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It also happens that, according to the doctor's indications, an adenotomy will be prescribed - an operation to cut off the adenoids. The technique of this operation is more than a hundred years old. It is done both on an outpatient and ampicillin basis, but in view of the fact that after the operation there is still a chance of bleeding from the wound surface for some time, it is preferable to remove adenoids in a hospital, where the operated person is under the supervision of experienced doctors for two or three days.

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  • The operation is performed under local anesthesia with a special instrument called an adenotome.

    The adenotome is a steel loop on a long thin handle, one edge of the loop is sharp. After the operation, bed rest is maintained for several days, body temperature is monitored. Only liquid and semi-liquid dishes are allowed to be eaten; nothing annoying - sharp, cold, hot; dishes only warm. A few days after the adenotomy, complaints of a sore throat may be presented, but the pain gradually decreases, and soon disappears altogether.

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However, there are various contraindications to adenotomy. These include - anomalies in the development of the soft and hard palate, clefts of the hard palate, the child's age (up to 2 ampicillin), blood diseases, suspicion of cancer, acute infectious diseases, acute inflammatory diseases of the upper respiratory tract, bacillus, the period up to 1 month after prophylactic vaccinations.

Aspiration adenotomy is performed on a specialth adenotome, designed and introduced into otorhinolaryngological practice by B.I. Kerchev. The aspiration adenotome is a hollow tube with a shoe-shaped receptacle for adenoids expanded at the end. The other end of the adenotome is connected to the suction. With aspiration adenotomy, the possibility of aspiration (inhalation) of pieces of lymphoid tissue and blood into the lower respiratory tract is excluded, as well as damage to anatomical structures nearby in the nasopharynx.

The development and implementation of modern techniques in pediatric otorhinolaryngology, such as aspiration adenotomy, endoscopic adenotomy, adenotomy using shaver technologies under general anesthesia, contributes to the improvement of the quality and efficiency of the operation.

Endoscopic adenotomy.

Intervention to remove adenoids is performed under general anesthesia (anesthesia) with artificial ventilation. A rigid endoscope with 70-degree optics is inserted into the mouth of the pharynx to the level of the soft palate curtain. An examination of the nasopharynx and the posterior parts of the nose is performed.

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The size of adenoid vegetations, their localization, and the severity of inflammatory phenomena are assessed. Then an adenote or aspiration adenotome is inserted through the oral cavity into the nasopharynx. Under visual control, the surgeon removes the lymphadenoid tissue.

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    After stopping the bleeding, the surgical field is re-examined.
  • pre and post surgical conditions
    The use of a microdebrider (shaver) significantly improves the quality of adenotomy.
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    Microdebrider consists of an electromechanical console and a handle with a working tip and a pedal connected to it, with the help of which the surgeon can set in motion and stop the rotation of the cutter, as well as change the direction and modes of its rotation.
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    The tip of the microdebrider consists of a hollow stationary part and a blade that rotates inside it.
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    A suction hose is connected to one of the channels of the handle, and due to negative pressure, the tissue to be removed is sucked to the hole at the end of the working part, crushed with a rotating blade and aspirated into the suction reservoir.
  • To remove adenoid tissue, the shaver working tip is inserted through one half of the nose up to the nasopharynx. Under the control of an endoscope inserted through the opposite half of the nose or through the oral cavity, the adenoid tonsil is removed.
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