Ablative adenoidectomy: a new technique using simultaneous liquefaction/aspiration.

OBJECTIVE

This study was performed to critically evaluate a new cautery technique for adenoidectomy that combines indirect visualization with complete hemostasis, ultimately permitting the surgeon to tailor the procedure to the patient's specific needs.

DESIGN

This prospective study of 138 consecutive adenoidectomy patients of the senior author was carried out at the Montreal Children's Hospital over 17 months. Concurrent adenoidectomy patients of another senior otolaryngologist in our institution as well as cases of the senior author using the conventional cold curettage technique served as controls.

METHOD

Data were collected preoperatively with respect to indication for surgery and radiologic findings. Operative findings including duration of surgery, concurrent procedures, position of adenoid hypertrophy, and blood loss were also recorded. Postoperative complications such as hemorrhage, infection, dehydration, as well as the incidence of velopharyngeal insufficiency and nasopharyngeal stenosis were also recorded up to 1 year from the date of surgery. The operative technique involves indirect visualization of the nasopharynx with a laryngeal mirror combined with cautery-liquefaction and suction ablation of the adenoid tissue.

RESULTS

Our results demonstrate a significant reduction in blood loss as well as a reduction in operative time. There was a low incidence of postoperative infection, no patients required a return to the operating room for hemostasis, and there were no cases of recurrent adenoid hypertrophy. There was no detectable difference in the incidence of postoperative complications.

CONCLUSION

We conclude that this technique is safe and time-efficient, with the advantages of excellent visualization and essentially no operative blood loss.