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Adenoidectomy (pharyngeal tonsill (adenoid) resection)
Pic. 1 - Adenoid in normal size in posterior rhinoscopy. It occupies the roof of the nasopharynx only, not blocking the nose and the Eustachian tubes.
Adenoidectomy is necessary in case of two major clinical conditions - posterior nasal obstruction and recurrent upper respiratory tract infections due to chronic adenoiditis.
Adenoid is a part of the Waldeyer's ring occupying the nasopharynx. This localization implies its function and symptoms of its disease. Mass effect of its hypertrophy blocks back of the nasal cavity and forces not physiological mouth breathing. Following this, sinus infections, snoring, apnoea and dental issues develop.
Most Patients are in the age from 3 to 7 years as at that point the adenoid is biggest. Modern diagnosis is based on lateral X-ray of nasopharynx and nasal endoscopy the two being complementary at some point. Endoscopy is the gold standard and verifies the diagnosis.
Adenoidectomy lasts for about 20-30 minutes and is performed in general anaesthesia with tracheal intubation. It can be combined with paracenthesis and ventilation tube insertion in case of chronic otitis media coexisting. Patient can be discharged the same or next day after the surgery.
Pic. 2 - Hypertrophy of the adenoid - the mass of the tonsill partially blocks the choanae and compresses the pharyngeal opening of the Eustachian tube.
Pic. 3 - Adenoid resected
(c) 2008-2016 - Rafał Chmielewski