Tonsil 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.

Publications

Tonsillolith: not just a stone but a living biofilm (Download PDF)
Laser tonsil cryptolysis: in-office 500 cases review (Download PDF)