Cryptolysis

Clinical case:Cryptolysis, Ablation of Tonsil Crypts
Laser used:Epic-S Diode Laser 940 nm
Accessory used:400 um bare fiber tip, initiate, black tip, 100mm long
Surgery handpiece
Treatment parameters:6 Watt CW contact mode
Authored by physician:Yosef Krespi, MD
Professor of Otolaryngology, Hofstra School of Medicine, New York

Patient symptoms:

Can range from chronic tonsillitis with recurrent infections to food entrapment and possible halitosis. Chronic inflammation can cause enlarge tonsils with deep pockets filled with Tonsilloliths (Biofilm).

Diagnosis:

Tonsillar surface will show furrows and deep pockets. Tonsillar stones (Biofilm) ranging size and causing oral mal-odor. Stones can be removed using tongue blades, pressing anterior pillars.

Management:

The management is surgical once any symptoms arise. Surgical solution consist of ablating the involved pockets with flattening of the pockets reverting to a non particle entrapping formation. The alternative is Tonsillectomy or Tonsillotomy under General Anesthesia.

Laser surgery, Pre-Op:

Anesthesia is achieved with local injection of 2% lidocaine with epinephrine 1:100,000.

Post-Op:
Silver nitrate can help further sealing the pocket

Tip:

Viscous lidocaine can help in post operative period.