PNN Laser Ablation

Clinical Case

Allergic and/or Non Allergic Rhinitis

Laser Used

Epic-S Diode Laser 940 nm

Accessory Used

400 um bare fiber tip, uninitiated tip, 100mm (fresh tip)
Surgery handpiece

Treatment Parameters

6 Watts CW, use non-contact mode to coagulate (blanch the mucosa) around the region of posterior - lateral wall of middle meatus, under endoscopic visualization. Follow the small blood vessels for higher efficacy. Reach above the middle turbinate to ablate the superior branch of PNN.

Authored by Physician

Yosef Krespi, MD
Professor of Otolaryngology, Hofstra School of Medicine, New York

Patient Symptoms

Recurrent nasal congestion, clear nasal drip and airway obstruction. Failed medical management.  

Diagnosis

Normal endoscopic exam and CT scan.

Management

In-office (local / topical anesthesia) or ASU (general anesthesia) procedure. Location and type of anesthesia determined according to the anatomy of the posterior nose and patient preference. For bilateral procedures, use a new fiber tip for each side.

Laser Surgery, Pre-Op

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

Publication

Laser ablation of posterior nasal nerves for rhinitis (Download PDF)

Advantages

✔︎   User friendly with complete physician’s control
✔︎   Direct endoscopic visualization
✔︎   Ability to reach and ablate both inferior and superior branches of the nerve
✔︎   Non-contact, minimal mucosa blanching (no need for conductive gel)

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.