an example. Figure 7D depicts a side view of the nasal dressing delivery device shown in Figure 7A with the outer sheath in the proximal position and a plurality of prongs in the closed state, according to an example. Figure 8A depicts a first stage of a process of using a nasal dressing delivery device, according to an example. Figure 8B depicts a second stage of a process of using a nasal dressing delivery device, according to an example. Figure 8C depicts a third stage of a process of using a nasal dressing delivery device, according to an example. Figure 9 depicts a flowchart for a process of delivering a nasal dressing to a target site in a nasal cavity, according to an example. DESCRIPTION Disclosed examples will now be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all of the disclosed examples are shown. Indeed, several different examples may be described and should not be construed as limited to the examples set forth herein. Rather, these examples are described so that this disclosure will be thorough and complete and will fully convey the scope of the disclosure to those skilled in the art. By the term “approximately” or “substantially” with reference to amounts or measurement values described herein, it is meant that the recited characteristic, parameter, or value need not be achieved exactly, but that deviations or variations, including for example, tolerances, measurement error, measurement accuracy limitations and other factors known to those of skill in the art, may occur in amounts that do not preclude the effect the characteristic was intended to provide. As noted above, a nasal dressing can be used to assist with healing after a medical procedure is performed in a nasal cavity. For example, a nasal dressing can be delivered to a nasal cavity to assist with support and stabilization of tissue in the nasal cavity, help control bleeding, absorb drainage (e.g., blood, mucus, and/or other fluids), and/or deliver a drug to help promote healing. One challenge associated with nasal dressings is that it can be difficult to access a target site in the nasal cavity at which the nasal dressing is to be delivered. For instance, it can be particularly challenging to access and deliver the nasal dressing to a sinus cavity (e.g., a frontal sinus cavity, a sphenoid sinus cavity, a maxillary sinus cavity, and/or an ethmoid sinus cavity) and/or a recess of the sinus cavity (e.g., a frontal recess, a sphenoid recess, a maxillary recess, and/or an ethmoid recess). The present application provides for a nasal dressing delivery device, a nasal dressing delivery system, and a method of delivering a nasal dressing that can help to address challenges associated with delivering a nasal dressing to the target site in the nasal cavity. Referring now Figures 1A-1B, a nasal dressing delivery device 100 is shown according to an example. As shown in Figures 1A-1B, the nasal dressing delivery device 100 includes a handle 110 having a proximal handle end 110A and a distal handle end 110B. In general, the handle 110 can be configured to facilitate a user gripping and manipulating the nasal dressing delivery device 100 while delivering a nasal dressing to a target site in the nasal cavity. For example, the handle 110 can have a shape and/or a size that can facilitate a user performing the procedure by manipulating the nasal dressing delivery device 100 using a single hand. In the example shown in Figures 1A-1B, the handle 110 can have a shape and/or a size that facilitates the user holding the nasal dressing delivery device 100 using a writing utensil grip. However, as described with respect to Figures 5A-5B below, the handle 110 can have a shape and/or a shape that facilitates the user holding the nasal dressing delivery device 100 using other grips. As shown in Figures 1A-1B, the nasal dressing delivery device 100 also includes an inner shaft 112 extending from the distal handle end 110B of the handle 110. A proximal shaft end 112A of the inner shaft 112 is fixedly coupled to the handle 110. As such, the inner shaft 112 can be fixed and non-movable relative to the handle 110 in this example. A distal shaft end 112B of the inner shaft 112 includes a plurality of prongs 114 that are moveable between a closed state and an open state. Figure 1A depicts the nasal dressing delivery device 100 with the prongs 114 in the open state, and Figure 1B depicts the nasal dressing delivery device 100 with the prongs 114 in the closed state. The nasal dressing delivery device 100 further includes an outer sheath 116 extending distally of the distal handle end 110B of the handle 110. The inner shaft 112 is disposed in a lumen of the outer sheath 116, and the outer sheath 116 is moveable relative to the inner shaft 112 between a proximal position and a distal position. The proximal position of the outer sheath 116 relative to the inner shaft 112 is shown in Figure 1A, and the distal position of the outer sheath 116 relative to the inner shaft 112 is shown in Figure 1B. As shown in Figure 1A, when the outer sheath 116 is in the proximal position relative to the inner shaft 112, at least a portion of the prongs 114 are distal of a distal sheath end 116B of the outer sheath 116 such that the prongs 114 are allowed to transition from the closed state to the open state. As shown in Figure 1B, when the outer sheath 116 is in the distal position relative to the inner shaft 112, the outer sheath 116 covers the at least the portion of prongs 114 such that the outer sheath 116 maintains the prongs 114 in the closed state and prevents the prongs 114 from transitioning to the open state. In some examples, each prong 114 of the plurality of prongs 114 can be configured to move about a respective pivot point of a plurality of pivot points on the inner shaft 112. In the open state, the prongs 114 are not constrained by the outer sheath 116 and, thus, the prongs 114 are free to move about the pivot points. This can help to provide a space between the prongs 114 to receive a nasal dressing when loading the nasal dressing into the nasal dressing delivery device 100 and/or when delivering the nasal dressing to the target site in the nasal cavity. As described in further detail below, the nasal dressing can assist in expanding the prongs 114 during delivery of the nasal dressing when the prongs are in the open state. Additionally, the pivot points can assist in collapsing the prongs 114 towards each other when the prongs 114 transition from the open state to the closed state. This can help to grab and retain the nasal