ABLATIVE ADENOIDECTOMY - A NEW TECHNIQUE USING SIMULTANEOUS LIQUEFACTION ASPIRATION/

Objective: This study was performed to critically evaluate a new caute ry technique for adenoidectomy that combines indirect visualization wi th complete hemostasis, ultimately permitting the surgeon to tailor th e procedure to the patient's specific needs. Design: This prospective study of 138 consecutive adenoidectomy patients of the senior author w as carried out at the Montreal Children's Hospital over 17 months. Con current adenoidectomy patients of another senior otolaryngologist in o ur institution as well as cases of the senior author using the convent ional cold curettage technique served as controls. Method: Data were c ollected preoperatively with respect to indication for surgery and rad iologic findings. Operative findings including duration of surgery, co ncurrent procedures, position of adenoid hypertrophy, and blood loss w ere also recorded. Postoperative complications such as hemorrhage, inf ection, dehydration, as well as the incidence of velopharyngeal insuff iciency and nasopharyngeal stenosis were also recorded up to 1 year fr om the date of surgery. The operative technique involves indirect visu alization of the nasopharynx with a laryngeal mirror combined with cau tery-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 postop erative infection, no patients required a return to the operating room for hemostasis, and there were no cases of recurrent adenoid hypertro phy. There was no detectable difference in the incidence of postoperat ive complications. Conclusion: We conclude that this technique is safe and time-efficient, with the advantages of excellent visualization an d essentially no operative blood loss.