Overview

Adenoidectomy is a surgical procedure to remove the adenoids, commonly performed for nasal obstruction, sleep apnea, or recurrent infections.

Adenoidectomy is crucial for treating nasal obstruction, sleep-disordered breathing, and recurrent adenoiditis in children.

Learn more in our comprehensive RxDx ENT Course

Indications

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Nasal Obstruction

Severe adenoid hypertrophy

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Sleep Apnea

Obstructive sleep apnea

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Recurrent Adenoiditis

Multiple infections

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Otitis Media

Recurrent ear infections

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Sinusitis

Chronic sinusitis

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Uncontrolled bleeding
✗ Severe coagulopathy

Relative Contraindications

✗ Active infection
✗ Recent surgery
✗ Cleft palate

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient assessment, anesthesia planning, equipment setup, and understanding contraindications.

Step-by-Step Procedure

Step 1: Patient Preparation

Position patient, administer anesthesia.

⚠️ Common Mistakes to Avoid:

  • Poor positioning
  • Inadequate anesthesia

💡 Pro Tip:

Use proper positioning.

Step 2: Mouth Gag Placement

Insert mouth gag for exposure.

⚠️ Common Mistakes to Avoid:

  • Poor exposure
  • Tongue injury

💡 Pro Tip:

Protect tongue and teeth.

Step 3: Adenoid Removal

Remove adenoid tissue with curette.

⚠️ Common Mistakes to Avoid:

  • Incomplete removal
  • Bleeding

💡 Pro Tip:

Use proper technique.

Step 4: Hemostasis

Control bleeding from adenoid bed.

⚠️ Common Mistakes to Avoid:

  • Inadequate hemostasis
  • Post-op bleeding

💡 Pro Tip:

Ensure complete hemostasis.

Step 5: Inspection

Inspect for residual tissue.

⚠️ Common Mistakes to Avoid:

  • Missed tissue
  • Incomplete procedure

💡 Pro Tip:

Thorough inspection.

Step 6: Post-procedure Care

Monitor and provide instructions.

⚠️ Common Mistakes to Avoid:

  • Poor monitoring
  • Inadequate instructions

💡 Pro Tip:

Provide clear instructions.

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Post-procedure Care

Post-procedure care involves pain management, monitoring for bleeding, and follow-up evaluation.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 1-3% Active bleeding, hematemesis Return to OR, cautery Proper hemostasis
Infection 1-2% Fever, pain, foul odor Antibiotics Sterile technique
Velopharyngeal insufficiency 0.5-1% Nasal regurgitation Speech therapy Proper technique
Nasopharyngeal stenosis 0.1-0.5% Nasal obstruction Dilation, surgery Proper technique

Clinical Pearls

💡

Use proper mouth gag positioning.

🎯

Ensure complete removal.

⚡

Monitor for post-op bleeding.

🔍

Check for residual tissue.

📊

Document procedure details.

🎨

Provide clear post-op instructions.

⚠️

Be prepared for emergency management.