dressing between the prongs 114 while loading the nasal dressing, and/or while navigating the nasal dressing delivery device 100 through the nasal cavity to the target site. As described above and in further detail below, the outer sheath 116 can constrain and force the prongs 114 towards each other (and a nasal dressing between the prongs 114) when the outer sheath 116 is in the distal position and the prongs 114 are in the closed state as shown in Figure 1B. In some examples, each prong 114 of the plurality of prongs 114 can one or more teeth on an interior surface of the prong 114. This can help to enhance a grip of the prongs 114 on the nasal dressing when loading the nasal dressing delivery device 100 (e.g., while moving the outer sheath 116 over the inner shaft 112, the prongs 114, and the nasal dressing) and/or while navigating the nasal dressing delivery device 100 to the target site in the nasal cavity. In the example shown in Figures 1A-1B, the prongs 114 consist of four prongs. However, in other examples, the prongs 114 can include three or more prongs 114. For instance, in one implementation, the prongs 114 can consist of three prongs 114. This can help to provide suitable performance of the prongs 114 gripping and/or compressing the nasal dressing in view of space constraint considerations associated with the lumen of the outer sheath 116, which is navigated through the nasal cavity to the target site. For instance, in some examples, the outer sheath 116 can have an outer diameter that is less than or equal to approximately 4 millimeters (i.e., approximately 0.157 inches). This can help to navigate the nasal dressing delivery device 100 to areas of the nasal cavity that are difficult to reach (e.g., the frontal recess). As shown in Figures 1A-1B, the nasal dressing delivery device 100 can include a sheath actuator 118 coupled to the outer sheath 116. In this example, the sheath actuator 118 is configured to move relative to the handle 110 to move the outer sheath 116 between the proximal position and the distal position relative to the handle 110 and the inner shaft 112. In this arrangement, moving the sheath actuator 118 in a distal direction relative to the handle 110 moves the outer sheath 116 distally relative to the inner shaft 112 and the prongs 114. Similarly, moving the sheath actuator 118 in a proximal direction relative to the handle 110 moves the outer sheath 116 proximally relative to the inner shaft 112 and the prongs 114. The sheath actuator 118 can be configured enable a finger of the user (e.g., index finger or thumb) to easily move the sheath actuator 118 relative to the handle 110. For example, as shown in Figures 1A-1B, the sheath actuator 118 can include a generally convex surface for engaging a finger of the user. However, the sheath actuator 118 can have a different shape and/or a different size in other examples. Additionally, although the sheath actuator 118 is moveable along a top surface of the handle 110 in the illustrated example, the sheath actuator 118 can be disposed and moveable along a different surface of the handle 110 in other examples. As shown in Figures 1A-1B, the sheath actuator 118 can be a slider that is configured to move within a slot 120 in the exterior surface of the handle 110. The slot 120 can extend in a direction that is parallel to a longitudinal axis of the inner shaft 112. In some examples, a length of the slot 120 can define a range of motion of the outer sheath 116 relative to the inner shaft 112. For instance, a distal end of the slot 120 can provide a distal stop to define a distalmost position of the outer sheath 116 relative to the inner shaft 112 and/or a proximal end of the slot 120 can define a proximal stop to define a proximal-most position of the outer sheath 116 relative to the inner shaft 112. In one example, the range of motion can be approximately 10 millimeters (i.e., approximately 0.4 inches). This range of motion can allow a user to comfortably move the sheath actuator 118 between the distal position and the proximal position of the outer sheath 116 without having to adjust a grip on the handle 110. In another example, the range of motion can be a range between approximately 0.25 inch and approximately 1.50 inches (i.e., approximately 0.25 millimeters and approximately 38.1 millimeters). Although the inner shaft 112 is shown as having a straight shape in Figures 1A- 1B, the inner shaft 112 can have a bend between the proximal shaft end 112A and the distal shaft end 112B. The bend can help to navigate the inner shaft 112 and the outer sheath 116 through the nasal cavity to the target site. In some examples, at least a portion of the inner shaft 112 is malleable. Accordingly, the inner shaft 112 can be bendable in response to a bending force without breaking, and the inner shaft 112 can retain a bent shape after the bending force is removed. This may allow a user to modify the shape of the inner shaft 112 according to a specific anatomy of a particular patient and/or adapt the inner shaft 112 for treating one or more anatomical structures (e.g., a frontal sinus cavity, a sphenoid sinus cavity, a maxillary sinus cavity, an ethmoid sinus cavity, a frontal recess, a sphenoid recess, a maxillary recess, and/or an ethmoid recess). In an example of an implementation in which the inner shaft 112 is malleable at a distal portion, a manufacturing process can include a step of annealing the portion of the inner shaft 112 to impart malleability. [0002] In other examples, the inner shaft 112 can be non-malleable. In such examples, the shape of the inner shaft 112 is fixed and cannot be changed without compromising a structural integrity of the inner shaft 112 (e.g., without forming a kink in the inner shaft 112). This can assist in inhibiting or preventing a user from altering the inner shaft 112 to have a shape that is not well suited for accessing and treating a particular anatomical structure, and/or to inhibit a user from using the nasal dressing delivery device 100 for treating an anatomical structure other than an intended anatomical structure. [0003] In some examples in which the portion of the inner shaft 112 is malleable or non-malleable, the bend can be formed during the manufacturing process and prior to a user preparing to use the nasal dressing delivery device 100. In such examples, the nasal dressing delivery device 100 can be preset for accessing and treating an anatomical structure without any modifications to the inner shaft 112 by the user. In other examples in which the portion of the inner