Posterior Nasal Obstruction

Clinical Case

Persistent nasal obstruction unilateral or bilateral, nasal congestion, pressure headaches and sleeping difficulties, failed medical Rx.

Laser Used

Epic-S Diode Laser 940 nm

Accessory Used

400 um bare fiber tip, initiate the tip, black tip, 100mm long will reach the nasopharynx
Surgery handpiece

Treatment Parameters

6 Watt CW, contact mode, incise the wall of lesion vertical and horizontal. Coagulate the small vessels and suction the cyst content. Take a culture if infection is suspected. Take a small biopsy if indicated.

Authored by Physician

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

Patient Symptoms

Can range from persistent or recurrent nasal obstruction unilateral or bilateral and congestion. Pressure headaches and sleep disturbance is very common. Medical management should be tried first.

Diagnosis

Endoscopic exam under topical anesthesia and inspecting the posterior nasal cavity and nasopharynx confirmed the findings. Obtain CT scan when indicated.

Management

Medical management usually fails. Considered CT scan if vascular lesion is suspected. Consider in-office laser surgical approach with topical and / or local anesthesia.

Laser Surgery, Pre-Op

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