Swell Bodies

Clinical case:Ablation of Septal Swell Bodies
Laser used:Epic-S Diode Laser 940 nm
Accessory used:400 um bare fiber tip
Surgery handpiece
Authored by physician:Yosef Krespi, MD
Professor of Otolaryngology, Hofstra School of Medicine, New York

Patient symptoms:

Nasal obstruction with or without rhinorrhea. Possible symptoms include itchy nose, sneezing, dry mouth and runny nose. Nasal obstruction may aggravate underlying conditions such as asthma, sleep apnea and snoring.

Diagnosis:

Septal swelling (soft tissue) at middle meatus level, deviation and/or septal spur obstructing the nasal airway. Gentle endoscopic palpation confirms the site and degree of Swell Body enlargement. Hypertrophy of the inferior turbinates may also be present.

Management:

Initially medical management can address the swell bodies and hypertrophied turbinate. Medical treatment includes nasal steroid sprays or anti-histamines. When medical management fails or patient is unwilling to continue, surgical solution is attempted.

Laser surgery, Pre-Op:

Anesthesia is achieved with a topical application of a mixture of lidocaine 2% and neosynephrine, followed by injection of 2% lidocaine with epinephrine 1:100,000.

Tips:

When ablating septal swell bodies limit insertion of laser fiber (3) to avoid perforation. Bleeding control in the end of procedure is of utmost importance to avoid synechia formation.

CAUTION
The laser treatment parameters above are provided as a guide and are based on results published or reported by physicians with experience in this indication. Individual treatment should be based on clinical training, clinical observation of laser-tissue interaction, appropriate clinical endpoints and each physician’s own medical judgment.