shaft 112 is malleable, the inner shaft 112 can be manufactured without the bend, and the user can form the bend by bending the portion of the inner shaft 112 prior to inserting the nasal dressing delivery device 100 into the nasal cavity of the patient. As described above, the outer sheath 116 is movable relative to the inner shaft 112. Within examples, the outer sheath 116 can be formed from a flexible material such that the outer sheath 116 can move along the bend in the inner shaft 112. In one example, the outer sheath 116 can be sufficiently conformable to navigate along the bend, but sufficiently stiff to constrain the prongs 114 when the outer sheath 116 is in the distal position. Figures 2A-2E depict a nasal dressing delivery system 222 including the nasal dressing delivery device 100 of Figures 1A-1B and a nasal dressing 224, according to an example. In particular, Figure 2A depicts the nasal dressing delivery device 100 in the closed state and Figure 2B depicts the nasal dressing delivery device 100 in the open state. As shown in Figures 2A-2B, the nasal dressing 224 is configured to be: (i) positioned between the plurality of prongs 114 when the plurality of prongs 114 are in the open state (as shown in Figure 2B), and (ii) compressed between the plurality of prongs 114 when the plurality of prongs 114 are in the closed state (as shown in Figure 2A). Additionally, as shown in Figure 2A, the nasal dressing 224 can be configured to be received within the lumen of the outer sheath 116 when the outer sheath 116 is in the distal position relative to the inner shaft 112. As shown in Figures 2A-2B, the inner shaft 112 can include a bend 212C at a distal portion of the inner shaft 112. As described above, the bend 212C can help to navigate the nasal dressing delivery device 100 to the target site in the nasal cavity. Additionally, Figure 2A shows the outer sheath 116 in the distal position, and Figure 2B shows the outer sheath 116 in the proximal position. As shown in Figures 2A-2B, the outer sheath 116 is configured to move along the bend 212C of the inner shaft 11. In some examples, the nasal dressing 224 can include a foam. For instance, the foam can include a polyurethane scaffold. In some examples, the nasal dressing 224 can be configured to elute a drug. For instance, in one example, the nasal dressing 224 can include a polyurethane scaffold, chitosan additive as an active hemostatic agent and mometasone as a corticosteroid. In some examples, the foam is resorbable. In some examples, the foam can elute greater than 80 percent of the drug from the foam within 10 days of being positioned at the target site in the nasal cavity. In the illustrated example, the nasal dressing 224 can have a cylindrical shape when in free space and prior to being compressed by the prongs 114, as shown in Figure 2C. However, in other examples, the nasal dressing 224 can have a conical shape and/or an hourglass shape. A conical shape can help to provide for easier loading of the nasal dressing 224 into the outer sheath 116 of the nasal dressing delivery device 100. Figures 3A-3H depict a process for using the nasal dressing delivery device 100 to deliver the nasal dressing 224 to a target site. Figures 3A-3C depict s process for loading the nasal dressing 224 in the nasal dressing delivery device 100. Figure 3A depicts the nasal dressing 224 positioned between the prongs 114 while the prongs 114 are in the open state. As shown in Figure 3A, the distal sheath end 116B of the outer sheath 116 is proximal of the pivot points of the prongs 114 such the prongs 114 can diverge from a longitudinal axis 326 of the inner shaft 112 to provide a space for receiving the nasal dressing 224 between the prongs 114. In this example, each prong 114 of the plurality of prongs 114 can have a first length (e.g., in a dimension parallel to the longitudinal axis 326), the nasal dressing 224 can have a second length (e.g., in the dimension parallel to the longitudinal axis 326), and the first length can be less than one half of the second length. This can allow the prongs 114 to compress and grip a proximal portion of the nasal dressing 224. By engaging with the proximal portion of the nasal dressing 224 and not the distal portion of the nasal dressing 224, the prongs 114 can expand and release the nasal dressing 224 as the outer sheath 116 is moved proximally from the distal position toward the proximal position. In other examples, the first length can be less than one third of the second length and/or less than one quarter of the second length. A ratio of the first length relative to the second length can be designed to provide a balance between being long enough to engage the nasal dressing 224 sufficiently during loading while short enough to fully disengage from the nasal dressing 224 during delivery (e.g., given the space constraints imposed by the sinus ostium at which the nasal dressing 224 is being delivered). In Figure 3B, the outer sheath 116 is moved distally (e.g., responsive to moving the sheath actuator 118 shown in Figures 1A-1B) to an intermediate position that is (i) distal of the proximal position of the outer sheath 116 shown in Figure 3A and (ii) proximal of the distal position of the outer sheath 116 shown in Figure 3C. As shown in Figure 3C, the distal sheath end 116B extends over the prongs 114 forcing the prongs 114 towards each other and compressing the nasal dressing 224. The compressive force applied by the prongs 114 to the nasal dressing 224 can help to grip the nasal dressing 224 as the outer sheath 116 moves over and covers the nasal dressing 224. As shown in Figure 3B, when the distal sheath end 116B is at a distal end of the prongs 114, a proximal portion of the nasal dressing 224 can be compressed in the outer sheath 116 while a distal portion of the nasal dressing 224 remains uncompressed at a position that is external (e.g., distal) to the outer sheath 116. In Figure 3C, the outer sheath 116 is in the distal position. As shown in Figure 3C, the outer sheath 116 substantially covers (or entirely covers) the nasal dressing 224. This can provide for compressing the proximal portion and the distal portion of the nasal dressing 224 so that the nasal dressing 224 can have a size, and can be navigated through the nasal cavity to the target site. Figure 3D depicts the nasal dressing delivery device 100 inserted into the nasal cavity to a target site while the nasal dressing 224 is in the lumen of the outer sheath 116, the outer sheath 116 is in the distal position, and the prongs 