- Email: [email protected]
Endoscopic visualization facilitates adenoidectomy
Otolaryngology–Head and Neck Surgery (2007) 136, 510
LETTER TO THE EDITOR Endoscopic visualization facilitates adenoidectomy We read with interest the article by Joshua et al (Adenoidectomy: Long-term follow-up. Otolaryngol Head Neck Surg 2006;135:576-80.) Our experience agrees with that of the authors, that children with small tonsils and airway obstruction from large adenoids benefit from adenoidectomy alone. It is no longer appropriate or necessary to remove the tonsils “as long as we are in there.” According to published literature, the chance of adenoid regrowth after adenoidectomy is less than 5%. Adenoid regrowth results from residual adenoid tissue that swells from patient factors such as nasal allergies and laryngopharyngeal reflux. We have performed over 4000 adenoidectomies with endoscopic visualization of the nasopharynx and are aware of only 2 patients who showed clinically significant regrowth of adenoid tissue. We therefore recommend the use
of a 70 degree sinus endoscope to visualize the nasopharynx during adenoidectomy. The advantages of improved visualization with a transoral endoscopic adenoidectomy are: 1) complete removal of adenoid tissue even from the choanae/nasal cavity; 2) precise hemostasis under direct visualization; and 3) avoidance of damage to normal structures, ie, vomer and torus tubarius. There is a short learning curve when applying endoscopic sinus techniques to the adenoidectomy procedure. We believe otolaryngologists will find transoral endoscopic adenoidectomy to be easily learned and clinically successful, with little chance of adenoid regrowth. Scott R. Schaffer, MD Gabriel H. Wong, MD The ENT Specialty Center Gibbsboro, NJ doi:10.1016/j.otohns.2006.11.055
0194-5998/$32.00 © 2007 American Academy of Otolaryngology–Head and Neck Surgery Foundation, Inc. All rights reserved. doi:10.1016/j.otohns.2006.11.055
LETTER TO THE EDITOR Endoscopic visualization facilitates adenoidectomy We read with interest the article by Joshua et al (Adenoidectomy: Long-term follow-up. Otolaryngol Head Neck Surg 2006;135:576-80.) Our experience agrees with that of the authors, that children with small tonsils and airway obstruction from large adenoids benefit from adenoidectomy alone. It is no longer appropriate or necessary to remove the tonsils “as long as we are in there.” According to published literature, the chance of adenoid regrowth after adenoidectomy is less than 5%. Adenoid regrowth results from residual adenoid tissue that swells from patient factors such as nasal allergies and laryngopharyngeal reflux. We have performed over 4000 adenoidectomies with endoscopic visualization of the nasopharynx and are aware of only 2 patients who showed clinically significant regrowth of adenoid tissue. We therefore recommend the use
of a 70 degree sinus endoscope to visualize the nasopharynx during adenoidectomy. The advantages of improved visualization with a transoral endoscopic adenoidectomy are: 1) complete removal of adenoid tissue even from the choanae/nasal cavity; 2) precise hemostasis under direct visualization; and 3) avoidance of damage to normal structures, ie, vomer and torus tubarius. There is a short learning curve when applying endoscopic sinus techniques to the adenoidectomy procedure. We believe otolaryngologists will find transoral endoscopic adenoidectomy to be easily learned and clinically successful, with little chance of adenoid regrowth. Scott R. Schaffer, MD Gabriel H. Wong, MD The ENT Specialty Center Gibbsboro, NJ doi:10.1016/j.otohns.2006.11.055
0194-5998/$32.00 © 2007 American Academy of Otolaryngology–Head and Neck Surgery Foundation, Inc. All rights reserved. doi:10.1016/j.otohns.2006.11.055