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2004, Number 1

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Cir Cir 2004; 72 (1)

Endoscopic adenoidectomy; use or abuse of the technology?

Bross-Soriano D, Schimelmitz-Idi J, Arrieta-Gómez JR
Full text How to cite this article

Language: Spanish
References: 6
Page: 15-19
PDF size: 58.62 Kb.


Key words:

Adenoidectomy, Endoscopic removal.

ABSTRACT

Objective: To evaluate efficacy of the conventional technique of adenoidectomy by means of transoperative endoscopic revision of the nasopharynx and to evaluate the need for including telescopes as part of usual instruments used in adenoidectomy.
Material and methods: Prospective, open, comparative, and transversal study. We included the first 150 patients with absolute indication for adenoidectomy. We did 150 adenoidectomy procedures by conventional technique using Beckman adenotomes, and La Force adenotomes, using a laryngeal mirror to observe condition of nasopharynx once the surgeon thought the procedure was completed, we did a revision of adenoid area with Hopkins telescopes of 0 and 30; if we founded residues of adenoids, these were eliminated with Guggenheim forceps, adenotomes, or curved 40° microdebrider tip, all after endoscopic viewing, which also helped in control of area bleeding.
Measured parameters: Presence or absence of adenoids residue’ location, and presence or absence of active bleeding.
Results: Total removal of adenoids was carried in 43 patients, our finding adenoid residues in 107 of cases. Of these, 45.3% were occluding pharyngeal part of Eustachian tubes.
Conclusions: Conventional technique for adenoidectomy was effective in < 30%; therefore, it is imperative to use endoscopic revision in each case.


REFERENCES

  1. Bluestone CH. Tonsils and adenoids. Otolaryngol Clin North Am. Philadelphia. Cibro, PA, USA: WB Saunders Co.;1989. pp. 1-89.

  2. Paparella MM, Shumrick DA. Otolaryngology. Head and neck surgery. 3rd ed. Vol. III. Philadelphia, PA, USA: WB Saunders Co.;1991. pp. 2129-2148.

  3. Becker R, Setphen P. Endoscopic adenoidectomy for relief of serous otitis media. Laryngoscope 1992;102:890-892.

  4. Kendrick D, et al. An audit of the complications of pediatric tonsillectomy, adenoidectomy and adenotonsillectomy. Clin Otolaryngol 1993;18(2):5-7.

  5. Guindy A, et al. Endoscopic management of posterior nasal obstruction. J Laryngol Otol 1992;106(11):977-980.

  6. Goumaz CF. L´apport de léndoscopie dans diagnostic et le traitement de l´hyperplasie adénoïdienne. Rev Med Suisse Romande 1983;103:205-208.




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Cir Cir. 2004;72