114 are in the closed state. In this example, the target site is at a frontal recess. However, as described above, the target site can be a different anatomical structure in the nasal cavity in other examples. As shown in Figure 3D, the distal sheath end 116B can be positioned at the target site. Figures 3E-3G depict a process for delivering the nasal dressing 224 from the nasal dressing delivery device 100 to the target site. Figure 3E depicts the distal sheath end 116B at the target site while the nasal dressing 224 is in the lumen of the outer sheath 116, the outer sheath 116 is in the distal position, and the prongs 114 are in the closed state. In Figure 3F, the outer sheath 116 is proximal to the intermediate position. As shown in Figure 3F, the distal sheath end 116B is retracted proximally of the distal portion of the nasal dressing 224. As the outer sheath 116 no longer applies a compressive force to the distal portion of the nasal dressing 224, the distal portion of the nasal dressing 224 can expand in size. In Figure 3G, the outer sheath 116 is in the proximal position. As such, the distal sheath end 116B is proximal of the pivot points of the prongs 114. As the outer sheath 116 no longer applies a compressive force to the prongs 114, the prongs 114 can diverge outwardly away from each other and the nasal dressing 224. Within examples, the nasal dressing 224 can help to apply a radially outward force on the prongs 114 to assist in moving the prongs 114 from the closed state to the open state. When the prongs 114 are in the open state, the nasal dressing 224 can be released to a position in at the target site in the nasal cavity. Figure 3H depicts the nasal dressing 224 at the target site in the nasal cavity as the nasal dressing delivery device 100 is withdrawn from the nasal cavity. In some examples, the outer sheath 116 can be in the distal position while the nasal dressing delivery device 100 is withdrawn from the nasal cavity. This can help to reduce a size of the nasal dressing delivery device 100 to facilitate removal of the nasal dressing delivery device 100 from the nasal cavity. Although not shown in Figures 3A-3H, the process can also include forming the bend 212C in the inner shaft 112 prior to inserting the nasal dressing delivery device 100 in the nasal cavity. In such examples, the process can also include moving the outer sheath 116 along the bend 212C when moving the outer sheath 116 between the proximal position and the distal position. The process can further include resorbing the nasal dressing 224 over a period of times (e.g., 10 days). The process can additionally or alternatively include eluting a drug from the nasal dressing 224 while the nasal dressing 224 is positioned at the target site in the nasal cavity. The process can additionally or alternatively include removing the nasal dressing 224 (e.g., using the nasal dressing delivery device 100) after a period of time (e.g., after 10 days from delivery of the nasal dressing 224). For instance, a removal process can include inserting the nasal dressing delivery device 100 to a position of the nasal dressing 224 in the nasal cavity. The nasal dressing delivery device 100 can be inserted with the outer sheath 116 in the distal position such that the prongs 114 are in the closed state and covered by the outer sheath 116. At the nasal dressing 224, the outer sheath 116 can be moved from the distal position toward the proximal position to move the prongs 114 from the closed state to the open state. With the prongs 114 in the open state, the nasal dressing 224 can be position between the prongs 114. After positioning the nasal dressing 224 between the prongs 114, the outer sheath 116 can be moved to the distal position to close the prongs 114 around the nasal dressing 224, and cover the nasal dressing 224 with the outer sheath 116. The nasal dressing delivery device 100 can then be withdrawn from the nasal cavity to remove the nasal dressing 224 from the nasal cavity. Figure 4A depicts a distal portion of a nasal dressing delivery device 400, and Figure 4B depicts a distal portion of the nasal dressing delivery device 400 and a nasal dressing 424, according to another example. The nasal dressing delivery device 400 is substantially similar or identical to the nasal dressing delivery device 100 shown and described above with respect to Figures 1A-3H, except the inner shaft 112 includes a rod 428 that extends between the plurality of prongs 114 and distally of the plurality of pivot points. The rod 428 can help to facilitate easy loading of the nasal dressing 224. For example, the nasal dressing 424 can have a through-bore 430 that extends entirely through the nasal dressing 424 between a first end of the nasal dressing 424A and a second end of the nasal dressing 424B. The through-bore 430 of the nasal dressing 424 can be configured to receive the rod 428. In this arrangement, the rod 428 can help to stabilize the nasal dressing 424 between the prongs 114 when the prongs 114 are in the open state. The rod 428 can additionally or alternatively help to position the nasal dressing 424 in a centered position between the prongs 114 such that prongs 114 can apply a relatively uniform pressure to the nasal dressing 424 at each prong 114. In some example, the rod 428 can be formed from a non-malleable material. In other examples, the rod 428 can be formed from a malleable material. This can allow the rod 428 to manipulated to adjust an angle of the nasal dressing 424 relative to the longitudinal axis (e.g., the longitudinal axis 326) of the inner shaft 112, which can help to better deliver the nasal dressing 424 to the target site in some implementations. Additionally, as shown in Figures 4A-4B, each prong 114 of the plurality of prongs 114 can one or more teeth 432 on an interior surface of the prong 114. This can help to enhance a grip of the prongs 114 on the nasal dressing 424 when loading the nasal dressing delivery device 100. Although the nasal dressing 424 includes the through-bore 430 that extends entirely through the nasal dressing 424 in Figure 4B, the nasal dressing 424 can include a bore that extends partially through the nasal dressing 424 in other examples. In such examples, the bore has a length that is great enough to receive the rod 428 and allow the outer sheath 116 to substantially cover the nasal dressing 424 when the outer sheath 116 is in the distal position. Referring now to Figures 5A-5B, a nasal dressing delivery device 500 is shown according to another example. Figure 5A depicts