Power-Assisted Partial Adenoidectomy

Abstract

We and other authors have found power-assisted partial adenoidectomy to provide a faster, more precise operation than curette techniques, with benefits for both patient and surgeon.

Changing Trends in Adenoidectomy

“…On an average, microdebrider saved 4 min 46 s which is highly significant while the amount of blood loss in both the groups was not of significant difference. A similar prospective study of 140 cases by Rodigruez et al [20] has evaluated various parameters like intra-operative time and amount of bleeding showing significant reduction in the surgical time in group B as compared to group A. A prospective study by Somani et al [12] (of 44 children) and a retrospective study by Costatini et al [21] (of 201 children) reported an operating time (with microdebrider assisted adenoidectomy) as 12.5 min each and the average blood loss of 30 and 28 ml respectively.…”

The Evolution of the Adenoidectomy: Analysis of Different Power-Assisted Techniques

“…This analysis considered 12 articles. Among these, the techniques can be schematically divided in non-endoscopic, usually performed with a laryngeal or a dental mirror [1][2][3][4][5]21], and endoscopic-assisted [6,11,[25][26][27]. The endoscopic control can be obtained either trans-nasally or trans-orally, as well as the microderbider can be inserted in the nasal cavity (straight blades) or maneuvered through the oral cavity (curved blades).…”

“…The classic surgical technique performed with an adenoid curette or an adenotome has recently evolved by the introduction of the endoscopic sinus surgery instrumentation, with an improved patients' outcome and a better satisfaction of the surgeon [1][2][3][4][5][6]. The standard adenoidectomy technique is performed with an adenoid curette or an adenotome, under general anesthesia via oro-tracheal intubation [7,8].…”

“…Subsequently, the whole procedure was performed with this technique, always along a laryngeal/ dental mirror or endoscopic control [17][18][19][20]. The introduction of powered instrumentation for sinus surgery prompted the use of a shaver system for a power-assisted adenoidectomy; however, the approach still was a transoral one, along with an indirect visualization through a laryngeal mirror [1][2][3][4][5]21]. In the '90s, the advent of ESS popularized the use of intranasal scopes and the endoscopic adenoidectomy became the natural evolution of the conventional adenoidectomy, permitting a direct visualization [13,22].…”

Endoscopy in Nasopharyngeal Adenoid Surgery

“…Both the hand piece and the endoscope can be introduced through the oral cavity if the nasal fossa is too narrow, in younger children. One of the major advantages of using the microdebrider is having the option to remove adenoid tissue only partially (Rodriguez et al, 2002;Koltai et al, 2002), as in cases of insufficient velopharyngeal valve, in cases of repaired cleft palate, and those with submucous cleft palate.…”