PNN Laser Ablation

Clinical case:Ablation of Posterior Nasal Nerves (PNN)
Laser used:Epic-S Diode Laser 940 nm
Accessory used:400 um bare fiber tip, non-initiated, clear tip, 100mm long
Surgery handpiece
Treatment parameters:5 Watt CW
Non-contact ablation with clear (white) tip
Authored by physician:Yosef Krespi, MD
Professor of Otolaryngology, Hofstra School of Medicine, New York

Patient symptoms:

Nasal congestion and obstruction with watery rhinorrhea (nasal drip). Possible symptoms include itchy nose, sneezing and runny nose. Nasal obstruction may aggravate sleeping conditions and snoring.


No history or findings of sinusitis. Relatively normal nasal septum. Enlarged inferior turbinates and swell bodies could be present.


Medical management includes allergy testing. Medical treatment includes nasal sprays steroids or anti-histamine with or without oral anti-histamines, steroids, montelukast (Singulair). When medical management fails or patient is unwilling to continue with it surgical solution is attempted.

Laser surgery, Pre-Op:

Anesthesia is achieved with local application of a mixture of lidocaine2% and neosynephrine followed by injection of epinephrine 1:100000 with 2% lidocaine.

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.