a perspective view of the nasal dressing delivery device 500, and Figure 5B depicts an exploded view of the nasal dressing delivery device 500, according to an example. The nasal dressing delivery device 500 can be substantially similar or identical to the nasal dressing delivery devices 100, 400 shown and described above with respect to Figures 1A-4B, except the nasal dressing delivery device 500 includes a handle 510 having a different configuration than the handle 110 described above. For example, in Figures 5A-5B, the handle 510 includes a proximal handle portion 534 that is fixedly coupled to the inner shaft 112 and a distal handle portion 536 that is fixedly coupled to the outer sheath 116. The distal handle portion 536 can be configured to move relative to the proximal handle portion 534 to move the outer sheath 116 relative to the inner shaft 112 (e.g., between the proximal position and the distal position as described above). Also, in this example, the proximal handle portion 534 includes a first finger hole, and the distal handle portion 536 includes a second finger hole and a third finger hole to facilitate gripping the handle 510 and moving the distal handle portion 536 relative to the proximal handle portion 534. Figures 6A-6D depict a plurality of nasal dressings 624A-624D as further implementations of the nasal dressings 224, 424 described above, according to additional examples. In Figures 6A-6D, the nasal dressings 624A-624D include a skirt portion 638 and a body portion 640. The skirt portion 638 can taper outwardly from the body portion 640 towards a distal end 642 of the nasal dressing 624A-624D. This can allow for retention of the nasal dressing 624A-624D by extending past a narrowing of an ostia of the target site. Additionally, Figures 6A-6B show that the nasal dressing 624A, 624B can be provided in different sizes to treat different patient anatomies. The nasal dressing 624C shown in Figure 6C includes an inwardly tapered portion 644 extending from the body portion 640 to a proximal end 646 of the nasal dressing 624C. This can help to make loading the nasal dressing 624C easier than implementations that omit the inwardly tapered portion 644. The nasal dressing 624D shown in Figure 6D includes a plurality of ribs 648 on the body portion 640. This can help to position and retain the nasal dressing 624D at the target site. In Figures 6A-6D, the nasal dressings 624A-624D include a through-bore 630 that extends entirely through the nasal dressings 624A-624D between the distal end 642 and the proximal end 646. This can help with loading the nasal dressing 624A-624D in implementations in which the nasal dressing delivery device 100 includes the rod 428. Additionally or alternatively, the through-bore 630 can provide a passage for airflow and/or drainage through the nasal dressing 624A-624D. However, in other examples, the nasal dressings 624A-624D can include a bore that extends partially through the nasal dressings 624A-624D, or the nasal dressings 624A-624D can be solid and omit the bore and the through- bore 630. Referring now to Figures 7A-7D, a nasal dressing delivery device 700 is shown according to another example. Figure 7A depicts a side view of the nasal dressing delivery device 700 with the outer sheath 116 in the distal position, Figure 7B depicts the side view of the nasal dressing delivery device 700 shown in Figure 7A with a portion of the handle 110 omitted, Figure 7C depicts a side view of the nasal dressing delivery device 700 with the outer sheath 116 in the proximal position and a plurality of prongs 714 in the open state, and Figure 7D depicts a side view of the nasal dressing delivery device 700 with the outer sheath 116 in the proximal position and the prongs 714 in the closed state, according to an example. The nasal dressing delivery device 700 can be substantially similar or identical to the nasal dressing delivery devices 100, 400, 500 shown and described above with respect to Figures 1A-5B, except the nasal dressing delivery device 700 includes (i) a handle 710, a sheath actuator 718, and a plurality of prongs 714 having different configurations than the handles 110, 510, the sheath actuator 118, and the prongs 114 described above, and/or (ii) a prongs actuator 750 that is configured to actuate the prongs 714 between the closed state and the open state. As shown in Figures 7A-7D, the nasal dressing delivery device 700 includes the handle 710 having a proximal handle end 710A and a distal handle end 710B. The nasal dressing delivery device 700 also includes the inner shaft 112 extending from the distal handle end 710B of the handle 710. As described above, a proximal shaft end of the inner shaft 112 is fixedly coupled to the handle 710, and a distal shaft end of the inner shaft 112 includes the plurality of prongs 714 that are moveable between the closed state and the open state. The nasal dressing delivery device 700 further includes the outer sheath 116 extending distally of the distal handle end 710B of the handle 710, the inner shaft 112 is disposed in a lumen of the outer sheath 116, and the outer sheath 116 is moveable relative to the inner shaft 112 between the proximal position and the distal position. As described above, when the outer sheath 116 is in the proximal position relative to the inner shaft 112, at least a portion of the plurality of prongs 714 are distal of the distal sheath end 116B of the outer sheath 116 such that the plurality of prongs 714 are allowed to transition from the closed state to the open state. When the outer sheath 116 is in the distal position relative to the inner shaft 112, the outer sheath 116 covers the at least the portion of the plurality of prongs 114 such that the outer sheath 116 maintains the plurality of prongs 114 in the closed state and prevents the plurality of prongs 114 from transitioning to the open state. In the example shown in Figures 7A-7D, the nasal dressing delivery device 700 also includes a sheath actuator 718 coupled to the outer sheath 116. The sheath actuator 718 is configured to move relative to the handle 710 to move the outer sheath 116 between the proximal position and the distal position relative to the handle 710 and the inner shaft 112. In this example, the sheath actuator 718 can include a slider 718A that is configured to move the outer sheath 116 in a distal direction towards the distal position shown in Figures 7A-7B, and a sheath trigger 718B that is configured to move the outer sheath 116 in a proximal direction towards the proximal position shown in