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).


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.


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.

Silver nitrate can help further sealing the pocket


Viscous lidocaine can help in post operative period.