Figures 7C-7D. As shown in Figures 7A-7D, the slider 718A can extend outwardly from a first side of the handle 710 and the sheath trigger 718B extending outwardly from a second side of the handle 710. For instance, in this example, the handle 710 can include an upper body portion 752A and a handgrip portion 752B that extends transversely and downwardly from the upper body portion such that the handle 710 can be held using a pistol grip with the fingers of the user wrapped around the handgrip portion 752B. In this arrangement, the first side of the handle 710 can be a top surface of the upper body portion 752A, and the second side of the handle 710 can be a distal surface of a handgrip portion 752B of the handle 710. Positioning the slider 718A and the sheath trigger 718B on different sides of the handle 710 can, for example, help to provide for more intuitive operation of the nasal dressing delivery device 700 in some implementations. As shown in Figure 7B, the slider 718A and the sheath trigger 718B can be integrally formed as a single, monolithic structure. As such, moving the slider 718A relative to the handle 710 can cause a corresponding movement of the sheath trigger 718B relative to the handle 710, and moving the sheath trigger 718B relative to the handle 710 can cause a corresponding movement of the slider 718A relative to the handle 710. Additionally, as shown in Figure 7B, the sheath actuator 718 can include a lumen that extends through the sheath actuator 718 along a longitudinal axis of at least a portion of the outer sheath 716. In this example, the outer sheath 716 can be fixedly coupled to the sheath actuator 718 in the lumen of the sheath actuator 718. In some examples, to provide the slider 718A on the top surface of the upper body portion 752A and the sheath trigger 718B on the distal side of the handgrip portion 752B, the sheath actuator 718 can include a linkage portion 718C that can extend between the slider 718A and the sheath trigger 718B. In this way, the linkage portion 718C can couple the slider 718A and the sheath trigger 718B such that movement of one causes corresponding movement of the other, as described above. This can simplify manufacture, reduce costs, and/or enhance robustness by providing for a single coupling between the sheath actuator 718 and the outer sheath 116 (e.g., at the lumen of the sheath actuator 718). Although the sheath actuator 718 includes the linkage portion 718C to couple the slider 718A to the sheath trigger 718B, the sheath actuator 718 can omit the linkage portion 718C and the slider 718A and the sheath trigger 718B can instead be independently coupled to the outer sheath 116 in other examples. Also shown in Figure 7B, the handle 710 can include the slot 120 described above and the slider 718A can extend from the linkage portion 718C and/or the lumen of the sheath actuator through the slot 120 such that the slider 718A can be accessed at an exterior of the handle 710. In some examples, the slider 718A and/or the sheath trigger 718B can operable to move the outer sheath 116 in the proximal direction and the distal direction. In other examples, the slider 718A can be operable to move the outer sheath 116 only in the distal direction, and/or the sheath trigger 718B can be operable to move the outer sheath 116 only in the proximal direction. As described above, the nasal dressing delivery device 700 shown in Figures 7A-7D can also include the prongs actuator 750 that is configured to actuate the plurality of prongs 714 between the closed state shown in Figure 7D and the open state shown in Figure 7C. In this example, the prongs actuator 750 is operable in a proximal direction relative to the handle 710 to move the prongs 714 from the open state to the closed state. In one example, the prongs actuator 750 can include a pivoting lever system in which moving the prongs actuator 750 in the proximal direction relative to the handle 710 can rotate a lever 751 (e.g., via a linkage 757 coupling the prongs actuator 750 to the lever 751), which in turn pulls a pull wire 753 that moves the prongs 714 relative to each other. In some implementations, the prongs actuator 750 can also include a spring 755 that is configured to automatically return the prongs 714 to the open state responsive to releasing the prongs actuator 750. For example, a first end of the spring 755 can be coupled to the lever 751, and a second end of the spring 755 can be coupled to a component that is fixed relative to the handle 710 (e.g., the handle 710 and/or the inner shaft 112). In this arrangement, the spring 755 can apply a biasing force to the lever 751 that causes the prongs 714 to be biased towards the open state. In other examples, the spring 755 can apply the biasing force directly to the prongs actuator 750 instead of the lever 751. As shown in Figure 7B, the prongs actuator 750 can include a lumen and the outer sheath 116 can be slidably disposed in the lumen of the prongs actuator 750. In this arrangement, the outer sheath 116 can help to support and define an axis of movement of the prongs actuator 750. Additionally, in this arrangement, the sheath actuator 718 and the prongs actuator 750 can be operated independently of each other. As shown in Figures 7C-7D, the prongs 714 can consist of a top jaw and a bottom jaw. In the examples described above with respect to Figures 1A-5B, the prongs 114 are actuated between the closed state and the open state by moving the outer sheath 116 relative to the inner shaft 112. In such examples, it can be beneficial to have three or more prongs 114 to facilitate loading the nasal dressing into the outer sheath 116 (e.g., to maintain the nasal dressing between the prongs 114 as the outer sheath 116 is moved distally over the prongs 114 and the nasal dressing). However, examples in which the prongs 714 can be actuated independently of the outer sheath 116 (e.g., such as the example shown in Figures 7A-7D), the prongs 114 can consist of two prongs 114 arranged as a pair of jaws. This can allow for the prongs 714 to occupy a relatively smaller portion of the lumen of the outer sheath 116, and/or simplify a design of prongs actuator 750. However, in other examples, the prongs 714 can include more than two prongs 714 that can be actuated by the prongs actuator 750 between the closed state and the open state. Figures 8A-8C depict a process for using the nasal dressing delivery device 700 to deliver the nasal dressing 224 to a target site. To load the nasal dressing 224 into the nasal dressing delivery device 700, the sheath actuator 718 can first be moved to the proximal position on the handle 710 to cause the outer sheath 116 to be in the proximal position. Figure 8A depicts the sheath actuator 718 in the proximal position on the handle 710, and the outer sheath 116 in the proximal position such that the distal sheath end 116B of the outer sheath 116 is proximal of the prongs 714 of the inner shaft 112. Accordingly, as shown in Figure 8A, the prongs 714 are exposed and free to actuate between the open state and the closed state. Next, while the outer sheath 116 is in the proximal position and the prongs 714 are in the open state, the nasal dressing 224 can be positioned between the prongs 714. While the nasal dressing 224 is positioned between the prongs 714, the prongs actuator 750 can be actuated towards the handle 710 (e.g., by overcoming a biasing force applied by the spring 755 to the prongs actuator 750) to close the prongs 714 around the nasal dressing 224. In this way, the prongs 714 can compress and hold the nasal dressing 224. While holding the nasal dressing 224 between the prongs 714 and with the prongs actuator 750 depressed, the slider 718A can be moved in the distal direction relative to the handle 710 to cause the outer sheath 116 to move distally to the distal position. Figure 8B depicts the nasal dressing delivery device 700 and the nasal dressing 224 after the slider 718A has been moved from the proximal position to the distal position to cause the outer sheath 116 to slide over the prongs 714 and the nasal dressing 224. As shown in Figure 8B, the prongs 714 and the nasal dressing 224 are disposed in the lumen of the outer sheath 116 (e.g., the distal sheath end 116B of the outer sheath 116 can be distal of the prongs 714 and/or the nasal dressing 224). Additionally, as shown in Figure 8B, the sheath trigger 718B has moved distally relative to the position shown in Figure 8A responsive to the slider 718A moving to the distal position shown in Figure 8B. As described above (e.g., with respect to Figure 3D), the nasal dressing delivery device 700 can then be inserted into the nasal cavity to a target site while the nasal dressing 224 is in the lumen of the outer sheath 116, the outer sheath 116 is in the distal position, and the prongs 114 are in the closed state. While the distal sheath end 116B of the outer sheath 116 is positioned at the target site, the sheath trigger 718B can be actuated (e.g., depressed towards the handle 710) to move the outer sheath 116 to the proximal position as shown in Figure 8C. Although the slider 718A could alternatively be used to move the outer sheath 116 to the proximal position, the sheath trigger 718B can provide several advantages over the slider 718A for this operation. For example, the sheath trigger 718B can allow the operator to move the outer sheath 116 proximally with a single hand and/or without having to adjust their grip on the handle 710. Given that the nasal dressing delivery device 700 is inserted in the nasal cavity when moving the outer sheath 116 proximally to deliver the nasal dressing 224, the sheath trigger 718B can help to reduce inadvertent movements and/or maintain a more steady position of the distal sheath end 116B when delivering the nasal dressing 224. Additionally or alternatively, the single hand operation provided by the sheath trigger 718B can free up the other hand of the operator for other purposes such as, for example, holding an imaging device disposed in the nasal cavity (e.g., an endoscope). In Figure 8C, the outer sheath 116 is in the proximal position and the prongs 714 and the nasal dressing 224 are at a position that is distal of the distal sheath end 116B of the outer sheath 116. As the outer sheath 116 no longer applies a compressive force to the distal portion of the nasal dressing 224 and/or the prongs 714, the prongs 714 can diverge outwardly away from each other and the nasal dressing 224. Within examples, the nasal dressing 224 and/or the spring 755 can help to apply an outward force on the prongs 714 to assist in moving the prongs 714 from the closed state to the open state (e.g., when the operator releases the prongs actuator 750). When the prongs 714 are in the open state, the nasal dressing 224 can be released to a position in at the target site in the nasal cavity. In some instances, the prongs actuator 750 can be actuated one or more times to manipulate the nasal dressing 224 at the target site (e.g., grabbing, moving, and/or releasing the nasal dressing 224 with the prongs 714). The process can additionally or alternatively include removing the nasal dressing 224 (e.g., using the nasal dressing delivery device 100) after a period of time (e.g., after 10 days from delivery of the nasal dressing 224), as described above. Referring now to Figure 9, a flowchart for a process 900 of delivering a nasal dressing to a target site in a nasal cavity is shown according to an example. At block 910, the process 900 includes loading a nasal dressing in the nasal dressing delivery device by positioning the nasal dressing between the plurality of prongs while the plurality of prongs are in the open state at block 912 and, after positioning the nasal dressing between the plurality of prongs at block 912, moving the outer sheath to the distal position to cover the nasal dressing with the outer sheath at block 914. After loading the nasal dressing in the nasal dressing delivery device at block 914, the process 900 includes inserting the nasal dressing delivery device in a nasal cavity to position the nasal dressing at the target site in the nasal cavity at block 916. At block 918, the process 900 includes delivering the nasal dressing from the nasal dressing delivery device to the target site in the nasal cavity by moving the outer sheath from the distal position to the proximal position at block 918. The description of the different advantageous arrangements has been presented for purposes of illustration and description, and is not intended to be exhaustive or limited to the embodiments in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art. Further, different advantageous embodiments may provide different advantages as compared to other advantageous embodiments. The implementation or implementations selected are chosen and described in order to best explain the principles of the embodiments, the practical application, and to enable others of ordinary skill in the art to understand the disclosure for various embodiments with various modifications as are suited to the particular use contemplated.

Claims

CLAIMS WHAT IS CLAIMED IS: 1. A nasal dressing delivery device, comprising: a handle having a proximal handle end and a distal handle end; an inner shaft extending from the distal handle end of the handle, wherein a proximal shaft end of the inner shaft is fixedly coupled to the handle, wherein a distal shaft end of the inner shaft comprises a plurality of prongs that are moveable between a closed state and an open state; and an outer sheath extending distally of the distal handle end of the handle, wherein the inner shaft is disposed in a lumen of the outer sheath, wherein the outer sheath is moveable relative to the inner shaft between a proximal position and a distal position, wherein, when the outer sheath is in the proximal position relative to the inner shaft, at least a portion of the plurality of prongs are distal of a distal sheath end of the outer sheath such that the plurality of prongs are allowed to transition from the closed state to the open state, and wherein, when the outer sheath is in the distal position relative to the inner shaft, the outer sheath covers the at least the portion of the plurality of prongs such that the outer sheath maintains the plurality of prongs in the closed state and prevents the plurality of prongs from transitioning to the open state.

2. The nasal dressing delivery device of claim 1, wherein each prong of the plurality of prongs is configured to move about a respective pivot point of a plurality of pivot points on the inner shaft.

3. The nasal dressing delivery device of any one of claims 1-2, wherein each prong of the plurality of prongs comprises one or more teeth on an interior surface of the prong.

4. The nasal dressing delivery device of any one of claims 1-3, wherein the plurality of prongs consists of three prongs.

5. The nasal dressing delivery device of any one of claims 1-4, wherein the inner shaft includes a rod that extends between the plurality of prongs and distally of the plurality of pivot points.

6. The nasal dressing delivery device of any one of claims 1-5, further comprising a sheath actuator coupled to the outer sheath, wherein the sheath actuator is configured to move relative to the handle to move the outer sheath between the proximal position and the distal position relative to the handle and the inner shaft.

7. The nasal dressing delivery device of claim 6, wherein the sheath actuator comprises a slider that is configured to move within a slot in an exterior surface of the handle.

8. The nasal dressing delivery device of claim 6, wherein the sheath actuator comprises: a slider is configured to move the outer sheath in a distal direction towards the distal position; and a sheath trigger is configured to move the outer sheath in a proximal direction towards the proximal position.

9. The nasal dressing delivery device of claim 8, wherein the slider and the sheath trigger are integrally formed as a single, monolithic structure.

10. The nasal dressing delivery device of any one of claims 8-9, wherein the slider extends outwardly from a first side of the handle and the sheath trigger extends outwardly from a second side of the handle.

11. The nasal dressing delivery device of claim 10, wherein the first side of the handle is a top surface, and the second side of the handle is distal surface of a handgrip of the handle.

12. The nasal dressing delivery device of any one of claims 8-11, wherein the sheath actuator comprises a lumen, and the outer sheath is fixedly disposed in the lumen of the sheath actuator.

13. The nasal dressing delivery device of any one of claims 6-12, further comprising a prongs actuator that is configured to actuate the plurality of prongs between the closed state and the open state.

14. The nasal dressing delivery device of claim 13, wherein the prongs actuator is operable in a proximal direction to move the plurality of prongs from the open state to the closed state.

15. The nasal dressing delivery device of any one of claims 13-14, wherein the prongs actuator comprises a lumen and the outer sheath is slidably disposed in the lumen of the prongs actuator.

16. The nasal dressing delivery device of any one of claims 6-15, wherein the plurality of prongs consists of a top jaw and a bottom jaw.

17. The nasal dressing delivery device of any one of claims 1-5, wherein the handle comprises a proximal handle portion that is fixedly coupled to the inner shaft and a distal handle portion that is fixedly coupled to the outer sheath, wherein the distal handle portion is configured to move relative to the proximal handle portion to move the outer sheath relative to the inner shaft.

18. The nasal dressing delivery device of any one of claims 1-17, wherein the inner shaft is malleable.

19. The nasal dressing delivery device of any one of claims 1-17, wherein the inner shaft is non-malleable.

20. The nasal dressing delivery device of any one of claims 1-19, wherein the outer sheath is formed from a flexible material such that the outer sheath can move along a bend in the inner shaft.

21. A nasal dressing delivery system, comprising: a nasal dressing delivery device according to any one of claims 1-20; and a nasal dressing that is configured to be: (i) positioned between the plurality of prongs when the plurality of prongs are in the open state, and (ii) compressed between the plurality of prongs when the plurality of prongs are in the closed state.

22. The nasal dressing delivery system of claim 21, wherein the nasal dressing is configured to be received within the lumen of the outer sheath when the outer sheath is in the distal position relative to the inner shaft.

23. The nasal dressing delivery system of any one of claims 21-22, wherein each prong of the plurality of prongs has a first length, the nasal dressing has a second length, and the first length is less than one third of the second length.

24. The nasal dressing delivery system of any one of claims 21-23, wherein the nasal dressing has a conical shape.

25. The nasal dressing delivery system of any one of claims 21-24, wherein the nasal dressing has a through-bore that extends entirely through the nasal dressing between a first end of the nasal dressing and a second end of the nasal dressing.

26. The nasal dressing delivery system of any one of claims 21-25, wherein the nasal dressing comprises a foam.

27. The nasal dressing delivery system of any one of claims 21-26, wherein the nasal dressing is configured to elute a drug.

28. The nasal dressing delivery system of any one of claims 21-27, wherein the outer sheath has an outer diameter that is less than or equal to approximately 4 millimeters.

29. A method of delivering a nasal dressing to a target site in a nasal cavity, comprising: loading a nasal dressing in the nasal dressing delivery device of any one of claims 1- 28 by: positioning the nasal dressing between the plurality of prongs while the plurality of prongs are in the open state, and after positioning the nasal dressing between the plurality of prongs, moving the outer sheath to the distal position to cover the nasal dressing with the outer sheath; after loading the nasal dressing in the nasal dressing delivery device, inserting the nasal dressing delivery device in a nasal cavity to position the nasal dressing at the target site in the nasal cavity; and delivering the nasal dressing from the nasal dressing delivery device to the target site in the nasal cavity by moving the outer sheath from the distal position to the proximal position.